{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T23:24:51Z","timestamp":1780529091551,"version":"3.54.1"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T00:00:00Z","timestamp":1554422400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005848","name":"Health Care and Promotion Fund","doi-asserted-by":"publisher","award":["06130305"],"award-info":[{"award-number":["06130305"]}],"id":[{"id":"10.13039\/501100005848","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Aims: A community-based multi-component intervention (increasing awareness of the importance of physical activity in chronic illness management through reading comic books, training regarding warm-up stretching exercises, identifying facilitators and barriers to exercise through photosharing, supporting self-reflection and development of action plans) was developed to promote physical activity (PA) among patients with diabetes and hypertension. This study aimed to evaluate the efficacy of this intervention on health behaviour (walking) and health outcomes. Design: A non-randomized controlled trial with waitlisted control and pre- and post-measures. Setting: Community centres for the elderly. Participants: A total of 204 older adults with diabetes and\/or hypertension were recruited. They were assigned to either the intervention group (IG) or waitlisted to the control group (CG). Intervention: Under the supervision of a nurse, six weekly group meetings were arranged in community centres for the elderly in which the participants freely exchanged their views regarding the barriers and facilitators of regular physical activity. Participants were encouraged to take photos in their neighbourhood or at home and brought these photos to share at the group meetings. The photos showed both the barriers and the facilitators to PA. In the last meeting, each participant worked out a plan to perform PA in the coming four weeks. Measures: PA referred to the number of steps taken per day and it was measured by a Garmin Accelerometer at baseline, Week 6 and Week 10. Other measures included the nine-item Self-Efficacy Scale for Exercise\u2013Chinese version (SEE-C), and the 23-item Chinese Barriers to Exercise Scale and Senior Fitness Tests. Generalised estimating equations (GEE) models compared the outcomes over time between IG and CG. Results: A statistically significant difference in the changes in the average number of steps taken daily between the two groups at Week 10 (mean difference = 965.4; 95% confidence interval: 92.2, 1838.6, p = 0.030) was observed, although the difference at Week 6 was non-significant (mean difference = 777.6; 95% confidence interval: \u221235.3, 1590.5, p = 0.061). IG participants also showed significant improvements in lower body strength (mean difference = 0.967; 95% confidence interval: 0.029, 1.904, p = 0.043) and lower limb flexibility (mean difference = 2.068; 95% confidence interval: 0.404, 3.731, p = 0.015) at Week 10 compared to CG participants. Conclusion: This multi-component intervention improved the participants\u2019 physical activity level and physical fitness, particularly in lower limb flexibility and body strength.<\/jats:p>","DOI":"10.3390\/ijerph16071219","type":"journal-article","created":{"date-parts":[[2019,4,5]],"date-time":"2019-04-05T11:36:01Z","timestamp":1554464161000},"page":"1219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Motivating Diabetic and Hypertensive Patients to Engage in Regular Physical Activity: A Multi-Component Intervention Derived from the Concept of Photovoice"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9836-1925","authenticated-orcid":false,"given":"Angela Y.M.","family":"Leung","sequence":"first","affiliation":[{"name":"Centre for Geronotological Nursing (CGN), School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-8020","authenticated-orcid":false,"given":"Pui Hing","family":"Chau","sequence":"additional","affiliation":[{"name":"School of Nursing, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac S.H.","family":"Leung","sequence":"additional","affiliation":[{"name":"Centre for Geronotological Nursing (CGN), School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6712-6466","authenticated-orcid":false,"given":"Michael","family":"Tse","sequence":"additional","affiliation":[{"name":"Institute of Human Performance, The University of Hong Kong, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perick L.C.","family":"Wong","sequence":"additional","affiliation":[{"name":"Hong Kong Sheng Kung Hui Welfare Council Western District Elderly Community Centre, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wai Ming","family":"Tam","sequence":"additional","affiliation":[{"name":"Hong Kong Sheng Kung Hui Welfare Council Western District Elderly Community Centre, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doris Y. P.","family":"Leung","sequence":"additional","affiliation":[{"name":"School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1177\/109019810102800504","article-title":"Photovoice ethics: Perspectives from flint photovoice","volume":"28","author":"Wang","year":"2001","journal-title":"Health Educ. Behav."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1177\/1524839909355519","article-title":"Framing photovoice using a social-ecological logic model as a guide","volume":"11","author":"Strack","year":"2010","journal-title":"Health Promot. 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