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Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity Before Bariatric Surgery: A Single-Case Experimental Study (Part I)

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Abstract

Background

Physical activity (PA) can play an important role in optimizing metabolic/bariatric surgery (MBS) outcomes. However, many MBS patients have difficulty increasing PA, necessitating the development of theory-driven counseling interventions. This study aimed to (1) assess the feasibility and acceptability of the TELEhealth BARIatric behavioral intervention (TELE-BariACTIV) trial protocol/methods and intervention, which was designed to increase moderate-to-vigorous intensity physical activity (MVPA) in adults awaiting MBS and (2) estimate the effect of the intervention on MVPA.

Methods

This trial used a repeated single-case experimental design. Twelve insufficiently active adults awaiting MBS received 6 weekly 45-min PA videoconferencing counseling sessions. Feasibility and acceptability data (i.e., refusal, recruitment, retention, attendance, and attrition rates) were tracked and collected via online surveys, and interviews. MVPA was assessed via accelerometry pre-, during, and post-intervention.

Results

Among the 24 patients referred to the research team; five declined to participate (refusal rate = 20.8%) and seven were ineligible or unreachable. The recruitment rate was 1.2 participants per month between 2021–09 and 2022–07. One participant withdrew during the baseline phase, and one after the intervention (retention rate = 83.3%). No participant dropouts occurred during the intervention and 98.6% of sessions were completed. Participants’ anticipated and retrospective acceptability of the intervention was 3.2/4 (IQR, 0.5) and 3.0/4 (IQR, 0.2), respectively. There was a statistically significant increase in MVPA [Tau-U = 0.32(0.11; 0.51)] from pre- to post-intervention.

Conclusion

Despite a low recruitment rate, which could be explained by circumstances (COVID-19 pandemic), results support feasibility, acceptability, and preliminary efficacy of the TELE-Bari-ACTIV intervention for increasing MVPA in patients awaiting MBS.

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Data Availability

The R syntax for main analyses is provided on the Open Sciences Framework (https://osf.io/vpmzf/). Raw MVPA, light PA, sedentary time, daily steps, and pain score data are available in Supplemental Files. Other data described in the manuscript and code book will be made available on request pending application.

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Acknowledgements

The authors would like to thank Maxime St-Pierre, Mélanie Nadeau, Annie Quesnel, Mélissa Pelletier, and Mélanie Belley for assisting with the recruitment of participants and data collection, Karine Lavallée for conducting the interviews, Jenson Price for contributing to the intervention, and Felix-Gabriel Duval for managing the accelerometer data. Maxime St-Pierre received a scholarship grant from the Regroupement intersectoriel de recherche en santé de l’Université du Québec (RISUQ). AB and AJR are recipients of salary awards from the Fonds de recherche du Québec-Santé (FRQ-S). JB is supported by a Tier II Canada Research Chair in Physical Activity Promotion for Cancer Prevention and Survivorship.

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Authors and Affiliations

  1. École Interdisciplinaire de Santé, Université du Québec en Outaouais, 283 Boul. Alexandre-Taché, Gatineau, Québec, J8X 3X7, Canada

    Aurélie Baillot

  2. Institut du Savoir Montfort, Ottawa, ON, Canada

    Aurélie Baillot & Jennifer Brunet

  3. Centre de Recherche en Médecine Psychosociale, Centre Intégré de Santé et Services, Sociaux de L’Outaouais, Gatineau, Québec, Canada

    Aurélie Baillot

  4. Université de Lorraine, 2LPN, F-57000, Metz, France

    Marine Asselin

  5. Department of Physical Activity Sciences, Université du Québec À Montréal, Montréal, Québec, Canada

    Paquito Bernard & Josyanne Lapointe

  6. Centre de Recherche, Institut Universitaire en Santé Mentale de Montréal, Montréal, Québec, Canada

    Paquito Bernard, Josyanne Lapointe & Ahmed Jérôme Romain

  7. Department of Surgery, Hartford Hospital/HealthCare, Hartford, CT, USA

    Dale S. Bond

  8. School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada

    Ahmed Jérôme Romain

  9. Department of Surgery, Université de Montréal, Montréal, Québec, Canada

    Pierre Y. Garneau

  10. Institut Universitaire de Cardiologie et de Pneumologie de Québec et Faculté de Médecine, Université Laval, Québec, Québec, Canada

    Laurent Biertho

  11. Institut Universitaire de Cardiologie et de Pneumologie de Québec et École de Nutrition, Université Laval, Québec, Québec, Canada

    André Tchernof

  12. Division of Kinesiology, Department of Health Sciences, Université du Québec À Chicoutimi, Chicoutimi, Québec, Canada

    Patricia Blackburn

  13. CHUS Research Center and Division of Endocrinology, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada

    Marie-France Langlois

  14. Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada

    Jennifer Brunet

  15. Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Jennifer Brunet

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  1. Aurélie Baillot
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  2. Marine Asselin
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  3. Paquito Bernard
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Corresponding author

Correspondence to Aurélie Baillot.

Ethics declarations

Ethics Approval

Ethics approval was obtained from three institutions: Quebec Heart and Lung Institute, Sacré Cœur Hospital, Montreal [Centre Intégré Universitaire de Soins et de Services de Santé (CIUSSS) du Nord-de-l’Île-de-Montréal] and Chicoutimi Hospital, Chicoutimi [CIUSSS Saguenay–Lac-Saint-Jean]. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflicts of Interest

AT and LB received funding from Johnson & Johnson, Medtronic, and GI Windows for studies on bariatric surgery. AT has been a consultant for Biotwin, Bausch Health, Novo Nordisk, and Eli Lilly. MFL has been a consultant for Eli Lilly, Novo Nordisk, Rhythm, and Takeda and received research funding from Merck Canada and Novo Nordisk. AT and LB are codirectors of the Research Chair in Bariatric and Metabolic Surgery at Laval University. AB, MA, PB, JL, DB, PYG, JB, PB, and AJR have no conflict of interest.

Human Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Study Registration and Analytic Plan Registration

The study protocol with analytic plan was previously registered in Baillot et al. (2022). Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity: Protocol for a Single-Case Experimental Study. JMIR Res Protoc, 11(9), e39633.

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Key Points

1. Six weeks of physical activity (PA) tele-counseling is feasible for adults awaiting MBS.

2. Six weeks of PA tele-counseling (45 min/week) is acceptable for adults awaiting MBS.

3. A theory-based tele-counseling shows promise to increase MVPA in adults awaiting MBS.

Supplementary Information

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Baillot, A., Asselin, M., Bernard, P. et al. Acceptability and Feasibility of the Telehealth Bariatric Behavioral Intervention to Increase Physical Activity Before Bariatric Surgery: A Single-Case Experimental Study (Part I). OBES SURG 34, 1639–1652 (2024). https://doi.org/10.1007/s11695-024-07161-0

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  • DOI: https://doi.org/10.1007/s11695-024-07161-0

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