Determinants of Dropout from and Variation in Adherence to an Exercise Intervention: The STRRIDE Randomized Trials.

Abstract

Purpose

This study aimed to characterize the timing and self-reported determinants of exercise dropout among sedentary adults with overweight or obesity. We also sought to explore variations in adherence among individuals who completed a 6- to 8-month structured exercise intervention.

Methods

A total of 947 adults with dyslipidemia [STRRIDE I, STRRIDE AT/RT] or prediabetes [STRRIDE-PD] were enrolled to either control or to one of 10 exercise interventions, ranging from doses of 8-23 kcal/kg/week; intensities of 50%-75% V̇O2 peak; and durations of 6-8 months. Two groups included resistance training and one included dietary intervention (7% weight loss goal). Dropout was defined as an individual who withdrew from the study due a variety of determinants. Timing of intervention dropout was defined as the last session attended and categorized into phases. Exercise training adherence was calculated by dividing weekly minutes or total sets of exercise completed by weekly minutes or total sets of exercise prescribed. General linear models were used to characterize the associations between timing of dropout and determinant category.

Results

Compared to exercise intervention completers (n=652), participants who dropped out (n=295) were on average non-white (98% vs. 80%, p<0.01), had higher body mass index (31.0 kg/m2 vs. 30.2 kg/m2; p<0.01), and were less fit at baseline (25.0 mg/kg/min vs. 26.7 ml/kg/min, p<0.01). Of those who dropped out, 67% did so prior to the start of or while ramping up to the prescribed exercise volume and intensity. The most commonly reported reason for dropout was lack of time (40%). Notably, among individuals who completed the ramp training period, subsequent exercise intervention adherence did not waiver over the ensuing 6-8 months of training.

Conclusion

These findings are some of the first to delineate associations between the timing of dropout and dropout determinants, providing guidance to future exercise interventions to better support individuals at-risk for dropout.

Department

Description

Provenance

Citation

Published Version (Please cite this version)

10.1249/tjx.0000000000000190

Publication Info

Collins, Katherine A, Kim M Huffman, Ruth Q Wolever, Patrick J Smith, Ilene C Siegler, Leanna M Ross, Elizabeth R Hauser, Rong Jiang, et al. (2022). Determinants of Dropout from and Variation in Adherence to an Exercise Intervention: The STRRIDE Randomized Trials. Translational journal of the American College of Sports Medicine, 7(1). p. e000190. 10.1249/tjx.0000000000000190 Retrieved from https://hdl.handle.net/10161/30213.

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Scholars@Duke

Collins

Katherine Collins

Medical Instructor in Population Health Sciences

Katherine A. Collins-Bennett, PhD, NBC-HWC, is a Medical Instructor in the Department of Population Health Sciences and affiliated with the Duke Molecular Physiology Institute at Duke University School of Medicine, and is a board-certified health and wellness coach. She studies barriers and predictors of health-promoting behavior change. The ultimate goal of her translational research is to design trials to optimize health-promoting behaviors for those at risk for "relapse" or ceased behavioral modification, in order to improve long-term health and well-being.

Huffman

Kim Marie Huffman

Associate Professor of Medicine

Determining the role of physical activity in modulating health outcomes (cardiovascular disease risk) in persons with rheumatologic diseases (rheumatoid arthritis, gout, osteoarthritis)

Integrating clinical rheumatology, basic immunology, metabolism, and exercise science in order to reduce morbidity in individuals with arthritis

Evaluating relationships between circulating and intra-muscular metabolic intermediates and insulin resistance in sedentary as well as individuals engaging in regular exercise

Addressing the role of physical activity in modulating inflammation, metabolism, and functional health in aging populations


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