Applying Mobile-Persuasive Technologies to Increase Physical Activity in Women

描述（由申请人提供）：在美国，只有不到一半的成年女性参与推荐的身体活动水平。因此，他们患心脏病、中风、高血压、糖尿病、某些癌症和过早死亡的风险增加。鉴于移动电话技术的快速发展和用户数量的增加，我们为久坐不动的女性开发了一种基于手机的互动体育活动干预（基于美国心脏协会为久坐不动的女性开发的“选择运动”计划）。我们在一项为期3周的研究中评估了该干预措施的可行性和可接受性。在这项研究中，我们有快速入组、无损耗、高依从性（95%的依从性使用计步器，85%的依从性使用手机日记）和显著增加的步数。我们现在建议进行一项随机对照试验，以评估基于手机的体育活动干预在3个月期间增加体育活动的功效。192名久坐不动的女性将以2比1的比例随机分为三个月的手机运动干预组和对照组。两组参与者都将收到一个计步器和一个手机，并被要求佩戴计步器，并在每晚睡觉前通过手机日记发送他们的总步数。只有干预组的参与者才能通过他们的手机通过每日提示、每周视频剪辑、定制反馈和自我监控来接收“选择运动”项目。主要结果将是每天的总步数（由计步器测量）。次要结果将是每天的有氧步数（也由计步器测量）和自我报告的7天身体活动回忆。为了深入了解如何在完成3个月的项目后最大限度地发挥持续体育活动的潜力，干预组中完成体育活动项目的女性将进一步随机分为6个月的维持干预+项目（计步器加手机日记）或6个月的维持干预-常规项目（仅计步器）。与传统的维持随访不同，所有受试者继续在各自的随机分组中，将受试者重新随机分为维持干预-常规组或维持干预-额外组，如果干预有效，我们可以检查维持方法的“剂量反应”。我们还将探讨潜在的中介因素（身体活动、自我效能、社会支持、结果预期和决策平衡）和调节因素（BMI和年龄）在身体活动变化中的作用。如果被证明是有效的，基于手机的干预的一个主要优势是它可以潜在地应用于大量妇女。公共卫生相关性：86%的美国成年人使用移动电话。评估移动说服技术至关重要，因为它可以很容易地应用于大量久坐不动的女性。

DESCRIPTION (provided by applicant): Fewer than half of adult women in the US engage in recommended levels of physical activity. As a consequence, they are at increased risk of heart disease, stroke, hypertension, diabetes, certain cancers, and premature mortality. Given the rapid growth of mobile phone technology and the increasing number of users, we developed an interactive mobile phone-based physical activity intervention for sedentary women (based on the Choose to Move program developed by the American Heart Association for sedentary women). We assessed the feasibility and acceptability of this intervention in a 3-week pre-post study in which we had rapid enrollment, no attrition, high compliance (95% compliance with a pedometer and 85% compliance with a cell phone diary), and a significantly increased step count. We now propose to conduct a randomized, controlled trial to assess the efficacy of the mobile phone-based physical activity intervention on increasing physical activity over a 3-month period. 192 sedentary women will be randomized in a 2-to-1 ratio to a 3-month mobile phone-based physical activity intervention group or to a control group. Participants in both groups will receive a pedometer and a mobile phone and will asked to wear a pedometer and to send their total number of steps through a cell phone diary before going to bed each night. Only participants in the intervention group will receive the Choose to Move program through their cell phones via daily prompts, weekly video clips, and customized feedback and self-monitoring. The primary outcome will be total steps per day (as measured by the pedometer). Secondary outcomes will be the aerobic steps per day (also measured by the pedometer) and self-reported 7-day physical activity recall. To provide insight into how best to maximize the potential for sustained physical activity after completion of the 3-month program, women in the intervention group who complete the physical activity program will be further randomized into a 6-month maintenance intervention-PLUS program (pedometer plus cell phone diary) or to a 6-month maintenance intervention-REGULAR program (pedometer only). Unlike a conventional maintenance follow-up in which all subjects continue in their respective randomization arms, re-randomizing subjects into either a maintenance intervention-REGULAR group or a maintenance intervention-PLUS group will allow us to examine the "dose-response" of the maintenance methods if the intervention is effective. We will also explore the role of potential mediating factors (physical activity, self-efficacy, social support, outcome expectation, and decisional balance) and moderating factors (BMI and age) on changes in physical activity. If proven effective, a major advantage of a mobile phone-based intervention is that it could potentially be administered to a large number of women. Public health relevance: 86% of US adults use mobile phones. Evaluating mobile persuasive technologies is critical because it could be easily administered to large number of sedentary women. PUBLIC HEALTH RELEVANCE: Despite the health benefits of regular physical activity, more than half of adult women in the United States do not engage in recommended levels of physical activity. To reach a larger population of sedentary women, we will apply cell phone technologies as a means to deliver a physical activity program, and to motivate participants, so that their physical activity goals can be achieved.