Effect and process evaluation of a smartphone app to promote an active lifestyle in lower educated working young adults: cluster randomized controlled trial

Simons, Dorien and De Bourdeaudhuij, Ilse and Clarys, Peter and De Cocker, Katrien and Vandelanotte, Corneel and Deforche, Benedicte (2018) Effect and process evaluation of a smartphone app to promote an active lifestyle in lower educated working young adults: cluster randomized controlled trial. JMIR MHealth and UHealth, 6 (8):e10003. pp. 1-18.

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BACKGROUND: Mobile technologies have great potential to promote an active lifestyle in lower educated working young adults, an underresearched target group at a high risk of low activity levels.

OBJECTIVE: The objective of our study was to examine the effect and process evaluation of the newly developed evidence- and theory-based smartphone app 'Active Coach' on the objectively measured total daily physical activity; self-reported, context-specific physical activity; and self-reported psychosocial variables among lower educated working young adults.

METHODS: We recruited 130 lower educated working young adults in this 2-group cluster randomized controlled trial and assessed outcomes at baseline, posttest (baseline+9 weeks), and follow-up (posttest+3 months). Intervention participants (n=60) used the Active Coach app (for 9 weeks) combined with a Fitbit activity tracker. Personal goals, practical tips, and educational facts were provided to encourage physical activity. The control group received print-based generic physical activity information. Both groups wore accelerometers for objective measurement of physical activity, and individual interviews were conducted to assess the psychosocial variables and context-specific physical activity. Furthermore, intervention participants were asked process evaluation questions and generalized linear mixed models and descriptive statistics were applied.

RESULTS: No significant intervention effects were found for objectively measured physical activity, self-reported physical activity, and self-reported psychosocial variables (all P>.05). Intervention participants evaluated the Active Coach app and the combined use with the Fitbit wearable as self-explanatory (36/51, 70.6%), user friendly (40/51, 78.4%), and interesting (34/51, 66.7%). Throughout the intervention, we observed a decrease in the frequency of viewing graphical displays in the app (P<.001); reading the tips, facts, and goals (P<.05); and wearing the Fitbit wearable (P<.001). Few intervention participants found the tips and facts motivating (10/41, 24.4%), used them to be physically active (8/41, 19.6%), and thought they were tailored to their lifestyle (7/41, 17.1%).

CONCLUSIONS: The lack of significant intervention effects might be due to low continuous user engagement. Advice or feedback that was not perceived as adequately tailored and the difficulty to compete with many popular commercial apps on young people's smartphones may be responsible for a decrease in the engagement. A stand-alone app does not seem sufficient to promote an active lifestyle among lower educated working young adults; therefore, multicomponent interventions (using both technological and human support), as well as context-specific sensing to provide tailored advice, might be needed in this population.

TRIAL REGISTRATION: ClinicalTrials.gov NCT02948803; https://clinicaltrials.gov/ct2/show/results/NCT02948803 (Archived by WebCite at http://www.webcitation.org/71OPFwaoA).

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: ©Dorien Simons, Ilse De Bourdeaudhuij, Peter Clarys, Katrien De Cocker, Corneel Vandelanotte, Benedicte Deforche. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 24.08.2018.
Faculty/School / Institute/Centre: No Faculty
Faculty/School / Institute/Centre: No Faculty
Date Deposited: 11 Oct 2019 04:32
Last Modified: 01 Jun 2021 00:16
Uncontrolled Keywords: Fitbit; accelerometers; active transport; emerging adulthood; health promotion; mHealth; mobile apps; mobile phone; physical activity intervention
Fields of Research (2008): 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111799 Public Health and Health Services not elsewhere classified
11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Fields of Research (2020): 42 HEALTH SCIENCES > 4299 Other health sciences > 429999 Other health sciences not elsewhere classified
42 HEALTH SCIENCES > 4207 Sports science and exercise > 420799 Sports science and exercise not elsewhere classified
Identification Number or DOI: https://doi.org/10.2196/10003
URI: http://eprints.usq.edu.au/id/eprint/37062

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