The U.S. Cooperative Extension Service (CE) has potential to deliver the National Diabetes Prevention Program (NDPP) to rural residents with prediabetes. However, the CE remains underutilized for the delivery of NDPP. We compared the feasibility/effectiveness of the NDPP (0–6 mos.) delivered by CE personnel to rural residents with prediabetes using Zoom^® (CE-Zoom^®) or by our research staff using Facebook^® (FB). Adults (n = 31, age ~55 years) were enrolled (CE-Zoom^® n = 16, FB n = 15). Attendance did not differ significantly between groups (CE Zoom^® = 69%, FB = 83%, p = 0.15). Participant retention was similar in the CE Zoom^® (88%) and FB groups (87%). CE-Zoom^® and FB^® groups provided weekly, self-monitoring data for 83% and 84% of the 24 potential weeks, respectively. Six-month weight loss was not different between groups (CE-Zoom^® = −5.99 ± 8.0 kg, −5.4%, FB = −1.68 ± 3.3 kg, −1.6% p = 0.13). Participants achieving ≥5% weight loss was greater in the CE-Zoom^® (44%) compared with the FB group (7%, p = 0.04). Participants achieving the NDPP program goal for physical activity (≥150 min/week) did not differ (CE-Zoom^® = 75%, FB = 67%, p = 0.91). This pilot trial demonstrated the potential feasibility and effectiveness of the NDPP delivered by CE personnel in a group remote format (Zoom^®) to adults with prediabetes living in rural areas.

Exergames may be a feasible alternative to in-person exercise that is adaptable for adults with Down Syndrome (DS). The purpose of this study was to conduct a 12-week pilot trial to assess the feasibility of exergames for adults with DS. Adults with DS were provided Ring Fit Adventure™ which uses a resistance ring and body weight to perform cardiovascular and strength exercises. Participants were instructed to play Ring Fit Adventure™ for 120 min/week and attend 30-min weekly virtual coaching sessions where a health educator encouraged gameplay via goal setting, helped troubleshoot technological issues, and collected self-reported minutes of gameplay. Intervention outcomes included attendance, adherence to weekly gameplay goals, retention, safety, and exercise intensity captured via heart rate and indirect calorimetry. Twenty adults with DS (age 23.5 years, 89 % non-Hispanic white, 61 % female) enrolled and 19 participants completed the trial. Participants attended 93 % of coaching sessions and 90 % met the weekly gameplay goals. The average gameplay duration was 39 min/session and 123 min/week at 67.3 % of the participants' estimated maximum heart rate. Both the average heart rate during the intervention and metabolic equivalents (3.4 ± 1.0) during the indirect calorimetry assessment were suggestive of moderate intensity exercise. Attendance and adherence to the weekly gameplay goal were high among adults with DS who were able to reach and sustain moderate intensity during the exergame sessions. Exergaming represents a home-based option for accumulating minutes of moderate-to-vigorous physical activity that is feasible for and acceptable to adults with DS.

The purpose of this project was to examine the effect of a concurrent exercise program (sprint interval training and resistance exercise) on body composition in women with obesity and factors associated with continued exercise participation following the program. Twenty women (37.1 ± 7.4 y, height = 1.63 ± 0.09 m, weight = 98.22 ± 0.22 kg, BMI = 34.2 ± 2.50 kg/m²) participated in a 10-week exercise intervention consisting of a sprint interval treadmill protocol and resistance training three times a week totaling 30 sessions. Body composition was measured by dual-energy X-ray absorptiometry (iDXA) at pretest, 12 weeks, and six months post-intervention. Semi-structured interviews assessed participants’ perception of the program at both 12 weeks and six months. Participants significantly reduced fat mass (p < 0.001), gynoid fat mass (p < 0.010), android fat mass (p = 0.003), and visceral fat mass (p = 0.003) at 12 weeks post-test. At six months, participants maintained their reductions in fat mass (p = 0.015), visceral fat (p = 0.040) and gynoid fat mass (p = 0.032). There were no significant main time effects in lean mass (p = 0.099) or caloric intake (p = 0.053) at 12 weeks or six months. Themes that emerged from the semi-structured interviews at 12 weeks reflected enjoyment in the training, increases in competence and knowledge, as well as apprehension of continuing training on their own. At six months, themes that emerged reflected overcoming barriers, competence regarding high-intensity training, and a lack of competence to engage in resistance training. Sprint interval training coupled with resistance training is a feasible exercise protocol for women with obesity and results in reduced fat mass over six months. Improving women’s competence for training is imperative for continued participation.

Objectives: Women have a higher prevalence of metabolic syndrome than their male counterparts, and interventions should target women with or at risk for metabolic syndrome. The objective of this study was to compare two intervention strategies on long-term outcomes following the completion of an exercise intervention. Methods: Twenty-six women ( M age = 43.35 ± 9.03) with at least one risk factor for metabolic syndrome were randomized into either a motivational interviewing group ( n = 10) or self-regulation-based mobile messaging control group ( n = 16) as a 12-week follow-up to a 10-week, 30-session exercise intervention. Outcomes of interest were body fat percentage, bone mineral density, waist circumference, systolic blood pressure, diastolic blood pressure, triglycerides, high-density cholesterol, and fasting blood glucose. Results: Mixed ANOVAs revealed a significant effect for group × time for body fat percentage F(1, 24) = 8.30, p = 0.01, [ ] = 0.26, bone mineral density F(1, 24) = 6.68, p = 0.02, [ ] = 0.22, waist circumference F(1, 24) = 10.35, p = 0.01, [ ] = 0.30, triglycerides F(1, 24) = 5.06, p = 0.03, [ ] = 0.17, and systolic blood pressure F(1, 24) = 5.39, p = 0.03, [ ] = 0.18 all in favor of the motivational interviewing group after 12 weeks when compared to the self-regulation-based mobile messaging group. No significant effect for group × time was noted for diastolic blood pressure p = 0.36, [ ] = 0.04, high-density cholesterol p = 0.08, [ ] = 0.12, or fasting blood glucose p = 0.85, [ ] = 0.01 when comparing the motivational interviewing and self-regulation-based mobile messaging groups. Conclusions: Motivational interviewing may be a more impactful solution to extend the effects of exercise intervention studies compared to a self-regulation-based mobile messaging control group. Future interventions should focus on increasing sample size, utilizing more objective measures of body composition, utilizing booster sessions, and increasing the length of follow-up periods.

Over the last decade, active video games have emerged as a unique opportunity to merge popular entertainment with potential health benefits.