A Group-Based Mobile Application to Increase Adherence in Exercise and Nutrition Programs: A Factorial Design Feasibility Study.
A Group-Based Mobile Application to Increase Adherence in Exercise and Nutrition Programs: A Factorial Design Feasibility Study.
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DOI：
10.2196/mhealth.4900
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发表时间：
2016-01-15
影响因子：
5
通讯作者：
Pirolli P
中科院分区：
文献类型：
--
作者：
Du H;Venkatakrishnan A;Youngblood GM;Ram A;Pirolli P
需要新的方法来促进自我监控和社会支持，以确保行为改变的长期维持。在这篇文章中，我们直接调查了团体支持在运动和营养计划中的效果，该计划由一个名为Fitte的mHealth应用程序提供。我们的第一个具体研究目标是探索社会支持是否提高了健康计划的依从性。我们的第二个具体研究目标是评估媒体类型(电子纸和手机)是否与不同程度的遵从性和对健康计划的坚持有关。第三个目标是评估与传统的纸质程序相比，使用mHealth应用程序是否导致参与者的饮食行为、体力活动和压力水平发生积极变化。采用2×2(媒体：移动VS ePaper×小组类型：团队VS Solo)析因设计可行性研究。124名对改善饮食行为、增加体力活动或减轻压力感兴趣的志愿者参与了这项研究。研究持续时间为8周。所有小组都是自我指导的，没有来自研究团队的持续的人力投入。电子纸条件下的参与者比移动条件下的参与者有更高的流失率，χ32=9.96，P=0.02(N=124)。在移动条件下的参与者报告说，他们在接近挑战活动完成时间的时候遵守了更高的频率(比较分布的2样本Kolmogorov-Smirnov检验非常显著-KS=0.33，P<；.001[N=63])。与移动条件下的参与者相比，电子纸条件下的参与者在报告时有更高的猜测频率-χ1 2=25.25，P<；.001(N=63)。总而言之，这些发现表明，这款移动应用程序允许使用一种更准确的方法来报告和跟踪更长时间内的健康行为，而不是传统的基于电子纸的日记或日志。Mobile-Solo(平均[SD]0.30[0.39])和Mobile-Team(平均[SD]0.49[0.35])条件下的总体遵从性得分有显著差异(t50.82=1.94，P=0.05)。这表明，在团队中工作提高了参与者在菲特尔内部的总体遵从性。生存分析显示，被分配到团队条件下的参与者比那些被分配到Solo条件下的参与者更有可能更长时间地参与基于mHealth应用程序的干预。总体而言，所有组的参与者都报告了饮食行为、体力活动和压力水平的一些积极变化；然而，Mobile-Solo条件下的参与者在研究结束时报告了更高的感受到的压力水平。基于团队的菲特尔应用程序是一种可接受和可行的健康行为改变干预措施，有必要进行一项完全随机对照试验来调查这种干预措施的有效性。
Novel methods of promoting self-monitoring and social support are needed to ensure long-term maintenance of behavior change. In this paper, we directly investigate the effects of group support in an exercise and nutrition program delivered by an mHealth application called Fittle. Our first specific study aim was to explore whether social support improved adherence in wellness programs. Our second specific study aim was to assess whether media types (ePaper vs mobile) were associated with different levels of compliance and adherence to wellness programs. The third aim was to assess whether the use of an mHealth application led to positive changes to participants’ eating behavior, physical activity, and stress level, compared to traditional paper-based programs. A 2 × 2 (eg, Media: Mobile vs ePaper × Group Type: Team vs Solo) factorial design feasibility study was conducted. A sample of 124 volunteers who were interested in improving eating behavior, increasing physical activity, or reducing stress participated in this study. The study duration was 8 weeks. All groups were self-directed with no ongoing human input from the research team. Participants in ePaper conditions had higher attrition rates compared to participants in Mobile conditions, χ3 2=9.96, P=.02 (N=124). Participants in Mobile conditions reported their compliance with a much higher frequency closer to the time of challenge activity completion (2-sample Kolmogorov-Smirnov test comparing distributions was highly significant—KS=0.33, P<.001 [N=63]). Participants in ePaper conditions had a much higher frequency of guessing while reporting as compared with those in Mobile conditions—χ1 2=25.25, P<.001 (N=63). Together, these findings suggest that the mobile app allowed a more accurate method to report and track health behaviors over a longer period than traditional ePaper-based diaries or log books. There was a significant difference in the overall compliance score for Mobile-Solo (Mean [SD] 0.30 [0.39]) and Mobile-Team (Mean [SD] 0.49 [0.35]) conditions (t 50.82=1.94, P=.05). This suggests that working in a team increased participants’ overall compliance within Fittle. Survival analysis showed that participants assigned to Team conditions are 66% more likely to engage longer with mHealth app-based intervention than those assigned to the Solo condition. Overall, participants across all groups reported some positive changes in eating behavior, physical activity, and stress level; however, participants in the Mobile-Solo condition reported higher perceived stress levels at the end of the study. The team-based Fittle app is an acceptable and feasible wellness behavior change intervention and a full randomized controlled trial to investigate the efficacy of such an intervention is warranted.