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

项目总结 体力活动(PA)有许多好处，包括降低慢性病和认知疾病的风险 损害，改善精神健康和福祉，并延长寿命。然而，当测量时， 客观地说，只有5%的成年人达到了推荐的每周150分钟的PA指南。许多干预措施都有 已被开发用于在不够活跃的成年人中增加PA，但其影响并不大，许多人 在干预完成后，回到不活跃的生活方式。生命的意义，生命重要的感觉， 有道理，有目的，已经被证明是PA的一个强有力的预测因素。到目前为止，没有PA干预 深思熟虑地将生活的意义融入其中。基于意义的方法与自我一致 决定论(SDT)，关于人类动机和行为的理论。这个项目的总体目标是 系统地将生活意义和SDT原则纳入基于网络和文本消息的干预 (有意义的活动计划[“MAP to Health”])在中年活动不足的成年人中增加PA。 该项目将使用行为改变原理的科学和肥胖相关的行为干预 试验(轨道)框架，以进行MAP to Health的IIa阶段概念验证试点研究。这项研究已经 两个目标：(1)制定和审查技术和理论框架的可接受性 MAP to Health和(2)确定MAP to Health在理论上是否与 确定的行为改变机制(意义突显、基本心理需求满足、 和内部动机)。在探索性目标中，我们将评估如何干预和机制 变化与PA中的变化有关。参与者将是中年成年人(40岁-)，他们不够 积极，对增加PA感兴趣，没有从事PA的禁忌症，以及患者 美国中西部的大型医疗系统。在第一阶段，我们将开发基于Web的Health Online地图 访谈将被用来探索什么对参与者特别有意义，PA如何与 这些目标，以及患者计划参与的活动。参与者(N=12)将完成面试并 对干预措施的易用性、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周的预试监控期和为期8周的干预试点试验，评估 测试前(-4周)、基线(0周)、中点(4周)和 后测(8周)。此外，参与者将在12周内佩戴加速计来评估PA。如果 假设得到支持，我们将进行第三阶段疗效试验，将MAP与Health和PA提醒进行比较 短信干预。《健康地图》旨在吸引人并吸引人，以实现成果，但 节省资源以实现可伸缩性，并有可能改善 数以千计不够活跃的中年成年人。

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.