Effects Of A Telephone-based Lifestyle Intervention On Mobility Performance And Mobility-related Self-efficacy Among Rural Ohio Residents

Adults in rural communities are disproportionately impacted by obesity-related comorbidities and cancer incidence and mortality. Although exercise and dietary (EX+D) behavior change interventions (BCIs) consistently yield favorable improvements in body weight and clinically relevant health outcomes, most have been conducted in controlled settings, targeting predominantly urban populations. Consequently, there is a critical need to continue developing and implementing accessible and scalable interventions addressing EX+D behaviors of rural-dwelling adults. PURPOSE: The randomized controlled Home-based Exercise in Rural Ohio (HERO) trial evaluated the feasibility and preliminary efficacy of an individually-tailored, telephone-based, multi-component BCI, relative to a healthy lifestyle education control arm. This secondary analysis compared change in mobility performance (MP) and mobility-related self-efficacy (MRSE) beliefs between treatment arms. METHODS: 40 residents of rural Ohio (M age = 49, BMI ≥ 25 kg/m2) were randomized, via 2:1 ratio, to a telephone-based BCI (n = 27) or education control (n = 13) arm. MP was measured by 400-meter walk (400 MW) and lift-and-carry (LC) task performance. 400 MW MRSE and LC MRSE beliefs were measured prior to commencing each task. Assessments were obtained at baseline and 15-week follow-up visits. Comparisons were made using intention-to-treat ANCOVA models of baseline-adjusted change scores. RESULTS: Analyses revealed non-significant treatment effects (p > .05) for all outcomes. However, effect size estimates of mean change in MP, between the telephone-based BCI (-7.19 ± 16.7 s) and control arm (-2.15 ± 11.5 s), suggest the telephone-based BCI yielded more favorable improvements in 400 MW time (g = 0.35). CONCLUSIONS: Evidence from this analysis suggests the telephone-based, multi-component BCI produced change in select measures of MP and MRSE. Relative to the control arm, effect size estimates of mean change in 400 MW time, favored the telephone-based BCI. Findings from the HERO trial provide valuable insight into the feasibility of delivering multi-component, telephone-based, BCIs in rural populations. Supported by NCI (F99CA253745 to XZ), AICR (AWD-108802 to BCF) and the CRC/CCRM of the OSU Wexner Medical Center and College of Medicine.