Texting to Increase Adolescent Physical Activity: Feasibility Assessment.
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ABSTRACT: Objective
Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity.Methods
A 4-group randomized design with baseline and immediate post-study assessments was used. Groups (pedometer; pedometer + goal prompt; pedometer + goal prompt + theory-informed texts; no-treatment control) were systematically varied to assess the additive effect of intervention components on objectively measured physical activity (ie, ActiGraph). The primary outcome of the 12-week intervention was program feasibility. Changes in average daily step counts and minutes of moderate-to-vigorous physical activity also were examined. Post-intervention research with a subset of participants examined program reactions.Results
Participants (N = 160) were evenly split by sex, mostly 14-15 years old, and of diverse race/ethnicity. Feasibility criteria were met. The attrition rate was less than 2%. Modest increases in average daily step counts and moderate-to-vigorous physical activity were observed in all groups except the control group. Participants reported positive reactions to the intervention.Conclusions
An intervention consisting of pedometers, theory-informed texts, and goal prompts, is a feasible and acceptable method for promoting physical activity to adolescents.
SUBMITTER: Thompson D
PROVIDER: S-EPMC4922515 | biostudies-literature | 2016 Jul
REPOSITORIES: biostudies-literature
Publications
Texting to Increase Adolescent Physical Activity: Feasibility Assessment.
Thompson Debbe D Cantu Dora D Ramirez Betsy B Cullen Karen W KW Baranowski Tom T Mendoza Jason J Anderson Barbara B Jago Russell R Rodgers Wendy W Liu Yan Y
American journal of health behavior 20160701 4
<h4>Objective</h4>Feasibility trials assess whether a behavior change program warrants a definite trial evaluation. This paper reports the feasibility of an intervention consisting of Self Determination Theory-informed text messages, pedometers, and goal prompts to increase adolescent physical activity.<h4>Methods</h4>A 4-group randomized design with baseline and immediate post-study assessments was used. Groups (pedometer; pedometer + goal prompt; pedometer + goal prompt + theory-informed texts ...[more]
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Project description:BackgroundPhysical activity decreases from childhood through adulthood. Among youth, teenagers (teens) achieve the lowest levels of physical activity, and high school age youth are particularly at risk of inactivity. Effective methods are needed to increase youth physical activity in a way that can be maintained through adulthood. Because teens text a great deal, text messages promoting walking, a low cost physical activity, may be an effective method for promoting sustainable physical activity.ObjectiveThe objective of our study was to determine the effect of pedometers, self selected step goals, and texts grounded in the self-determination theory (SDT) on physical activity among the teens.Methods"TXT Me!" was a 12 week intervention that texted 14-17 year olds to increase their daily physical activity by increasing the number of steps they take each day. The intervention was grounded in the SDT. Formative research with the teens helped construct the intervention and develop the texts. A total of 84 texts were developed (12 to set a step goal, and 72 promoting autonomy, competence, and relatedness). The pilot evaluation used a four group, randomized design (n=160). After baseline data collection, the participants were randomized to one of four conditions (no treatment control, pedometer only, pedometer + weekly prompts, pedometer + weekly prompts + SDT grounded texts). Data were collected at baseline and immediately upon completion of the study. The primary outcome was physical activity, measured by 7 days of accelerometry. Basic psychological needs, physical activity motivation, process evaluation, and program satisfaction data were also collected.ResultsTo our knowledge, this is one of the first studies to explore the use of stand alone, SDT grounded texts, supported by pedometers and prompts to set a self selected step goal, as a method for increasing physical activity among teens.ConclusionsThis pilot study will contribute valuable information regarding whether theoretically grounded text messages show promise as an effective method to increase physical activity among teens.Trial registrationClinicaltrials.gov NCT01482234; http://clinicaltrials.gov/ct2/show/NCT01482234 (Archived by WebCite at http://www.webcitation.org/6NYvRMOoq).
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Project description:Physical inactivity increases risks of cardiovascular disease, poor mental health, and morbidity. School-based physical activity (PA) promotion can reach children from differing backgrounds in a large proportion of their waking hours. Education outside the classroom (EOtC) is an PA-integrating pedagogical approach that aligns PA with the primary goals of schools and is therefore thought to present an acceptable, feasible, and efficacious model for school-based PA. This registered report used a cluster randomised wait list design to evaluate the efficacy of an EOtC intervention that aims to increase adolescents' (ages 10-16 years) school-based (school week) and overall (full week) PA by providing a course on the pedagogical and didactic methods of EOtC to teachers across 30 Danish schools, and subsequently the teachers implementing EOtC in their classes > 5 h weekly over the course of one school year. Across 20 schools, 503 pupils aged 9-14 years were enrolled. The intervention group classes delivered a weekly mean of 238 (± 50) minutes of EOtC per-protocol and engaged in 20.4% moderate-to-vigorous school-based PA above the control group, however with no effect on overall PA. Enhancing effectiveness on overall PA, supplementing the intervention with additional PA activities, or adjusting its delivery and implementation is necessary.Protocol registration The stage 1 protocol for this Registered Report was accepted in principle on 22/08/22. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/NTM9K .
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Project description:Purpose of reviewTo evaluate the feasibility of exergaming among older adults, focusing on acceptability, demand, implementation, and practicality. Additionally, to offer practical implications based on the review's findings.Recent findingsExergaming is a safe for older adults, potentially increasing physical activity, balance, cognition, and mood. Despite these possible benefits, barriers such as unfamiliarity with equipment, complex controls, and unclear instructions may challenge older adults in exergaming. Based on the experience of older adults, they found exergaming enjoyable, particularly the social interactions. Exergaming was perceived as physically and cognitively demanding, with technical and safety challenges. Introducing exergaming requires thorough familiarization, including written and video instructions, follow-up support, and home accessibility. To be able to follow improvements during exergaming as well as age-appropriate challenges are important for successful integration into daily life. Based on these findings, an ExerGameFlow model for older adults was developed which provides practical implications for future design of exergames and interventions.
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Project description:Introduction/purposeObservational research suggests that consistent exercise timing could be leveraged to promote moderate-to-vigorous physical activity (MVPA) among adults with obesity. However, the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting is unknown. The purpose of this study was to assess the feasibility and acceptability of prescribed consistent exercise timing in a free-living setting among inactive adults with obesity (primary) and to compare MVPA timing prescriptions and characterize exercise barriers/facilitators (secondary).MethodsUsing a within-subjects design, inactive adults with obesity (n=15) were randomized in counterbalanced order to three 3-wk exercise timing conditions separated by 2-wk washout periods: 1) consistent morning, 2) consistent evening, and 3) choice timing (control). Feasibility was assessed using prespecified benchmarks. Acceptability and preferred timing were assessed with questionnaires post-intervention. Secondarily, exercise timing and MVPA were assessed via accelerometry and nightly surveys and barriers/facilitators were assessed with nightly surveys.ResultsAll feasibility benchmarks were achieved (e.g., timing adherence = 69.9% via accelerometry and 87.4% via self-report (target: ≥60%)). Consistent exercise timing was acceptable (mean rating = 3.7 of 5 (target: ≥3.5)). Choice was the most popular prescription. There were medium- to large-sized effects (partial η2 of 0.09-0.16) of condition on MVPA; MVPA was higher during the morning and evening conditions versus choice condition. Facilitators were similar across conditions, while some barriers were time specific.ConclusionPrescribed exercise timing in a free-living setting appears feasible and acceptable. While choice timing was most preferred, consistent timing appeared most effective for increasing MVPA. Data warrant larger trials to test the efficacy and mechanisms of consistent exercise timing as a translational strategy for promoting MVPA. Pending findings from a fully powered randomized trial, practitioners interested in promoting MVPA among their patients or clients could consider encouraging exercise at a consistent time day-to-day.
| S-EPMC10722958 | biostudies-literature
Project description:BackgroundMost adolescent girls in the UK do not meet government physical activity recommendations and effective interventions are needed. This study reports the results of a feasibility trial of PLAN-A, a novel school-based peer-led physical activity intervention for adolescent girls.MethodsA two-arm cluster randomised controlled feasibility study was conducted in six English secondary schools (4 intervention & 2 control). Year 8 (age 12-13) girls were eligible and randomisation was at school-level. The intervention involved training Year 8 girls (out of school for two consecutive days, plus one top-up day 5 weeks later), who were identified by their peers as influential, to provide informal support to their friends to increase their physical activity. Feasibility of the intervention and the research was examined, including: recruitment, training attendance and data provision rates, evidence of promise of the intervention to affect weekday moderate-to-vigorous physical activity (MVPA), intervention cost and estimation of the sample size for a definitive trial. Accelerometer and questionnaire data were collected at the beginning of Year 8 (Time 0), the end of Year 8 (10-weeks after peer-supporter training) and the beginning of Year 9 (Time 2).ResultsFour hundred twenty-seven girls were recruited (95% recruitment rate). 55 girls consented to be a peer-supporter and 53 peer-supporters were trained (97% of those invited). Accelerometer return rates exceeded 85% at each time point and wear time criteria was met by 83%, 71% and 62% participants at Time 0, 1 and 2 respectively. Questionnaire data were provided by >91% of participants at each time point. Complete-case adjusted linear regression analysis showed evidence of a 6.09 minute (95% CI = 1.43, 10.76) between-arms difference in weekday MVPA at Time 2 in favour of the intervention arm. On average PLAN-A cost £2685 per school to deliver (£37 per Year 8 girl). There were no adverse events. A trial involving 20 schools would be adequately powered to detect a between-arms difference in weekday MVPA of at least six minutes.ConclusionsThe PLAN-A intervention adopts a novel peer-led approach, is feasible, and shows evidence of promise to positively affect girls' physical activity levels. A definitive trial is warranted.Trial registrationISCTRN, ISRCTN12543546, Registered on 28/7/2015, URL of registry record: http://www.isrctn.com/ISRCTN12543546.
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Project description:BACKGROUND:Wearable technology interventions combined with digital behavior change resources provide opportunities to increase physical activity in adolescents. The implementation of such interventions in real-world settings is unknown. The Raising Awareness of Physical Activity (RAW-PA) study was a 12-week cluster randomized controlled trial targeting inactive adolescents attending schools in socioeconomically disadvantaged areas of Melbourne, Australia. The aim was to increase moderate- to vigorous-intensity physical activity using (1) a wrist-worn Fitbit Flex and app, (2) weekly challenges, (3) digital behavior change resources, and (4) email or text message alerts. OBJECTIVE:This paper presents adolescents' and teachers' perceptions of RAW-PA in relation to program acceptability, feasibility and perceived impact, adolescent engagement and adherence, and the potential for future scale-up. METHODS:A mixed methods evaluation of the RAW-PA study assessed acceptability, engagement, feasibility, adherence, and perceived impact. A total of 9 intervention schools and 144 intervention adolescents were recruited. Only adolescents and teachers (n=17) in the intervention group were included in the analysis. Adolescents completed web-based surveys at baseline and surveys and focus groups postintervention. Teachers participated in interviews postintervention. Facebook data tracked engagement with web-based resources. Descriptive statistics were reported by sex. Qualitative data were analyzed thematically. RESULTS:Survey data were collected from 142 adolescents at baseline (mean age 13.7 years, SD 0.4 years; 51% males) and 132 adolescents postintervention. A total of 15 focus groups (n=124) and 9 interviews (n=17) were conducted. RAW-PA had good acceptability among adolescents and teachers. Adolescents perceived the intervention content as easy to understand (100/120, 83.3%) and the Fitbit easy to use (112/120; 93.3%). Half of the adolescents perceived the text messages to be useful (61/120; 50.8%), whereas 47.5% (57/120) liked the weekly challenges and 38.3% (46/120) liked the Facebook videos. Facebook engagement declined over time; only 18.6% (22/118) of adolescents self-reported wearing the Fitbit Flex daily postintervention. Adolescents perceived the Fitbit Flex to increase their physical activity motivation (85/120, 70.8%) and awareness (93/119, 78.2%). The web-based delivery facilitated implementation of the intervention, although school-level policies restricting phone use were perceived as potential inhibitors to program roll-out. CONCLUSIONS:RAW-PA showed good acceptability among adolescents attending schools in socioeconomically disadvantaged areas and their teachers. Low levels of teacher burden enhanced their perceptions concerning the feasibility of intervention delivery. Although adolescents perceived that RAW-PA had short-term positive effects on their motivation to be physically active, adolescent adherence and engagement were low. Future research exploring the feasibility of different strategies to engage adolescents with wearable technology interventions and ways of maximizing system-level embeddedness of interventions in practice would greatly advance the field.
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Project description:Ankle accelerometry allows for 24-hr data collection and improves data volume/integrity versus hip accelerometry. Using Actical ankle accelerometry, the purpose of this study was to (a) develop sensitive/specific thresholds, (b) examine validity/reliability, (c) compare new thresholds with those of the manufacturer, and (d) examine feasibility in a community sample (low-income, urban adolescent girls).Two studies were conducted with 6th- through 7th-grade girls (aged 10-14 years old): First was a laboratory study (n = 24), in which 2 Actical accelerometers were placed on the ankle and worn while measuring energy expenditure (Cosmed K4b2, metabolic equivalents [METs]) during 10 prescribed activities. Analyses included device equivalence reliability (intraclass correlation coefficient [ICC], activity counts of 2 Acticals), criterion-related validity (correlation, activity counts and METs), and calculations of sensitivity, specificity, kappa, and receiver-operating characteristic curves for thresholds. The second was a free-living study (n = 459), in which an Actical was worn for more than 7 days on the ankle (full 24-hr days retained). Analyses included feasibility (frequencies, missing data) and paired t tests (new thresholds vs. those of the manufacturer).In the laboratory study, the Actical demonstrated reliability (ICC = .92) and validity (r = .81). Thresholds demonstrated sensitivity (91%), specificity (84%), kappa = .73 (p = .043), area under curve range = .81-.97. In the free-living study, 99.6% of participants wore the accelerometer; 84.1% had complete/valid data (mean = 5.7 days). Primary reasons for missing/invalid data included: improper programming/documentation (5.2%), failure to return device (5.0%), and wear-time ? 2 days (2.8%). The moderate-to-vigorous physical activity threshold (> 3,200 counts/minute) yielded 37.2 min/day, 2 to 4.5 times lower than that of the manufacturer's software (effect size = 0.74-4.05).Validity, reliability, and feasibility evidences support Actical ankle accelerometry to assess physical activity in community studies of adolescent girls. When comparing manufacturers' software versus new thresholds, a major difference was observed.
| S-EPMC4775231 | biostudies-literature
Project description:BackgroundInformant discrepancies in physical activity parenting practices (PAPP) are prevalent, but their effect on adolescent physical activity (PA) remains underexplored. This study aims to examine the relationship between the (in)congruence in the parent-adolescent reports of PAPP and adolescent physical activity (PA).MethodsSelf-administered questionnaires were used to collect perceptions on nine types of PAPP and adolescents' PA levels from 373 Chinese parent-adolescent dyads. Multiple linear regression, polynomial regression, and Response Surface Analysis were employed to explore the relationship between parent-adolescent (in)congruence in PAPP reports and adolescent physical activity.ResultsOver half of the dyads exhibited incongruence in their PAPP reports, with parents generally reporting higher PAPP scores compared to adolescents. Neither parent-reported nor adolescent-reported punishment, pressuring, and restriction were significantly associated adolescent PA. In contrast, adolescent-reported disengagement, expectation, facilitation, monitoring, non-directive support, and autonomy support demonstrated stronger significant associations with their PA levels compared to parent-reported measures. Congruence in reporting expectation, facilitation, monitoring, non-directive support, and autonomy support was positively associated with adolescent PA, while incongruence in these practices showed inverse associations. In addition, adolescents' gender-specific analyses demonstrated different informant effects on disengagement, monitoring, and non-directive support.ConclusionParent-adolescent (in)congruences on positive PAPP rather than negative PAPP showed significant relationships with adolescents' PA levels, highlighting the importance of aligning parents' and adolescents' perceptions on positive PAPP to promote adolescent PA. Moreover, adolescent girls appear to be more sensitive to PAPP involving parents' presence than boys.
| S-EPMC11575169 | biostudies-literature
Project description:ObjectiveThis study examined the feasibility of an activity tracker and app intervention to increase physical activity in whole families.MethodsThis was a single-arm feasibility study with pre-post-intervention measures. Between 2017 and 2018, 40 families (58 children aged 6-10 years, 39 mothers, 33 fathers) participated in the 6-week Step it Up Family programme in Queensland, Australia. It was delivered using Garmin activity trackers and apps, weekly motivational text messages and an introductory session. Online surveys and semi-structured interviews conducted with parents assessed intervention usage, acceptability, usability, perceived usefulness, use of physical activity self-management strategies and programme influence. Analyses included descriptive statistics, Wilcoxon signed-rank test and qualitative content analysis.ResultsOverall, 38 families completed the post-intervention survey (95% family retention; 90% children, 95% mothers, 88% fathers). Garmin activity tracker usage was high (i.e. nearly 24/7 during the 6 weeks intervention). Families also used the Garmin apps regularly (i.e. mostly 2-6 times per week). Further, 80% of mothers and 52% of fathers read the motivational mobile text messages. Usability and perceived usefulness of the Garmin activity trackers and apps were rated high. Both parents significantly increased their use of physical activity self-management strategies from pre to post-intervention. Parents expressed that the intervention had increased awareness of physical (in)activity in the family, encouraged to be active and promoted outdoor family activities.ConclusionsUsing activity trackers and apps to increase physical activity in the whole family was well received by children and parents which suggests that this intervention approach is feasible. However, further testing is needed amongst more diverse family populations. These early findings support the implementation of a randomised controlled trial to examine intervention efficacy.
| S-EPMC9548676 | biostudies-literature
Project description:BackgroundElectronic health (eHealth) and mobile health (mHealth) interventions have the potential to tackle the worldwide problem of physical inactivity. However, they often suffer from large attrition rates. Consequently, feasibility and acceptability of interventions have become important matters in the creation of e- and mHealth interventions. The aim of this study was to evaluate participants' opinions regarding acceptability and feasibility of a self-regulation, app-based intervention called 'MyDayPlan'. 'MyDayPlan' provides an innovative daily cycle providing several self-regulation techniques throughout the day that guide users towards an active lifestyle via various self-regulation techniques.MethodsSemi-structured interviews were conducted with 20 adults after using the app for 2 weeks. A directed content analysis was performed using NVivo Software.Results'MyDayPlan' was well-received and seems to be feasible and acceptable with inactive adults. The straightforward lay out and ease of use of the app were appreciated. Furthermore, the incorporation of the techniques 'action planning', and 'prompting review of behavioral goals' was positively evaluated. However, the users gave some recommendations: implementation of activity trackers to self-monitor physical activity could be of added value. Furthermore, increasing intuitiveness by minimizing text input and providing more preprogrammed options could further increase the ease of use. Finally, users indicated that they would benefit from more guidance during the "coping planning" component (barrier identification/problem solving), for example by receiving more tailored examples.ConclusionsBased on these findings, adaptations will be made to the 'MyDayPlan' app before evaluating its effectiveness. Furthermore, involving potential end users and evaluating acceptability and feasibility during the development of an e- and mHealth intervention is key. Also, creating interventions with a large ease of use and straightforward layout that provides tailored support during action and coping planning is key.
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