Development of Web-Based Computer-Tailored Advice to Promote Physical Activity Among People Older Than 50 Years
Development of Web-Based Computer-Tailored Advice to Promote Physical Activity Among People Older Than 50 Years
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DOI：
10.2196/jmir.1742
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发表时间：
2012-03-01
影响因子：
7.4
通讯作者：
Lechner, Lilian
中科院分区：
文献类型：
--
作者：
Peels, Denise A.;van Stralen, Maartje M.;Lechner, Lilian
背景资料：Active Plus项目是一项系统开发的基于理论和证据的计算机定制干预措施，被发现可以有效改变50岁以上人群的体育活动行为。Active Plus项目第一版的过程和效果结果被转化为使用RE-AIM框架的适应性干预。RE-AIM模型通常用于评估干预措施的潜在公共卫生影响，并区分五个维度：范围，有效性，采用，实施和maintenance.Objective：为了深入了解Active Plus项目的第一个打印版本的系统翻译成适应（基于Web的）后续项目。本研究的重点是达到和有效性的尺寸，因为这些尺寸是最受影响的结果，从原来的Active Plus project.Methods：我们优化了潜在的影响范围和效果的干预措施，通过扩展到一个额外的基于Web的干预交付模式的打印交付的干预。根据过程评价的结果、亚组内的效果分析以及对原始干预措施的工作机制的评价，对干预措施进行了调整。我们预先测试了新的干预材料和基于网络的干预版本。随后，新的干预条件下实施的集群随机对照trial.Results：适应导致四个改进的剪裁干预措施：（1）一个基本的打印交付的干预，（2）一个基本的基于Web的干预，（3）打印交付的干预与额外的环境组件，（4）一个基于Web的版本与额外的环境组件。对参与者的预测试结果表明，所有新的干预材料都具有适度的可用性和相对较高的赞赏度，填写在线问卷和执行在线任务没有问题。我们使用预测试结果来提高不同干预措施的可用性。实施新的干预措施在一个集群随机对照试验表明，印刷交付的干预措施比基于网络的干预措施有更高的响应率。低和高的社会经济地位的参与者都达到了印刷交付和基于网络的interventions.Conclusions：翻译（过程）的有效干预措施的评价适应干预是具有挑战性的，很少报告。我们讨论了从我们的经验中吸取的几个主要教训。
Background: The Active Plus project is a systematically developed theory-and evidence-based, computer-tailored intervention, which was found to be effective in changing physical activity behavior in people aged over 50 years. The process and effect outcomes of the first version of the Active Plus project were translated into an adapted intervention using the RE-AIM framework. The RE-AIM model is often used to evaluate the potential public health impact of an intervention and distinguishes five dimensions: reach, effectiveness, adoption, implementation, and maintenance.Objective: To gain insight into the systematic translation of the first print-delivered version of the Active Plus project into an adapted (Web-based) follow-up project. The focus of this study was on the reach and effectiveness dimensions, since these dimensions are most influenced by the results from the original Active Plus project.Methods: We optimized the potential reach and effect of the interventions by extending the delivery mode of the print-delivered intervention into an additional Web-based intervention. The interventions were adapted based on results of the process evaluation, analyses of effects within subgroups, and evaluation of the working mechanisms of the original intervention. We pretested the new intervention materials and the Web-based versions of the interventions. Subsequently, the new intervention conditions were implemented in a clustered randomized controlled trial.Results: Adaptations resulted in four improved tailoring interventions: (1) a basic print-delivered intervention, (2) a basic Web-based intervention, (3) a print-delivered intervention with an additional environmental component, and (4) a Web-based version with an additional environmental component. Pretest results with participants showed that all new intervention materials had modest usability and relatively high appreciation, and that filling in an online questionnaire and performing the online tasks was not problematic. We used the pretest results to improve the usability of the different interventions. Implementation of the new interventions in a clustered randomized controlled trial showed that the print-delivered interventions had a higher response rate than the Web-based interventions. Participants of both low and high socioeconomic status were reached by both print-delivered and Web-based interventions.Conclusions: Translation of the (process) evaluation of an effective intervention into an adapted intervention is challenging and rarely reported. We discuss several major lessons learned from our experience.