A Randomized Trial of Changing Exercise and Physical Activity Behavior in Asthma Patients

• Pedometer readings from enrollment to 12 months. [ Time Frame: every 2 months for 1 year ] [ Designated as safety issue: No ]
• Change in asthma status measured by the Asthma Control Questionnaire from enrollment to 12 months. [ Time Frame: baseline and one year after enrollment at closeout ] [ Designated as safety issue: No ]
• Change in quality of life measured by the Asthma Quality of Life Questionnaire enrollment to 12 months. [ Time Frame: at baseline, 4-,8-month follow-ups and one year after enrollment at closeout ] [ Designated as safety issue: No ]
• Changes in the SF-12 from enrollment to 12 months. [ Time Frame: baseline and one year after enrollment at closeout ] [ Designated as safety issue: No ]

• 1. Pedometer readings from enrollment to 12 months.
• 2. Change in asthma status measured by the Asthma Control Questionnaire from enrollment to 12 months.
• 3. Change in quality of life measured by the Asthma Quality of Life Questionnaire and the SF-12 from enrollment to 12 months.

The primary objective of this randomized trial is to evaluate a novel intervention of induced positive affect and induced self-affirmation to increase physical activity in patients with asthma.

The primary objective of this randomized trial is to evaluate a novel intervention of induced positive affect and induced self-affirmation to increase physical activity in patients with asthma. At the start of the trial all patients in conjunction with their physicians will select a program of mild to moderate physical activity or exercise to be adopted and maintained on a routine basis. All patients will record perceived exertion and pedometer measurements in a log diary. All patients will be contacted by telephone at set time intervals to encourage them to continue their selected physical activity or exercise. Patients randomized to the intervention arm will also receive induced positive affect and self-affirmation throughout the study period. Patients in the control arm will not receive the positive affect and self-affirmation components.

• No Intervention: 1
  This group received follow-up every 2-months for one year. Follow-up included questions about their asthma and how well they had been able to engage in their doctor approved physical activity goal.
  Intervention: Behavioral: Positive affect and self-affirmation induction
• Experimental: 2
  This group received follow-up every 2-months for one year. Follow-up included questions about their asthma and how well they had been able to engage in their doctor approved physical activity goal, which was the same as the control arm. Additionally, subjects in this arm were encouraged to use positive affect and self-affirmation techniques to motivate an increased level of participation in their physical activity goal. These subjects also received small token gifts to remind them of their participation in this study.
  Intervention: Behavioral: Positive affect and self-affirmation induction

• Mancuso CA, Choi TN, Westermann H, Wenderoth S, Hollenberg JP, Wells MT, Isen AM, Jobe JB, Allegrante JP, Charlson ME. Increasing Physical Activity in Patients With Asthma Through Positive Affect and Self-affirmation: A Randomized Trial. Arch Intern Med. 2012 Feb 27;172(4):337-43. Epub 2012 Jan 23.
• Mancuso CA, Peterson MG. Different methods to assess quality of life from multiple follow-ups in a longitudinal asthma study. J Clin Epidemiol. 2004 Jan;57(1):45-54.
• Mancuso CA, Rincon M, Robbins L, Charlson ME. Patients' expectations of asthma treatment. J Asthma. 2003 Dec;40(8):873-81.
• Mancuso CA, Rincon M, McCulloch CE, Charlson ME. Self-efficacy, depressive symptoms, and patients' expectations predict outcomes in asthma. Med Care. 2001 Dec;39(12):1326-38.
• Mancuso CA, Peterson MG, Charlson ME. Comparing discriminative validity between a disease-specific and a general health scale in patients with moderate asthma. J Clin Epidemiol. 2001 Mar;54(3):263-74.
• Mancuso CA, Peterson MG, Charlson ME. Effects of depressive symptoms on health-related quality of life in asthma patients. J Gen Intern Med. 2000 May;15(5):301-10.
• Mancuso CA, Choi TN, Westermann H, Wenderoth S, Wells MT, Charlson ME. Improvement in asthma quality of life in patients enrolled in a prospective study to increase lifestyle physical activity. J Asthma. 2013 Feb;50(1):103-7. doi: 10.3109/02770903.2012.743150. Epub 2012 Nov 22.
• Mancuso CA, Sayles W, Allegrante JP. Development and testing of the Asthma Self-Management Questionnaire. Ann Allergy Asthma Immunol. 2009 Apr;102(4):294-302.
• Westermann H, Choi TN, Briggs WM, Charlson ME, Mancuso CA. Obesity and exercise habits of asthmatic patients. Ann Allergy Asthma Immunol. 2008 Nov;101(5):488-94.
• Choi TN, Westermann H, Sayles W, Mancuso CA, Charlson ME. Beliefs about asthma medications: patients perceive both benefits and drawbacks. J Asthma. 2008 Jun;45(5):409-14.
• Mancuso CA, Westermann H, Choi TN, Wenderoth S, Briggs WM, Charlson ME. Psychological and somatic symptoms in screening for depression in asthma patients. J Asthma. 2008 Apr;45(3):221-5.
• Mancuso CA, Choi TN, Westermann H, Briggs WM, Wenderoth S, Charlson ME. Measuring physical activity in asthma patients: two-minute walk test, repeated chair rise test, and self-reported energy expenditure. J Asthma. 2007 May;44(4):333-40.

Inclusion Criteria:

Patients will be eligible for this study

• if their physicians consider them medically able to participate, if they are 18 years of age or older
• if they have a diagnosis of mild to moderate asthma based on the NHLBI Asthma Expert Panel's classification system which rates symptoms, frequency of exacerbations, nocturnal attacks, activity restriction, use of medications, and pulmonary function.

Exclusion Criteria:

Patients will be excluded from this study for the following reasons:

• If they are unable to walk several blocks for whatever reason;
• If they have musculoskeletal or neurological deficits that preclude increased physical activity;
• If they have other pulmonary diseases;
• If they have cardiac disease or other severe comorbidity;
• If they are unable to provide informed consent because of cognitive deficits;
• If they refuse to participate.