title: A lifestyle intervention supported by mobile health technologies to improve the cardiometabolic risk profile of individuals at risk for cardiovascular disease and type 2 diabetes: study rationale and protocol.
abstract: BACKGROUND
  Metabolic syndrome is a cluster of cardiovascular risk factors that greatly increase the risk of developing cardiovascular disease and type 2 diabetes. Regular exercise improves the risk profile, but most people do not successfully change their exercise habits to beneficially reduce risk. Tailored exercise prescribed by a family physician has shown promise as a means to increase fitness and reduce cardiometabolic risk, but optimal implementation practices remain unknown. Mobile health technologies have proved to be a beneficial tool to achieve blood pressure and blood glucose control in patients with diabetes. These technologies may address the limited access to health interventions in rural and remote regions. However, the potential as a tool to support exercise-based prevention activities is not well understood. This study was undertaken to investigate the effects of a tailored exercise prescription alone or supported by mobile health technologies to improve metabolic syndrome and related cardiometabolic risk factors in rural community-dwelling adults at risk for cardiovascular disease and type 2 diabetes.
  
  
  METHODS
  Adults (n = 149) with at least two metabolic syndrome risk factors were recruited from rural communities and randomized to either: 1) an intervention group receiving an exercise prescription and devices for monitoring of risk factors with a smartphone data portal equipped with a mobile health application; or 2) an active control group receiving only an exercise prescription. All participants reported to the research centre at baseline, and at 12-, 24- and 52-week follow-up visits for measurement of anthropometrics and blood pressure and for a blood draw to test blood-borne markers of cardiometabolic health. Vascular and autonomic function were examined. Fitness was assessed and exercise prescribed according to the Step Test and Exercise Prescription protocol.
  
  
  CONCLUSIONS
  This study tested the effects of a prescriptive exercise intervention alone, versus one supported by mobile health technology on cardiometabolic risk factors. The intervention was designed to be translated into clinical or community-based programming. Results will contribute to the current literature by investigating the utility of mobile health technology support for exercise prescription interventions to improve cardiometabolic risk status and maintain improvements over time; particularly in rural communities.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  NCT01944124.
authors.forename: Melanie I
authors.initials: MI
authors.lastname: Stuckey
authors.forename: Sheree
authors.initials: S
authors.lastname: Shapiro
authors.forename: Dawn P
authors.initials: DP
authors.lastname: Gill
authors.affiliation: Lawson Health Research Institute, Aging Rehabilitation and Geriatric Care Research Centre, 801 Commissioners Rd E, Ste B 3002, London, Ontario N6C 5J1, Canada. petrella@uwo.ca.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Petrella
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D040421:Cell Phone; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome; D008875:Middle Aged; D063731:Mobile Applications; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D017216:Telemedicine; D016896:Treatment Outcome; D055815:Young Adult