Development and Proof-of-Concept Trial of a Meaning and Theory-Based Physical Activity Intervention

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PROJECT SUMMARY Physical activity (PA) has numerous benefits, including reduced risk for chronic disease and cognitive impairment, improved mental health and well-being, and increased longevity. However, when measured objectively, only 5% of adults meet recommended PA guidelines of 150 min/week. Many interventions have been developed to increase PA among insufficiently active adults, yet the effects are modest, and many people return to inactive lifestyles after the intervention is completed. Meaning in life, the sense that one’s life matters, makes sense, and has purpose, has been shown to be a robust predictor of PA. To date, no PA interventions have thoughtfully incorporated meaning in life. A meaning-based approach is consistent with Self- Determination Theory (SDT), a theory of human motivation and behavior. The overall goal of this project is to systematically incorporate meaning in life and SDT principles into a web-based and text message intervention (Meaningful Activity Program [“MAP to Health”]) to increase PA among insufficiently active adults in midlife. The project will use Science of Behavior Change principles and the Obesity-Related Behavioral Intervention Trials (ORBIT) framework to conduct a Phase IIa proof-of-concept pilot study of MAP to Health. The study has two aims: (1) to develop and examine the acceptability of the technological and theoretical frameworks of MAP to Health and (2) to determine whether MAP to Health is related to changes in theoretically identified mechanisms of behavior change (meaning salience, basic psychological needs satisfaction, and internal motivation). In an exploratory aim, we will assess how the intervention and mechanisms of change are related to changes in PA. Participants will be adults in midlife (ages 40-64) who are insufficiently active, are interested in increasing PA, do not have contraindications to engaging in PA, and are patients in a large healthcare system in the Midwest. In Phase 1, we will develop the MAP to Health online web-based interview that will be used to explore what is particularly meaningful to participants, how PA is consistent with those goals, and what activities patients plan to engage in. Participants (N=12) will complete the interview and rate the ease of use, usefulness, intention to use, and theoretical fidelity of the intervention. In Phase 2, we will conduct a proof-of-concept pilot trial using a double-pretest single group design. Participants (N=35) will complete a 4-week pretest monitoring period and an 8-week pilot trial of the intervention, with assessments of SDT mechanisms and meaning salience at pretest (-4 weeks), baseline (0 weeks), midpoint (4 weeks) and posttest (8 weeks). In addition, participants will wear accelerometers to assess PA during the 12 weeks. If the hypotheses are supported, we will pursue a Stage III efficacy trial comparing MAP to Health to a PA reminder text message intervention. MAP to Health is designed to be compelling and engaging to achieve results, yet resource-sparing to achieve scalability, and has the potential to improve the health and well-being of thousands of insufficiently active middle-aged adults.