RobotReviewer report

Abstract

Here are the results from 4 PDFs.

Risk of bias table

trial design
Random sequence generation
Allocation concealment
Blinding of participants and personnel
Blinding of outcome assessment
Dishman RK, 2010 RCT ? ? ? ?
Fjeldsoe BS, 2010 RCT + ? ? ?
Online R, 2008 RCT ? ? ? ?
Furber S, 2010 RCT + + ? ?

Trial summaries

n Participants Interventions Outcomes punchline finding
664 fall 2005, with a multiracial/ethnic sample of employees at 16 geographically diverse worksites, cohort of participants (N = 664) from the 8 worksites randomized to the intervention moderate-to-vigorous physical activity (MVPA physical activity with changes in goal setting, satisfaction, self-efficacy, commitment and intention, pedometer steps and MVPA, physical activity, self-efficacy, commitment and intention about attaining their goals The results show a dose relation of increased physical activity with changes in goal setting, satisfaction, self-efficacy, commitment and intention, consistent with goal-setting theory. ↑ sig increase
88 Postnatal women (<12 months postpartum, postnatal women, Eighty-eight women, postnatal women primarily via mobile telephone short message service (SMS theory-based physical activity (PA) intervention, minimal contact control, SMS-based physical activity intervention frequency of PA and walking for exercise, PA frequency, PA participation and walking for exercise, walking for exercise frequency The median for MVPA and walking for exercise frequency was 1 day per week higher in the intervention group than the control group at baseline ( Table 2). ↑ sig increase
70 Seventy inactive people with type 2 diabetes, people diagnosed with type 2 diabetes or impaired glucose tolerance Publication Details, Data were collected from September 2000 through to September 2002 and analyzed from October 2002 to February 2003, people with type 2 diabetes, Diabetes outpatient clinic physical activity counseling or not, standard exercise information, Physical activity counseling, physical activity counseling, brief intervention using a pedometer and step-recording diary total activity, physical activity (recall and accelerometer, physical activity, physical activity (7-day recall and accelerometer), stages and processes of exercise behavior change, dramatic relief and stimulus control Self-reported minutes of walking were significantly higher in the intervention group than the comparison group at two week follow-up, after adjusting for minutes of walking at baseline; however there was no significant difference between study groups at 20 week follow-up (Table 2). ↑ sig increase
215 cardiac patients not attending cardiac rehabilitation, cardiac patients, cardiac patients who did not attend a CRP, 215 patients referred to a CRP but who could not or chose not to attend self-monitoring of physical activity using a pedometer and step calendar; and behavioural counselling and goal setting sessions, pedometer-based telephone intervention total physical activity sessions, walking sessions, physical activity, walking time, total physical activity time, physical activity levels There was a significant increase in the use of behavioural and cognitive self-management strategies in the intervention group at 6 weeks, but not at 6 months. ↑ sig increase

Characteristics of studies

Dishman RK, 2010

Population
  1. Research design and methods Subjects and setting Participants in this analysis were from a cohort of 664 employees (19-64 years of age; 36 6 10) from 8 intervention worksites who did not report overt cardiovascular, pulmonary or metabolic disease and signed a consent form that was approved by the Institutional Review Board on 1 December 2004.
Intervention
  1. Participants in the intervention exceeded 9000 daily pedometer steps and 300 weekly minutes of moderate-to-vigorous physical activity (MVPA) during the last 6 weeks of the study, which approximated or exceeded current public health guidelines.
  2. Participants in the intervention exceeded 9000 daily pedometer steps and 300 weekly minutes of moderate-to-vigorous physical activity (MVPA) during the last 6 weeks of the study, which approximated or exceeded current public health guidelines.
  3. We found that the increase in vigorous physical activity, a primary outcome measure in the study, was positively associated with the level of implementation of the intervention [13], defined as the intervention dose received by participants [7] (i.e. full participation in the goal-setting activities).
Outcomes
  1. The participants lost to follow-up at intervention sites did not differ (P > 0.30) at baseline from the intervention cohort analyzed here on the primary measure of physical activity, which assessed vigorous and moderate intensity of exercise habits and walking [12].
  2. We found that the increase in vigorous physical activity, a primary outcome measure in the study, was positively associated with the level of implementation of the intervention [13], defined as the intervention dose received by participants [7] (i.e. full participation in the goal-setting activities).
  3. LGM was used as a three-stage process to estimate (i) change in physical activity, goals, satisfaction and the theoretical moderators of goal setting (i.e. self-efficacy, commitment and intention) across time; (ii) the relation of change in physical activity with initial status and change in satisfaction, goals and the goal-setting moderators and (iii) the comparison of direct and indirect (i.e. mediated by changes in goals) relations between Dose relations during a workplace trial changes in satisfaction or the goal-setting moderators and change in physical activity.
BiasJudgement Support for judgement
Random sequence generation high/unclear
  1. Measures of goal-related physical activity Goal-related physical activity was corroborated in the intervention group using concurrent records of daily pedometer steps and 10-min blocks of MVPA.
  2. Research design and methods Subjects and setting Participants in this analysis were from a cohort of 664 employees (19-64 years of age; 36 6 10) from 8 intervention worksites who did not report overt cardiovascular, pulmonary or metabolic disease and signed a consent form that was approved by the Institutional Review Board on 1 December 2004.
  3. The sites had been paired with 8 other sites according to number of employees and nature of work (i.e. division office, call center, etc.), and each of the paired sites was randomly assigned to the intervention or a health education control condition.
Allocation concealment high/unclear
  1. Correlates of goal setting Participants were asked at baseline and subsequently every 2 weeks to self-set goals to [1] increase daily pedometer steps and the weekly number of 10-min blocks of MVPA accumulated during the subsequent 2-week period.
  2. The sites had been paired with 8 other sites according to number of employees and nature of work (i.e. division office, call center, etc.), and each of the paired sites was randomly assigned to the intervention or a health education control condition.
  3. Measures of goal-related physical activity Goal-related physical activity was corroborated in the intervention group using concurrent records of daily pedometer steps and 10-min blocks of MVPA.
Blinding of participants and personnel high/unclear
  1. The personal goals were evaluated and adjusted by participants biweekly.
  2. Procedures for recruitment and randomization, as well as other characteristics of the intervention and control conditions, have been described elsewhere [15].
  3. Consistent with theory and the study's hypotheses, there were linear dose relations between increases in participants' goals and their increases in pedometer steps and minutes of MVPA.
Blinding of outcome assessment high/unclear
  1. Research design and methods Subjects and setting Participants in this analysis were from a cohort of 664 employees (19-64 years of age; 36 6 10) from 8 intervention worksites who did not report overt cardiovascular, pulmonary or metabolic disease and signed a consent form that was approved by the Institutional Review Board on 1 December 2004.
  2. The personal goals were evaluated and adjusted by participants biweekly.
  3. Correlates of goal setting Participants were asked at baseline and subsequently every 2 weeks to self-set goals to [1] increase daily pedometer steps and the weekly number of 10-min blocks of MVPA accumulated during the subsequent 2-week period.

Fjeldsoe BS, 2010

Population
  1. This group is consistently shown to be less active than women of the same age without children [12][13][14][15] or women with older children [13,16,17].
  2. The purpose of this study was to evaluate the feasibility and efficacy of the MobileMums intervention for increasing physical activity among postnatal women living in a disadvantaged community, in a randomized controlled trial (RCT).
  3. Two participants per study group were required to detect a between-group difference of 1 day (SD±0.4 days) of MVPA or walking for exercise per week and 64 participants per study group to detect a between-group difference of 30 min (SD±68 min) of MVPA or walking for exercise per week.
Intervention
  1. In addition to the physical activity information pack, intervention group participants received two physical activity goal setting consultations with the behavioral counselor (one face-to-face as part of the initial consultation described above and one via telephone at 6 weeks), a goalsetting refrigerator magnet designed for weekly activity planning and self-monitoring of physical activity goals and rewards, 42 (three to five SMS per week) personally tailored SMS providing behavioral and cognitive strategies for behavior change, 11 weekly 'goal check' SMS and instructions to nominate a social support person to help them reach their physical activity goals.
  2. We hypothesized that exposure to the intervention would result in an increase in the frequency of moderate-to vigorous-intensity physical activity (MVPA) or walking for exercise of 1-day per week (or 30-min per week) relative to the control group.
  3. The intervention SMS promoted cognitive and behavioral strategies based on constructs of the social cognitive theory (SCT; 43) and focused on mediators previously found to be important for physical activity behavior change among postnatal women, including self-efficacy and social support [32].
Outcomes
  1. Frequency (days/week) and duration (min/week) of PA participation and walking for exercise were assessed via self-report at baseline, 6 and 13 weeks.
  2. At 13 weeks, 50% of 13-wk Follow-Up Completed 13-week follow-up (n=34) Not contactable for follow-up (n=2) Completed 13-week follow-up (n=32) Analysis Intention-to-treat analysis (n=45) Self-report data (n=45) Intention-to-treat analysis (n=43) Self-report data (n=43) Fig.
  3. The primary outcome for this study was the number of days per week that participants reported at least 30 min of MVPA or walking for exercise (referred to as frequency).
BiasJudgement Support for judgement
Random sequence generation low
  1. After all baseline data were collected, a coin was tossed to determine group allocation based on the prefix of the unique identifier label.
  2. Participants and the research assistant were blinded to group allocation at baseline; however, this could not be maintained at 6 and 13 weeks.
  3. Eighty-eight participants completed baseline assessment and thus were randomized to either the intervention group (n=45) or control group (n=43).
Allocation concealment high/unclear
  1. Participant Randomization Participants were randomized according to the prefix of the unique identifier label (1 or 2) attached to their baseline survey.
  2. Participants and the research assistant were blinded to group allocation at baseline; however, this could not be maintained at 6 and 13 weeks.
  3. After all baseline data were collected, a coin was tossed to determine group allocation based on the prefix of the unique identifier label.
Blinding of participants and personnel high/unclear
  1. Participants and the research assistant were blinded to group allocation at baseline; however, this could not be maintained at 6 and 13 weeks.
  2. After all baseline data were collected, a coin was tossed to determine group allocation based on the prefix of the unique identifier label.
  3. Assessor bias was minimized by training the research assistant not to deviate from the interview script.
Blinding of outcome assessment high/unclear
  1. Participants and the research assistant were blinded to group allocation at baseline; however, this could not be maintained at 6 and 13 weeks.
  2. After all baseline data were collected, a coin was tossed to determine group allocation based on the prefix of the unique identifier label.
  3. Assessor bias was minimized by training the research assistant not to deviate from the interview script.

Online R, 2008

Population
  1. While studies have demonstrated that pedometer-based intervention are effective in increasing physical activity in people with type 2 diabetes, 9,13,14 the effectiveness of the intervention could be related to the level of intensity and the multi-strategic nature of the intervention, such as the inclusion of goal setting, physical activity counselling, regular support for participants, and the IGT, and to determine the acceptability of the intervention in the short and longer term.
  2. Abstract Issue addressed: To evaluate the effectiveness of a brief intervention using a pedometer and step recording diary on promoting physical activity in people with type 2 diabetes or impaired glucose tolerance (IGT).
Intervention
  1. While studies have demonstrated that pedometer-based intervention are effective in increasing physical activity in people with type 2 diabetes, 9,13,14 the effectiveness of the intervention could be related to the level of intensity and the multi-strategic nature of the intervention, such as the inclusion of goal setting, physical activity counselling, regular support for participants, and the IGT, and to determine the acceptability of the intervention in the short and longer term.
  2. The intervention group received the same 15 minute talk on physical activity as given to the comparison group by one of the researchers (LF or LW), and in addition the researcher spent an extra ten minutes discussing the use of a pedometer and step diary.
  3. People with type 2 diabetes are offered individual appointments at the service with the diabetes nurse educator one to two weeks after the education session and with the dietitian within four weeks after the session, followed by a combined appointment with both the nurse educator and the dietitian three months later.
Outcomes
  1. The primary outcome measures of interest were the differences between study groups in mean self-reported minutes of walking during the previous week, and numbers of participants undertaking at least 150 minutes of moderate-intensity activity in five or more sessions over the previous week.
  2. 18 Primary and secondary outcomes were assessed for two and twenty week follow-up points.
  3. The secondary outcome measure of interest was the difference between study groups in the numbers of participants that undertook adequate total physical activity as measured by participation in 150 or more minutes of moderate or vigorous-intensity physical activity during the previous week in five or more sessions; total physical activity was calculated by adding the time spent in walking and other moderate activity and twice the time spent in vigorous activity (vigorous gardening or heavy work around the yard were not included in calculations).
BiasJudgement Support for judgement
Random sequence generation high/unclear
  1. Study participants self-selected into an education session which was then allocated to either the intervention or comparison arm (i.e. sessions were allocated to treatment arms and not individuals).
  2. However, the lack of randomisation is unlikely to have lead to any major selection biases as staff from the diabetes service were unaware of which study group an education session would be allocated to, final group characteristics were very similar, and no clustering was observed.
  3. 16 Participants were asked to use the pedometer and record their steps and time spent being physically active each day for the two weeks following the education session; the two week period was chosen as the aim of our study was to evaluate a brief intervention.
Allocation concealment high/unclear
  1. Study participants self-selected into an education session which was then allocated to either the intervention or comparison arm (i.e. sessions were allocated to treatment arms and not individuals).
  2. The design could have been strengthened by random allocation of groups to intervention or comparison.
  3. 19 Follow-up questionnaires were administered to participants via telephone two weeks and twenty weeks after their attendance at the education session.
Blinding of participants and personnel high/unclear
  1. Study participants self-selected into an education session which was then allocated to either the intervention or comparison arm (i.e. sessions were allocated to treatment arms and not individuals).
  2. The additional questions asked of participants in the intervention group regarding pedometer use made blinding of the interviewers to allocation impractical.
  3. 16 Participants were asked to use the pedometer and record their steps and time spent being physically active each day for the two weeks following the education session; the two week period was chosen as the aim of our study was to evaluate a brief intervention.
Blinding of outcome assessment high/unclear
  1. However, the lack of randomisation is unlikely to have lead to any major selection biases as staff from the diabetes service were unaware of which study group an education session would be allocated to, final group characteristics were very similar, and no clustering was observed.
  2. Group allocation for each session was not made known in advance to those referring to the service, taking bookings or those attending the session.
  3. All analyses were undertaken on a 'complete case' basis: subjects with complete outcome data were included in the analysis in the study group to which they were allocated, regardless of compliance with the intervention.

Furber S, 2010

Population
  1. Patients were eligible for this study if they had not attended an outpatient CRP, spoke English and had no co-morbidities affecting physical activity participation; they were invited to participate 2 months after discharge from hospital.
  2. A randomised controlled trial of exercise training versus percutaneous coronary angioplasty in people with stable coronary artery disease found that the exercise training group had a higher event free survival rate and lower healthcare costs because of reduced hospitalizations and fewer repeat revascularizations [6].
Intervention
  1. A randomised controlled trial of exercise training versus percutaneous coronary angioplasty in people with stable coronary artery disease found that the exercise training group had a higher event free survival rate and lower healthcare costs because of reduced hospitalizations and fewer repeat revascularizations [6].
  2. After 6 weeks, improvements in total physical activity time (p = 0.027), total physical activity sessions (p = 0.003), walking time (p = 0.013) and walking sessions (p = 0.002) in the intervention group were significantly greater than the control group after adjusting for baseline differences, and remained significant at 6 months.
  3. The aim of this study was to determine the effectiveness of an individualised pedometer-based telephone intervention on physical activity levels of cardiac patients who were referred to, but could not, or chose not to attend, a CRP.
Outcomes
  1. After 6 weeks, improvements in total physical activity time (p = 0.027), total physical activity sessions (p = 0.003), walking time (p = 0.013) and walking sessions (p = 0.002) in the intervention group were significantly greater than the control group after adjusting for baseline differences, and remained significant at 6 months.
  2. A randomised controlled trial of exercise training versus percutaneous coronary angioplasty in people with stable coronary artery disease found that the exercise training group had a higher event free survival rate and lower healthcare costs because of reduced hospitalizations and fewer repeat revascularizations [6].
  3. The Active Australia Questionnaire [13] which has demonstrated reliability in Australian populations [14] was used to assess self-reported physical activity.
BiasJudgement Support for judgement
Random sequence generation low
  1. Randomisation and blinding A set of 250 random numbers was generated using Microsoft Excel and the Statistical Package for Interactive Data Analysis (SPIDA) was used to group these numbers by blocks of four to ensure a balanced sample size across both study groups.
  2. The random numbers were generated and packaged into sealed envelopes by a researcher external to the study.
  3. A total of 222 (46.1% of those contacted) consented to participate in the trial and were randomly allocated into the intervention or control group.
Allocation concealment low
  1. Group allocation was concealed from the researcher until the participant had agreed to be in the study but was not concealed from the researcher when delivering the intervention or assessing outcomes.
  2. The random numbers were generated and packaged into sealed envelopes by a researcher external to the study.
  3. Randomisation and blinding A set of 250 random numbers was generated using Microsoft Excel and the Statistical Package for Interactive Data Analysis (SPIDA) was used to group these numbers by blocks of four to ensure a balanced sample size across both study groups.
Blinding of participants and personnel high/unclear
  1. Participants were not told whether they had been allocated to the intervention or control group and remained blind to group allocation.
  2. Group allocation was concealed from the researcher until the participant had agreed to be in the study but was not concealed from the researcher when delivering the intervention or assessing outcomes.
  3. The random numbers were generated and packaged into sealed envelopes by a researcher external to the study.
Blinding of outcome assessment high/unclear
  1. Participants were not told whether they had been allocated to the intervention or control group and remained blind to group allocation.
  2. Group allocation was concealed from the researcher until the participant had agreed to be in the study but was not concealed from the researcher when delivering the intervention or assessing outcomes.
  3. The aim of this study was to determine the effectiveness of an individualised pedometer-based telephone intervention on physical activity levels of cardiac patients who were referred to, but could not, or chose not to attend, a CRP.

References

1. Dishman RK et al. Dose relations between goal setting, theory-based correlates of goal setting and increases in physical activity during a workplace trial. Health Educ Res 2010. 25(4); 620-31 PMID: 19654220

2. Fjeldsoe BS et al. MobileMums: a randomized controlled trial of an SMS-based physical activity intervention. Ann Behav Med 2010. 39(2); 101-11 PMID: 20174902

3. Online R et al. The effectiveness of a brief intervention using a pedometer and step-recording diary in promoting physical activity in people diagnosed with type 2 diabetes or impaired glucose tolerance Publication Details Am J Prev Med 2008. 27(4); 289-96 PMID: 15488358

4. Furber S et al. Randomised controlled trial of a pedometer-based telephone intervention to increase physical activity among cardiac patients not attending cardiac rehabilitation. Patient Educ Couns 2010. 80(2); 212-8 PMID: 20022201