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

项目摘要 体力活动（PA）有许多好处，包括降低慢性疾病和认知障碍的风险。 改善心理健康和福祉，并延长寿命。然而，当测量 客观地说，只有5%的成年人符合推荐的PA指南150分钟/周。许多干预措施 已经开发了增加PA在不够活跃的成年人，但效果是温和的，许多人 在干预结束后恢复不活动的生活方式。生命的意义，一个人生命的意义， 有意义，有目的，已被证明是PA的可靠预测因子。迄今为止，没有巴勒斯坦权力机构的干预 已经深思熟虑地将意义融入了生活。一个基于意义的方法是一致的自我- 决定理论（Determination Theory，SDT）是一种关于人类动机和行为的理论。该项目的总体目标是 系统地将生命的意义和特殊和差别待遇原则纳入基于网络和短信的干预措施 （有意义的活动计划[“MAP to Health”]），以增加中年活动不足的成年人的PA。 该项目将使用行为改变科学原则和肥胖相关行为干预 试验（ORBIT）框架，以进行MAP to Health的IIa期概念验证试点研究。该研究 两个目标：（1）发展和审查技术和理论框架的可接受性 （2）确定MAP对健康的影响是否与理论上的 确定的行为改变机制（即显著性，基本心理需求满足， 内部动机）。在一个探索性的目标，我们将评估如何干预和机制， 变化与PA的变化有关。参与者将是中年（40-64岁）的成年人， 活跃，对增加PA感兴趣，没有从事PA的禁忌症，并且是 中西部的大型医疗保健系统。在第一阶段，我们将开发基于网络的在线健康地图， 访谈将用于探讨什么是特别有意义的参与者，PA是如何符合 这些目标，以及患者计划参与的活动。参与者（N=12）将完成访谈， 对干预的易用性、有用性、使用意图和理论保真度进行评级。在第二阶段，我们将 使用双预测试单组设计进行概念验证试点试验。参与者（N=35）将 完成为期4周的预测试监测期和为期8周的干预试点试验，评估 预测（-4周）、基线（0周）、中点（4周）和 后测（8周）。此外，参与者将在12周内佩戴加速计以评估PA。如果 假设得到支持，我们将进行III期疗效试验，比较MAP对健康和PA提醒 短信干预。MAP to Health旨在实现令人信服和参与的结果，但 节约资源，以实现可扩展性，并有可能改善健康和福祉的 数以千计的不太活跃的中年人。

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.