Publications by authors named "Derek P Hales"

11 Publications

  • Page 1 of 1

Accelerometer-Based Physical Activity Patterns and Associations With Outcomes Among Individuals With Osteoarthritis.

J Clin Rheumatol 2021 Apr 24. Epub 2021 Apr 24.

From the Medical College of Georgia at Augusta University, Augusta, GA Department of Medicine and Thurston Arthritis Research Center Division of Physical Therapy and Thurston Arthritis Research Center, Injury Prevention Research Center, Department of Epidemiology Department of Nutrition Gillings School of Global Public Health and Center for Health Promotion and Disease Prevention, University of North Carolina, Chapel Hill, NC.

Background: This study examined patterns of physical activity and associations with pain, function, fatigue, and sleep disturbance among individuals with knee or hip osteoarthritis.

Methods: Participants (n = 54) were enrolled in a telephone-based physical activity coaching intervention trial; all data were collected at baseline. Self-reported measures of pain and function (WOMAC [Western Ontario and McMaster Universities Osteoarthritis Index] subscales), fatigue (10-point numeric rating scale), and PROMIS (Patient-Reported Outcomes Information System) Sleep Disturbance were collected via telephone. Accelerometers were mailed to participants and were worn for at least 3 days. Proportion of time participants spent in sedentary behavior during the morning (from wake until 12:00 PM), afternoon (12:00 PM until 5:59 PM) and evening (6:00 PM until sleep) each day was averaged across all days of wear. Pearson correlations assessed associations between activity and self-reported measures.

Results: Participants spent a large proportion of time in sedentary behavior: 65.6% of mornings, 70.0% of afternoons, and 76.6% of evenings. Associations between proportion of time spent in sedentary behavior and reported outcomes were generally strongest in the afternoon, strongest for WOMAC function, and lowest for PROMIS Sleep Disturbance. In the evening hours, sedentary time was most strongly associated with fatigue.

Conclusions: Overall, findings stress the importance of reducing sedentary behavior among adults with osteoarthritis and suggest behavioral interventions may be strengthened by considering patients' within-day variation in symptoms and activity.
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http://dx.doi.org/10.1097/RHU.0000000000001750DOI Listing
April 2021

Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial.

Contemp Clin Trials 2021 Apr 27;103:106293. Epub 2021 Jan 27.

Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Introduction: Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS.

Purpose: To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS.

Methods: A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures.

Conclusions: IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.
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http://dx.doi.org/10.1016/j.cct.2021.106293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089056PMC
April 2021

Osteoarthritis physical activity care pathway (OA-PCP): results of a feasibility trial.

BMC Musculoskelet Disord 2020 May 16;21(1):308. Epub 2020 May 16.

Department of Exercise and Sport Science and Thurston Arthritis Research Center, University of North Carolina, 3330 Thurston Bldg, CB #7280, Chapel Hill, NC, #7280, USA.

Background: To obtain information on feasibility and acceptability, as well as preliminary data on efficacy, of an Osteoarthritis Physical activity Care Pathway (OA-PCP).

Methods: This was a single group pilot study involving 60 participants with symptomatic, physician diagnosed knee or hip OA, recruited from primary care clinics. Participants self-reported completing less than 150 min per week of moderate-to-vigorous physical activity (MVPA) at baseline. The 3-month OA-PCP intervention involved 3 physical activity (PA) coaching calls (focused on goal setting), three check-in emails and linkage with community-based or online resources to support PA. Efficacy outcomes were collected at baseline and 4-month follow-up. The primary efficacy outcome was minutes of MVPA, assessed via accelerometer. Secondary outcomes included minutes of light intensity activity, sedentary minutes, step counts, and Western Ontario and McMaster Universities (WOMAC) pain and function subscales. Participants were also asked to rate the helpfulness of the OA-PCP intervention on a scale of 0-10. Differences in efficacy outcomes between baseline and 4-month follow-up were assessed using paired t-tests.

Results: Among participants beginning the study, 88% completed follow-up assessments and ≥ 90% completed each of the intervention calls. Average daily minutes of MVPA was 8.0 at baseline (standard deviation (SD) = 9.9) and 8.9 at follow-up (SD = 12.1, p = 0.515). There were no statistically significant changes in light intensity activity, sedentary time or step counts. The mean WOMAC pain score improved from 8.1 (SD = 3.6) at baseline to 6.2 (SD = 3.8) at follow-up (p < 0.001); the mean WOMAC function score improved from 26.2 (SD = 13.2) to 20.2 (SD = 12.5; p < 0.001). The mean rating of helpfulness was 7.6 (SD = 2.5).

Conclusions: Results supported the feasibility and acceptability of the study, and participants reported clinically relevant improvements in pain and function. PA metrics did not improve substantially. Based on these results and participant feedback, modifications including enhanced self-monitoring are being made to increase the impact of the OA-PCP intervention on PA behavior.

Trial Registration: NCT03780400, December 19, 2018.
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http://dx.doi.org/10.1186/s12891-020-03339-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229580PMC
May 2020

HomeSTEAD's physical activity and screen media practices and beliefs survey: Instrument development and integrated conceptual model.

PLoS One 2019 31;14(12):e0226984. Epub 2019 Dec 31.

Center for Health Promotion and Disease Prevention, the University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.

The home environment has a significant influence on children's physical activity and obesity risk. Our understanding of this environment is limited by current measurement tools. The Home Self-administered Tool for Environmental assessment of Activity and Diet addresses this gap. This paper describes the development and psychometric testing of its family physical activity and screen media practices and beliefs survey.

Methods: Survey development was guided by the Analysis Grid for Environments Linked to Obesity (ANGELO) framework and informed by a literature review, expert opinion, and cognitive interviews. Parents of children ages 3-12 years (n = 129) completed the HomeSTEAD survey three times over 12-18 days. Additionally, parents reported on child behaviors and trained staff measured parent and child height and weight. Five exploratory factor analyses were conducted after categorizing items into: control of physical activity, control of screen media, explicit modeling, implicit modeling, and perceived barriers and facilitators. Scales with 3 or more items underwent scale reduction. Psychometric testing evaluated internal consistency (Chronbach's alphas), test-retest reliability (analysis of variance and intraclass correlations (ICC)), and construct validity (correlations with child BMI, physical activity, screen time). An integrated conceptual model of parent physical activity and screen media practices and beliefs was developed based on recent literature to aid in the identification and naming of constructs.

Results: Final scales demonstrated good internal consistency (median Cronbach's alpha = 0.81, IQR = 0.74-0.85), test-retest reliability (median ICC = 0.70, IQR = 0.66-0.78), and construct validity (with correlations between scale score and children's behaviors generally in the expected direction). Comparison with the integrated conceptual model showed that most identified constructs were captured.

Conclusions: The family physical activity and screen media practices survey advances the measurement of the home environment related to children's physical activity, screen time, and weight. The integrated conceptual model provides a useful framework for researchers studying both physical activity and screen media parenting practices.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0226984PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938346PMC
April 2020

The Role of Cohabitating Partner and Relationship Characteristics on Physical Activity among Individuals with Osteoarthritis.

Int J Behav Med 2019 Oct;26(5):522-530

John Theurer Cancer Center, Hackensack University Medical Center, 30 Prospect Ave, Hackensack, NJ, 07601, USA.

Background: Most individuals with knee or hip osteoarthritis do not meet recommendations for physical activity. The Social Cognitive Theory suggests that the social environment (e.g., spouses/partners) may influence the physical activity of individuals with osteoarthritis. The purpose of this study was to examine whether the physical activity of insufficiently active, coupled adults with osteoarthritis was associated with received partner support for physical activity, partner's engagement in physical activity, and relationship satisfaction.

Methods: Cross-sectional data from 169 couples were collected. Accelerometers estimated moderate-to-vigorous physical activity and daily steps for participants with osteoarthritis and their partners. Participants with osteoarthritis reported total received partner support for physical activity and relationship satisfaction.

Results: Participants with osteoarthritis were on average 65 years old, 65% female, 86% non-Hispanic white, and 47% retired. Receiving total partner support more frequently was associated with more minutes of moderate-to-vigorous physical activity but not with steps. Relationship satisfaction moderated the association of partner's physical activity on the daily steps of individuals with osteoarthritis such that having a partner who accomplished more daily steps was associated with participants with osteoarthritis accomplishing more daily steps themselves when they reported greater relationship satisfaction.

Conclusions: Partners and relationship satisfaction may play an important role in the physical activity of individuals with osteoarthritis. Interventions seeking to increase physical activity in this population may be enhanced by promoting partner support. Additional research is needed to further explain these associations within the context of relationship satisfaction.
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http://dx.doi.org/10.1007/s12529-019-09806-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7147336PMC
October 2019

Nutrition policies at child-care centers and impact on role modeling of healthy eating behaviors of caregivers.

J Acad Nutr Diet 2012 Jan 22;112(1):119-24. Epub 2011 Dec 22.

The Department of Nutrition and Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Studies suggest that caregivers influence children's dietary behaviors through role modeling in child-care environments. However, few studies have examined role modeling by caregivers and child-care center policies. This cross-sectional study evaluated the associations between child-care center policies about staff eating practices and caregivers' eating behaviors during mealtime interactions with children. Data were collected in 2008-2009 at 50 North Carolina child-care centers. Caregivers (n=124) reported about modeling healthy eating behaviors to children, trained research staff observed caregivers' (n=112) eating behaviors in classrooms, and directors reported about the presence/absence of center policies on staff eating practices. About 90% of caregivers reported modeling healthy eating behaviors to children. At 80% of centers, caregivers were observed modeling healthy dietary behaviors (eg, sitting with or eating same foods as children), but at fewer centers they were observed consuming unhealthy foods (eg, fast foods, salty snacks: 25%; and sugar-sweetened beverages: 50%). Although no substantial associations were observed between caregiver behaviors and center policies, effect size estimates suggest differences that may be of clinical significance. For example, caregivers were observed modeling healthy dietary behaviors more frequently at centers that had written policies about staff discouraging unhealthy foods for meals/snacks and having informal nutrition talks with children at meals. However, caregivers were observed consuming unhealthy foods and sugar-sweetened beverages more often at centers with policies that promoted healthier foods for meals/snacks. Future research should build on this study by using larger samples to understand why healthy food policies in child-care centers may not translate to eating practices among caregivers.
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http://dx.doi.org/10.1016/j.jada.2011.08.048DOI Listing
January 2012

Validity of social-cognitive measures for physical activity in middle-school girls.

J Pediatr Psychol 2010 Jan-Feb;35(1):72-88. Epub 2009 May 11.

Department of Kinesiology, The University of Georgia, Ramsey Student Center, Athens, GA 30602-6554, USA.

Objective: The factorial validity and measurement equivalence/invariance of scales used to measure social-cognitive correlates of physical activity among adolescent girls were examined.

Methods: Confirmatory factor analysis was applied to questionnaire responses obtained from a multi-ethnic sample (N = 4885) of middle-school girls from six regions of the United States. A cohort of 1893 girls completed the scales in both sixth and eighth grades, allowing longitudinal analysis.

Results: Theoretically and statistically sound models were developed for each scale, supporting the factorial validity of the scales in all groups. Multi-group and longitudinal invariance was confirmed across race/ethnicity groups, age within grade, BMI categories, and the 2-year period between grades.

Conclusions: The scores from the scales provide valid assessments of social-cognitive variables that are putative mediators or moderators of change in physical activity. The revised scales can be used in observational studies of change or interventions designed to increase physical activity among girls during early adolescence.
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http://dx.doi.org/10.1093/jpepsy/jsp031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2910934PMC
March 2010

The childcare environment and children's physical activity.

Am J Prev Med 2008 Jan;34(1):23-9

Department of Nutrition, Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.

Background: With increased numbers of children attending child care, this setting presents an ideal opportunity to promote physical activity and the early development of healthy behaviors. The purpose of this study was to examine the relationships between the childcare environment and physical activity behavior of preschool children.

Methods: Aspects of the environment hypothesized to influence children's physical activity were assessed in 20 childcare centers using the Environment and Policy Assessment and Observation (EPAO) instrument. Physical activity behavior was assessed over 2 days using direct observation.

Results: Children in centers with supportive environments achieved more moderate-to-vigorous physical activity (15% of observations vs 9%; effect size [ES]=1.17), spent less time in sedentary activities (50% vs 61%; ES=-1.52), and had higher mean physical activity levels (2.68 vs 2.43; ES=1.41) compared to centers with less supportive environments. Facets of the physical and social environment related to physical activity behavior included active opportunities, portable play equipment, fixed play equipment, sedentary environment, and physical activity training and education.

Conclusions: Previous research indicates that the childcare center that children attend significantly affects physical activity behavior. The current findings extend this evidence by identifying aspects of the childcare environment that relate to the physical activity behavior of children. These factors should be considered when identifying determinants of physical activity and designing interventions.
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http://dx.doi.org/10.1016/j.amepre.2007.09.022DOI Listing
January 2008

Factorial validity and invariance of the Physical Self-Description Questionnaire among black and white adolescent girls.

Ethn Dis 2006 ;16(2):551-8

Department of Kinesiology, The University of Georgia; Ramsey Student Center, 300 River Road, Athens, Georgia 30602-6554, USA.

Meaningful comparison of physical self-concept among racial or ethnic groups requires that the measurement instruments used have equivalent measurement properties. We tested the factorial validity and invariance of the Physical Self-Description Questionnaire (PSDQ) among Black (n = 658) and White (n = 479) adolescent girls in the 12th grade. Construct validity was examined by estimating correlations between PSDQ subscales and external criteria (physical activity, physical fitness, body mass index [BMI], and participation in sports). The hypothesized 11-factor model demonstrated adequate overall fit in both groups. Comparison of nested models supported the between-group invariance of the overall factor structure. Convergent and discriminant evidence for construct validity was supported by the pattern of correlations with the external criteria. The results indicate that a meaningful comparison of PSDQ scores can be made between Black and White girls in the 12th grade and that valid inferences from PSDQ scores can be made about specific aspects of physical self-concept. Despite lower levels of physical activity, sport participation, and fitness and higher BMI, Black girls had similar self-esteem and higher physical self-concept and perceived appearance compared to White girls.
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September 2007

Physical self-concept and self-esteem mediate cross-sectional relations of physical activity and sport participation with depression symptoms among adolescent girls.

Health Psychol 2006 May;25(3):396-407

Department of Exercise Science, University of South Carolina.

The authors tested whether physical self-concept and self-esteem would mediate cross-sectional relations of physical activity and sport participation with depression symptoms among 1,250 girls in 12th grade. There was a strong positive relation between global physical self-concept and self-esteem and a moderate inverse relation between self-esteem and depression symptoms. Physical activity and sport participation each had an indirect, positive relation with global physical self-concept that was independent of objective measures of cardiorespiratory fitness and body fatness. These correlational findings provide initial evidence suggesting that physical activity and sport participation might reduce depression risk among adolescent girls by unique, positive influences on physical self-concept that operate independently of fitness, body mass index, and perceptions of sports competence, body fat, and appearance.
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http://dx.doi.org/10.1037/0278-6133.25.3.396DOI Listing
May 2006

Factorial validity and invariance of the center for epidemiologic studies depression (CES-D) scale in a sample of black and white adolescent girls.

Ethn Dis 2006 ;16(1):1-8

Department of Exercise Science; The University of Georgia; Ramsey Student Center, 300 River Road; Athens, GA 30602-6554, USA.

Meaningful comparison of depression symptoms requires that the measurement instrument has equivalent measurement properties among racial and ethnic groups. We tested the factorial validity and invariance of the Center for Epidemiologic Studies-Depression (CES-D) Scale among Black (n=610) and White (n=452) adolescent girls in the 12th grade. The invariance analyses were conducted by using LISREL 8.70 with maximum likelihood estimation and Satorra-Bentler scaled chi-square statistics and standard errors. The hypothesized second-order model (first-order factors: depressed affect, somatic and retarded activity, interpersonal, and positive affect; second-order factor: depression) demonstrated good overall fit in both groups. Comparison of nested models supported the between-group invariance of the overall factor structure, first- and second-order factor loadings, first-order factor variances, and the second-order factor variance. Item uniquenesses were not invariant. Our results support the hypothesis that a meaningful comparison of composite CES-D scores can be made between Black and White girls in the 12th grade.
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June 2006