Increasing Physical Activity Efficiently: An Experimental Pilot Study of a Website and Mobile Phone Intervention Impact of Educational Level on Study Attrition and Evaluation of Web-Based Computer-Tailored Interventions: Results From Seven Randomized Controlled Trials Intervention-mediated effects for adult physical activity: A latent growth curve analysis. Self-monitoring of Physical Activity Effectiveness of a Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Intervention for Adults: A Cluster Randomized Controlled Trial Long term effects of self-determination theory and motivational interviewing in a web-based physical activity intervention: randomized controlled trial Effectiveness of an online computer-tailored physical activity intervention in a real-life setting. Feasibility and Effectiveness of Online Physical Activity Advice Based on a Personal Activity Monitor: Randomized Controlled Trial Using Online Computer Tailoring to Promote Physical Activity: A Randomized Trial of Text, Video, and Combined Intervention Delivery Modes The long-term efficacy of two computer-tailored physical activity interventions for older adults: main effects and mediators. A Web-Based, Social Networking Physical Activity Intervention for Insufficiently Active Adults Delivered via Facebook App: Randomized Controlled Trial Long-term efficacy of a printed or a Web-based tailored physical activity intervention among older adults Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Advice: Development, Dissemination Through General Practice, Acceptability, and Preliminary Efficacy in a Randomized Controlled Trial Evaluation of a website-delivered computer-tailored intervention for increasing physical activity in the general population. Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women. Randomized controlled trial testing an internet physical activity intervention for sedentary adults. A tailored Internet-plus-email intervention for increasing physical activity among ethnically-diverse women. Do Participants’ Preferences for Mode of Delivery (Text, Video, or Both) Influence the Effectiveness of a Web-Based Physical Activity Intervention? Effect of a Web-Based Intervention to Promote Physical Activity and Improve Health Among Physically Inactive Adults: A Population-Based Randomized Controlled Trial A social media-based physical activity intervention: a randomized controlled trial.
The main objective of this pilot study was to test the effectiveness of an  online , interactive physical activity intervention that also incorporated gaming components . The intervention design included an activity planner , progress monitoring , and gamification components and used SMS text as a secondary delivery channel and feedback to improve engagement in the intervention content . Healthy adults ( n = 21 ) recruited through ads in local newspapers ( age 35–73 ) were r and omized to the intervention or the control condition . Both groups reported physical activity using daily report forms in four registration weeks during the three-month study : only the experiment condition received access to the intervention . Analyses showed that the intervention group had significantly more minutes of physical activity in weeks five and nine . We also found a difference in the intensity of exercise in week five . Although the intervention group reported more minutes of physical activity at higher intensity levels , we were not able to find a significant effect at the end of the study period . In conclusion , this study adds to the research on the effectiveness of using the Internet and SMS text messages for delivering physical activity interventions and supports gamification as a viable intervention tool Background Web-based computer-tailored interventions have shown to be effective in improving health behavior ; however , high dropout attrition is a major issue in these interventions . Objective The aim of this study is to assess whether people with a lower educational level drop out from studies more frequently compared to people with a higher educational level and to what extent this depends on evaluation of these interventions . Methods Data from 7 r and omized controlled trials of Web-based computer-tailored interventions were used to investigate dropout rates among participants with different educational levels . To be able to compare higher and lower educated participants , intervention evaluation was assessed by pooling data from these studies . Logistic regression analysis was used to assess whether intervention evaluation predicted dropout at follow-up measurements . Results In 3 studies , we found a higher study dropout attrition rate among participants with a lower educational level , whereas in 2 studies we found that middle educated participants had a higher dropout attrition rate compared to highly educated participants . In 4 studies , no such significant difference was found . Three of 7 studies showed that participants with a lower or middle educational level evaluated the interventions significantly better than highly educated participants ( “ Alcohol-Everything within the Limit ” : F 2,376=5.97 , P=.003 ; “ My Healthy Behavior ” : F 2,359=5.52 , P=.004 ; “ Master Your Breath ” : F 2,317=3.17 , P=.04 ) . One study found lower intervention evaluation by lower educated participants compared to participants with a middle educational level ( “ Weight in Balance ” : F 2,37=3.17 , P=.05 ) . Low evaluation of the interventions was not a significant predictor of dropout at a later follow-up measurement in any of the studies . Conclusions Dropout attrition rates were higher among participants with a lower or middle educational level compared with highly educated participants . Although lower educated participants evaluated the interventions better in approximately half of the studies , evaluation did not predict dropout attrition . Further research is needed to find other explanations for high dropout rates among lower educated participants Data from two r and omized clinical trials ( RCT ) were used to examine the extent to which a health promotion intervention affected changes in growth trajectories of psychosocial constructs and if so , whether these constructs in turn explained changes in  physical activity ( PA ) . PA and psychosocial measures on 842 overweight adults in the United States were collected in two RCTs evaluating Internet-based behavior change interventions with assessment s at baseline , 6 and 12 months . A physical activity latent variable at 12 months was created using indicators of self-reported walking and leisure time activities . Intervention-mediated effects on  PA  at 12 months were found via latent growth curves representing self-efficacy and behavioral strategies , where increasing growth curves across time were associated with higher  PA values at 12 months . These findings provide some evidence that web-based self-help intervention programs worked through targeted behavior change constructs to influence physical activity levels in overweight adults Purpose : The purpose of this study was to test the effect of keeping daily activity records on physical activity levels and self-efficacy for physical activity in adults with type 2 diabetes , and to examine the feasibility and acceptability of this intervention from the perspective of the participants . Methods : This intervention study included 58 individuals with type 2 diabetes aged 40 to 65 years . Participants were r and omly assigned : individuals in the intervention group kept daily activity records for 6 weeks , mailed to the research er every 2 weeks . Data collection was completed at the beginning of the study and 6 weeks later , using the habitual physical activity index and the self-efficacy for exercise scale . Participants in the intervention group also completed the perceived feasibility checklist . Results : The intervention result ed in enhanced self-efficacy . Physical activity improved in both the intervention and control groups . Activity recording was judged to be acceptable and feasible . Conclusions : Daily activity recording can be used as part of a program to increase physical activity self-efficacy levels . Focused interactions between health care providers and patients may be enough to motivate people to higher levels of physical activity . The relationship between self-efficacy and behavior is complex and should be the subject of further research Background Computer-tailored physical activity ( PA ) interventions delivered through the Internet represent a promising and appealing method to promote PA at a population level . However , personalized advice is mostly provided based on subjectively measured PA , which is not very accurate and might result in the delivery of advice that is not credible or effective . Therefore , an innovative computer-tailored PA advice was developed , based on objective ly pedometer-measured PA . Objective The study aim was to evaluate the effectiveness of a computer-tailored , pedometer-based PA intervention in working adults . Methods Participants ( ≥18 years ) were recruited between May and December 2012 from eight Flemish workplaces . These workplaces were allocated r and omly to an intervention or control group . Intervention group participants ( n=137 ) received ( 1 ) a booklet with information on how to increase their steps , ( 2 ) a non-blinded pedometer , and ( 3 ) an Internet link to request computer-tailored step advice . Control group participants ( n=137 ) did not receive any of the intervention components . Self-reported and pedometer-based PA  were assessed at baseline ( T0 ) , and 1 month ( T1 ) and 3 months ( T2 ) months post baseline . Repeated measures analyses of covariance were used to examine intervention effects for both the total sample and the at-risk sample ( ie , adults not reaching 10,000 steps a day at baseline ) . Results The recruitment process result ed in 274 respondents ( response rate of 15.1 % ) who agreed to participate , of whom 190 ( 69.3 % ) belonged to the at-risk sample . Between T0 and T1 ( 1-month post baseline ) , significant intervention effects were found for participants ’ daily step counts in both the total sample ( P=.004 ) and the at-risk sample ( P=.001 ) . In the at-risk sample , the intervention effects showed a daily step count increase of 1056 steps in the intervention group , compared to a decrease of 258 steps in the control group . Comparison of participants ’ self-reported PA revealed a significant intervention effect for time spent walking in the at-risk sample ( P=.02 ) . Intervention effects were still significant 3 months post baseline for participants ’ daily step counts in both the total sample ( P=.03 ) and the at-risk sample ( P=.02 ) ; however , self-reported PA differences were no longer significant . Conclusions A computer-tailored , pedometer-based PA intervention was effective in increasing both pedometer-based and self-reported PA levels , mainly in the at-risk participants . However , more effort should be devoted to recruit and retain participants in order to improve the public health impact of the intervention . Trial Registration Clinical Trials.gov : NCT02080585 ; https:// clinical trials.gov/ct2/show/NCT02080585 ( Archived by WebCite at http://www.webcitation.org/6VvQnRQSy ) Background Our main objective in the current study was to evaluate the long-term effectiveness ( 12 months from baseline ) of I Move ( a web-based computer tailored physical activity intervention , based on self-determination theory and motivational interviewing ) . To this end , we compared I Move to a web-based computer tailored physical activity intervention based on traditional health behavior theories ( Active Plus ) , and to a no-intervention control group . As a secondary objective , the present study aim ed to identify participant characteristics that moderate the long term effects of I Move and Active Plus . Methods A r and omized controlled trial was conducted , comparing three research conditions : 1 ) the I Move condition  ,  participants in this condition received I Move ;  2 ) the Active Plus condition  , participants in this condition received Active Plus ; 3 ) the control condition ; participants in  this condition received no intervention and were placed on a waiting list . Main outcome measures were weekly minutes of moderate to vigorous physical activity and weekly days with minimal 30 min of physical activity . All measurements were taken by web-based question naires via the study website . Intervention effects were analyzed using multilevel linear regression analyses . Results At 12 months from baseline , I Move was found to be effective in increasing weekly minutes of moderate to vigorous physical activity ( ES = .13 ) , while Active Plus was not . In contrast , Active Plus was found to be effective in increasing weekly days with ≥ 30 min PA at 12 months ( ES = .11 ) , while I Move was not . No moderators of the effects of I Move were found . Conclusions The results suggest that web-based computer tailored physical activity interventions might best include elements based on both self-determination theory/motivational interviewing and traditional health behavioral theories . To be more precise , it is arguable that the focus of the theoretical foundations , used in new web-based PA interventions should depend on the intended program outcome . In order to draw firm conclusions , however , more research on the effects of self-determination theory and motivational interviewing in web-based physical activity promotion is needed . Trial registration Dutch Trial Register The aim of this study was to evaluate the effectiveness of a computer-tailored physical activity intervention delivered through the Internet in a real-life setting . Healthy adults ( n=526 ) , recruited in six worksites , between 25 and 55 years of age were r and omized to one of three conditions receiving , respectively , ( i ) online-tailored physical activity advice + stage-based reinforcement e-mails , ( ii ) online-tailored physical activity advice only , ( iii ) online non-tailored st and ard physical activity advice . At 6-month follow-up , no differences in physical activity between study conditions were found ; total physical activity , physical activity at moderate intensity and physical activity in leisure time significantly increased in all study conditions between baseline and follow-up . Further evaluation of the intervention material s showed that the tailored advice was more read , printed and discussed with others than the st and ard advice . Most of the respondents in the e-mail group indicated to be satisfied about the number , frequency and usefulness of the stage-based e-mails . In conclusion , although tailored advice was appreciated more than st and ard advice , no evidence was found that an online-tailored physical activity intervention program outperformed online st and ard information Background Inactive people are often not aware of the fact that they are insufficiently active . Providing insight into their actual physical activity ( PA ) levels may raise awareness and could , in combination with tailored PA advice , stimulate a physically active lifestyle . Objective This study evaluated the feasibility and effectiveness of a 3-month intervention in which Dutch office workers were provided with a personal activity monitor ( PAM ) coupled to simple and concise Web-based tailored PA advice ( PAM COACH ) . Method Participants were r and omly assigned to the 3-month PAM intervention ( n = 51 ) or received a single written information brochure with brief general PA recommendations ( n = 51 ) . Study outcome measures were changes in PA ( recall of minutes per week spent on PA , as measured by the Activity Question naire for Adolescents and Adults ) , determinants of PA , aerobic fitness , and body composition . Follow-up measurements were performed immediately after the 3-month intervention and at 8-months , 5 months after the end of the 3-month intervention period . Results A total of 102 workers , 23 to 39 years old , completed the baseline measurement at the worksite . 48 completed the 3-month follow up and 38 the 8-month follow-up in the intervention group , 50 completed the 3-month follow up and 42 the 8-month follow up in the control group . 35 out of 48 ( 73 % ) participants in the PAM intervention group reported wearing the PAM regularly , and the PAM COACH was used almost once a week ; 24 out of 46 ( 52 % ) PAM users set a personal goal , and 33 ( 72 % ) entered their favorite activities on the website . Main reasons for not using these items were lack of interest or not being able to find the item on the website . The majority of PAM users ( 34 out of 46 , 74 % ) read the advice , of whom 14 ( 39 % ) found it unappealing . After the 3-month intervention , no significant intervention effect was observed ( adjusted difference in min/week ) for sedentary behavior ( β = 10 , 95 % CI = −435 to 455 ) , light-intensity PA ( β = −129 , 95 % CI = −337 to 79 ) , moderate-intensity PA ( β = −13 , 95 % CI = −89 to 63 ) , vigorous-intensity PA ( β= −6 , 95 % CI = −75 to 62 ) , and moderate- to vigorous-intensity PA ( β = −23 , 95 % CI = −121 to 76 ) . No significant intervention effect was observed in the PA outcomes at the 8-month follow-up . For the determinants of PA , aerobic fitness , and body composition , no statistically significant intervention effect was observed in the total study population immediately after the 3-month intervention or the 8-month follow-up . Conclusions The intervention appeared to be easily applicable to real-life setting s. The intervention was ineffective in improving PA behavior or its determinants in healthy office workers . More attention should have been given to the quality and appropriateness of the tailored advice . Trial Registration International St and ard R and omized Controlled Trial Number ( IS RCT N ) : 93896459 ; http://www.controlled-trials.com/IS RCT N93896459/ ( Archived by WebCite at http://www.webcitation.org/5iR3mf7ex Website-delivered interventions are increasingly used to deliver physical activity interventions , yet problems with engagement and retention result in reduced effectiveness . Hence , alternative modes of online intervention delivery need to be explored . Therefore , this study aim ed to evaluate the acceptability and effectiveness of a computer-tailored physical activity intervention delivered on the Internet in 3 delivery modes : video , text , or both .  Australian adults ( N = 803 ) , recruited through e-mail , were r and omized into the three delivery modes and received personal physical activity advice . Intervention content was identical across groups . Repeated measures analyses of variance were used to compare the three groups regarding acceptability , website usability , and physical activity . Participants in the video group accepted the content of the physical activity advice significantly better ( F = 5.59 ; p < .01 ) , and spent significantly more time on the website ( F = 21.19 ; p < .001 ) compared with the text and combination groups . Total physical activity improved significantly over time in all groups ( F = 3.95 ; p < .01 ) . Although the combination group increased physical activity the most , few significant differences between groups were observed . Providing video-tailored feedback has advantages over the conventional text-tailored interventions ; however , this study revealed few behavioral differences . More studies , examining alternative delivery modes , that can overcome the limitations of the present study , are needed OBJECTIVE Low-cost ( e.g. , computer-tailored ) interventions with sustained effects are needed to increase and maintain physical activity in older adults . This study examined the long-term efficacy of 2 computer-tailored physical activity interventions  for older adults and its psychosocial and environmental mediators . METHODS A clustered r and omized controlled trial ( N = 1,971 ) was conducted that included 3 research arms : ( a ) basic computer-tailored print intervention , targeting psychosocial mediators ; ( b ) environmentally computer-tailored print intervention , targeting psychosocial and environmental mediators ; and ( c ) no-intervention control group . Interventions were developed using the intervention mapping approach and consisted of 3 computer-tailored letters delivered over 4 months . Question naires assessed the study outcomes ( i.e. , total weekly days and total weekly minutes of physical activity ) at baseline and 12 months . Potential mediators ( i.e. , awareness , attitude , self-efficacy , intention , social influence , intrinsic motivation , self-regulation , and perceived environment ) were assessed at baseline and at 3 or 6 months . RESULTS Multilevel regression analyses revealed that both interventions significantly changed total weekly days of physical activity compared with the control group , but only the environmentally computer-tailored print intervention significantly changed weekly minutes of physical activity . Multiple mediation models showed that the effects of both interventions on weekly days of physical activity were mediated by changes in awareness and intention . CONCLUSIONS Computer-tailored interventions were effective in inducing long-term behavioral changes in physical activity behavior  of older adults . Awareness and intention were found to be important mediators of changing daily physical activity and should be included in future computer-tailored intervention studies Background Online social networks offer considerable potential for delivery of socially influential health behavior change interventions . Objective To determine the efficacy , engagement , and feasibility of an online social networking physical activity intervention with pedometers delivered via Facebook app . Methods A total of 110 adults with a mean age of 35.6 years ( SD 12.4 ) were recruited online in teams of 3 to 8 friends . Teams were r and omly allocated to receive access to a 50-day online social networking physical activity intervention which included self-monitoring , social elements , and pedometers ( “ Active Team ” Facebook app ; n=51 individuals , 12 teams ) or a wait-listed control condition ( n=59 individuals , 13 teams ) . Assessment s were undertaken online at baseline , 8 weeks , and 20 weeks . The primary outcome measure was self-reported weekly moderate-to-vigorous physical activity ( MVPA ) . Secondary outcomes were weekly walking , vigorous physical activity time , moderate physical activity time , overall quality of life , and mental health quality of life . Analyses were undertaken using r and om-effects mixed modeling , accounting for potential clustering at the team level . Usage statistics were reported descriptively to determine engagement and feasibility . Results At the 8-week follow-up , the intervention participants had significantly increased their total weekly MVPA by 135 minutes relative to the control group ( P=.03 ) , due primarily to increases in walking time ( 155 min/week increase relative to controls , P<.001 ) . However , statistical differences between groups for total weekly MVPA and walking time were lost at the 20-week follow-up . There were no significant changes in vigorous physical activity , nor overall quality of life or mental health quality of life at either time point . High levels of engagement with the intervention , and particularly the self-monitoring features , were observed . Conclusions An online , social networking physical activity intervention with pedometers can produce sizable short-term physical activity changes . Future work is needed to determine how to maintain behavior change in the longer term , how to reach at-need population s , and how to disseminate such interventions on a mass scale . Trial Registration Australian New Zeal and Clinical Trials Registry ( ANZCTR ) : ACTRN12614000488606 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?id=366239 ( Archived by WebCite at http://www.webcitation.org/6ZVtu6TMz ) Background This study provides insight into the long-term efficacy ( i.e. 12 month results ) of the Web-based or print-delivered tailored Active Plus intervention ( with and without environmental approach ) to promote physical activity ( PA ) among the over-fifties . Differences in effect among subgroups are studied as well . Methods Intervention groups ( i.e. print-delivered basic ( PB ; N = 439 ) , print-delivered environmental ( PE ; N = 435 ) , Web-based basic ( WB ; N = 423 ) , Web-based environmental ( WE ; N = 432 ) ) and a waiting list control group ( N = 411 ) were studied in a clustered r and omized controlled trial . Intervention participants received tailored advice three times within 4 months . Long-term effects ( 12 months after the intervention has started , i.e. 8 months after the intervention was completed ) on PA ( i.e. self-reported weekly minutes and days of sufficient PA ) were tested using multilevel linear regression analyses . Participants ’ age , gender , BMI , educational level , PA intention and the presence of a chronic physical limitation were considered to be potential moderators of the effect . Results Overall , the Active Plus intervention was effective in increasing weekly days of sufficient PA ( B=0.49 ; p=.005 ) , but ineffective in increasing weekly minutes of PA ( B=84.59 ; p=.071 ) . Per intervention condition analysis showed that the PB-intervention ( Bdays=0.64 ; p=.002 ; Bmi n=111.36 ; p=.017 ) and the PE-intervention ( Bdays=0.70 ; p=.001 ; Bmi n=157.41 ; p=.001 ) were effective in increasing days and minutes of PA . Neither Web-based conditions significantly increased PA , while the control group decreased their PA . In contrast to the intervention effect on minutes of PA , the effect on weekly days of PA was significantly moderated by the participants ’ baseline intention to be sufficiently physically active . Conclusions In general , after 12 months the print-delivered interventions result ed in stronger effects than the Web-based interventions . The participants ’ baseline intention was the only significant moderator of the intervention effect . All other assessed user characteristics did not significantly moderate the effect of the intervention , which might indicate that the intervention is sufficiently tailored to the different participant characteristics . Additional efforts should be taken to increase the sustainability of Web-based interventions .Trial registration Dutch Trial Register : NTR2297 Background Computer tailoring is a relatively innovative and promising physical activity intervention approach . However , few  computer-tailored physical activity interventions in adults have provided feedback based on pedometer use . Objectives To ( 1 ) describe the development of a Web-based , pedometer-based , computer-tailored step advice intervention , ( 2 ) report on the dissemination of this tool through general practice , ( 3 ) report on its perceived acceptability , and ( 4 ) evaluate the preliminary efficacy of this tool in comparison with a st and ard intervention . Methods We recruited 92 participants through general practitioners and r and omly assigned them to a st and ard condition ( receiving a pedometer-only intervention , n = 47 ) and a tailored condition ( receiving a pedometer plus newly developed , automated , computer-tailored step advice intervention , n = 45 ) . Step counts , self-reported data obtained via telephone interview on physical activity , time spent sitting , and body mass index were assessed at baseline and postintervention . The present sample was mostly female ( 54/92 , 59 % ) , highly educated ( 59/92 , 64 % ) , employed ( 65/92 , 71 % ) , and in good health ( 62/92 , 67 % ) . Results Recruitment through general practitioners was poor ( n = 107 , initial response rate 107/1737 , 6.2 % ) ; however , the majority of participants ( 50/69 , 73 % ) believed it is useful that general practitioners help patients find ways to increase physical activity . In the tailored condition , 30/43 ( 70 % ) participants requested the computer-tailored step advice and the majority found it underst and able ( 21/21 , 100 % ) , credible ( 17/18 , 94 % ) , relevant ( 15/18 , 83 % ) , not too long ( 13/18 , 72 % ) , instructive ( 13/18 , 72 % ) , and encouraging to increase steps ( 16/24 , 67 % ) . Daily step counts increased from baseline ( mean 9237 , SD 3749 steps/day ) to postintervention ( mean 11,876 , SD 4574 steps/day ) in the total sample ( change of 2639 , 95 % confidence interval 105–5172 ; F 1 = 5.0 , P = .04 ) . No interaction or other time effects were found . Conclusions The majority of participants in the tailored condition accepted the step advice and indicated it was useful . However , in this selected sample of adults , the tailored condition did not show superior effects compared with the st and ard condition OBJECTIVE To examine if a website-delivered physical activity intervention , that provides participants with computer-tailored feedback , can improve physical activity in the general population . METHODS Healthy adults ( n=434 ) , recruited from parents and staff of 14 primary and secondary schools in Belgium in the spring of 2005 , were allocated into one of two intervention groups ( receiving intervention with or without repeated feedback ) or a no-intervention control group .  Physical activity-levels were self-reported at baseline and at 6 months ( n=285 ) , using a computerized long version of the International Physical Activity Question naire online . Repeated measures analysis of co-variances were used to examine differences between the three groups . RESULTS Intent-to-treat analysis showed significant time by group interaction effects in favor of both intervention groups compared with the control group . Significant increases were found for active transportation ( + 20 , + 24 , + 11 min/week respectively ) and leisure-time physical activity ( + 26 , + 19 , -4 min/week respectively ) ; a significant decrease for minutes sitting on weekdays ( -22 , -34 , + 4 min/day respectively ) . No significant differences were found between both intervention groups . CONCLUSION A website-delivered intervention , including computer-tailoring , was able to increase physical activity when compared to a no-intervention control group . High drop-out rate and the low number of participants who received repeated feedback indicated that engagement and retention are important challenges in e-health studies INTRODUCTION Direct-to-consumer mHealth devices are a potential asset to behavioral research but rarely tested as intervention tools . This trial examined the accelerometer-based Fitbit tracker and website as a low-touch physical activity intervention . The purpose of this study is to evaluate , within an RCT , the feasibility and preliminary efficacy of integrating the Fitbit tracker and website into a physical activity intervention for postmenopausal women . METHODS Fifty-one inactive , postmenopausal women with BMI ≥25.0 were r and omized to a 16-week web-based self-monitoring intervention ( n=25 ) or comparison group ( n=26 ) . The Web-Based Tracking Group received a Fitbit , instructional session , and follow-up call at 4 weeks . The comparison group received a st and ard pedometer . All were asked to perform 150 minutes/week of moderate to vigorous physical activity ( MVPA ) . Physical activity outcomes were measured by the ActiGraph GT3X+ accelerometer . RESULTS Data were collected and analyzed in 2013 - 2014 . Participants were aged 60 ( SD=7 ) years with BMI of 29.2 ( 3.5 ) kg/m(2 ) . Relative to baseline , the Web-Based Tracking Group increased MVPA by 62 ( 108 ) minutes/week ( p<0.01 ) ; 10-minute MVPA bouts by 38 ( 83 ) minutes/week ( p=0.008 ) ; and steps by 789 ( 1,979 ) ( p=0.01 ) , compared to non-significant increases in the Pedometer Group ( between-group p=0.11 , 0.28 , and 0.30 , respectively ) . The Web-Based Tracking Group wore the tracker on 95 % of intervention days ; 96 % reported liking the website and 100 % liked the tracker . CONCLUSIONS The Fitbit was well accepted in this sample of women and associated with increased physical activity at 16 weeks . Leveraging direct-to-consumer mHealth technologies aligned with behavior change theories can strengthen physical activity interventions OBJECTIVE Internet-based physical activity ( PA ) interventions have shown promise , although findings remain equivocal . We used formative research to enhance a previously demonstrated program ( Step into Motion ) with the goal of developing an Internet program poised for dissemination . METHODS We conducted focus groups to identify Internet features targeted to theoretical constructs ( social cognitive theory ) predictive of PA behavior and rated as " useful for increasing PA . " We identified 5 theory-targeted Internet features as useful for increasing PA : ( 1 ) a PA tracking/logging calendar targeting self-monitoring and goal setting ; ( 2 ) geographic mapping tools targeting perceived environment ; ( 3 ) a discussion forum targeting social support ; ( 4 ) exercise videos targeting observational learning ; and ( 5 ) regular up date s of peer PA progress targeting situation . We then tested the efficacy of the enhanced program ( enhanced Internet , EI ; N = 25 ) in relation to publicly available PA Websites ( st and ard Internet , SI ; N = 28 ) among 53 participants in a r and omized controlled trial . RESULTS The EI arm increased PA in relation to the SI arm at 3 months ( 18.4 to 186.0 min/wk vs. 20.9 to 57.3 min/wk ; p = .03 ) but between-groups differences were not observed at 6 months ( 176.8 vs. 133.5 min/wk ; p = .44 ) . EI participants maintained PA from 3 to 6 months ( 186.0 to 176.8 min/wk ) , and the SI group increased PA ( 57.3 to 133.5 min/wk ) . CONCLUSION The EI program was efficacious at improving PA levels in relation to publicly available Websites initially , but differences in PA levels were not maintained at 6 months . Future research should identify Internet features that promote long-term maintenance OBJECTIVE To evaluate the feasibility and efficacy of an individually tailored , Internet-plus-email physical activity intervention design ed for adult women . METHOD Healthy and ethnically-diverse adult females ( N=156 ) ( mean age=42.8 years , 65 % Caucasian ) from California were r and omly assigned to an intervention ( access to a tailored website and weekly emails ) or wait-list control group . Participants completed web-based assessment s of physical activity , stage of behavior change , and psychosocial variables at baseline , one month , two months , and three months . Data were collected during 2006 - 2007 . Multilevel r and om coefficient modeling examined group differences in rates of change . RESULTS As compared to the control condition , the intervention group increased walking ( + 69 versus + 32 min per week ) and total moderate-to-vigorous physical activity ( + 23 versus -25 min per week ) after three months . The intervention did not impact stage of behavior change or any of the other psychosocial variables . CONCLUSION A tailored , Internet-based intervention for adult women had a positive effect on walking and moderate-to-vigorous physical activity in an ethnically-diverse sample . However , given the lack of comparable research contact in the control group , these findings should be taken cautiously Background In r and omized controlled trials , participants can not choose their preferred intervention delivery mode and thus might refuse to participate or not engage fully if assigned to a nonpreferred group . This might underestimate the true effectiveness of behavior-change interventions . Objective To examine whether receiving interventions either matched or mismatched with participants ’ preferred delivery mode would influence effectiveness of a  Web-based physical activity intervention . Methods Adults ( n = 863 ) , recruited via email , were r and omly assigned to one of three intervention delivery modes ( text based , video based , or combined ) and received fully automated , Internet-delivered personal advice about physical activity . Personalized intervention content , based on the theory of planned behavior and stages of change concept , was identical across groups . Online , self-assessed question naires measuring physical activity were completed at baseline , 1 week , and 1 month . Physical activity advice acceptability and website usability were assessed at 1 week . Before r and omization , participants were asked which delivery mode they preferred , to categorize them as matched or mismatched . Time spent on the website was measured throughout the intervention . We applied intention-to-treat , repeated- measures analyses of covariance to assess group differences . Results Attrition was high ( 575/863 , 66.6 % ) , though equal between groups ( t 86 3 = 1.31 , P = .19 ) . At 1-month follow-up , 93 participants were categorized as matched and 195 as mismatched . They preferred text mode ( 493/803 , 61.4 % ) over combined ( 216/803 , 26.9 % ) and video modes ( 94/803 , 11.7 % ) . After the intervention , 20 % ( 26/132 ) of matched-group participants and 34 % ( 96/282 ) in the mismatched group changed their delivery mode preference . Time effects were significant for all physical activity outcomes ( total physical activity : F 2,801 = 5.07 , P = .009 ; number of activity sessions : F 2,801 = 7.52 , P < .001 ; walking : F 2,801 = 8.32 , P < .001 ; moderate physical activity : F 2,801 = 9.53 , P < .001 ; and vigorous physical activity : F 2,801 = 6.04 , P = .002 ) , indicating that physical activity increased over time for both matched and mismatched groups . Matched-group participants improved physical activity outcomes slightly more than those in the mismatched group , but interaction effects were not significant . Physical activity advice acceptability ( content scale : t 368 = .10 , P = .92 ; layout scale : t 368 = 1.53 , P = .12 ) and website usability ( layout scale : t 426 = .05 , P = .96 ; ease of use scale : t 426 = .21 , P = .83 ) were generally high and did not differ between the matched and mismatched groups . The only significant difference ( t 621 = 2.16 , P = .03 ) was in relation to total time spent on the website : the mismatched group spent significantly more time on the website ( 14.4 minutes ) than the matched group ( 12.1 minutes ) . Conclusion Participants ’ preference regarding delivery mode may not significantly influence intervention outcomes . Consequently , allowing participants to choose their preferred delivery mode may not increase effectiveness of Web-based interventions Background Many people in Western countries do not follow public health physical activity ( PA ) recommendations . Web-based interventions provide cost- and time-efficient means of delivering individually targeted lifestyle modification at a population level . Objective To examine whether access to a website with individually tailored feedback and suggestions on how to increase PA led to improved PA , anthropometrics , and health measurements . Methods Physically inactive adults ( n = 12,287 ) participating in a nationwide eHealth survey and health examination in Denmark were r and omly assigned to either an intervention ( website ) ( n = 6055 ) or a no-intervention control group ( n = 6232 ) in 2008 . The intervention website was founded on the theories of stages of change and of planned behavior and , apart from a forum page where a physiotherapist answered questions about PA and training , was fully automated . After 3 and again after 6 months we emailed participants invitations to answer a Web-based follow-up question naire , which included the long version of the International Physical Activity Question naire . A subgroup of participants ( n = 1190 ) were invited to a follow-up health examination at 3 months . Results Less than 22.0 % ( 694/3156 ) of the participants logged on to the website once and only 7.0 % ( 222/3159 ) logged on frequently . We found no difference in PA level between the website and control groups at 3- and 6-month follow-ups . By dividing participants into three groups according to use of the intervention website , we found a significant difference in total and leisure-time PA in the website group . The follow-up health examination showed no significant reductions in body mass index , waist circumference , body fat percentage , and blood pressure , or improvements in arm strength and aerobic fitness in the website group . Conclusions Based on our findings , we suggest that active users of a Web-based PA intervention can improve their level of PA . However , for unmotivated users , single-tailored feedback may be too brief . Future research should focus on developing more sophisticated interventions with the potential to reach both motivated and unmotivated sedentary individuals . Trial Registration Clinical trials.gov NCT01295203 ; http:// clinical trials.gov/ct2/show/NCT01295203 ( Archived by WebCite at http://www.webcitation.org/6B7HDMqiQ BACKGROUND Online social networks , such as Facebook ™ , have extensive reach , and they use technology that could enhance social support , an established determinant of physical activity . This combination of reach and functionality makes online social networks a promising intervention platform for increasing physical activity . PURPOSE To test the efficacy of a physical activity intervention that combined education , physical activity monitoring , and online social networking to increase social support for physical activity compared to an education-only control . DESIGN RCT . Students ( n=134 ) were r and omized to two groups : education-only controls receiving access to a physical activity-focused website ( n=67 ) and  intervention participants receiving access to the same website with physical activity self-monitoring and enrollment in a Facebook group  ( n=67 ) . Recruitment and data collection occurred in 2010 and 2011 ; data analyses were performed in 2011 . SETTING / PARTICIPANTS Female undergraduate students at a large southeastern public university . INTERVENTION Intervention participants were encouraged through e-mails , website instructions , and moderator communications to solicit and provide social support related to increasing physical activity through a physical activity-themed Facebook group . Participants received access to a dedicated website with educational material s and a physical activity self-monitoring tool . MAIN OUTCOME MEASURES The primary outcome was perceived social support for physical activity ; secondary outcomes included self-reported physical activity . RESULTS Participants experienced increases in social support and physical activity over time but there were no differences in perceived social support or physical activity between groups over time . Facebook participants posted 259 times to the group . Two thirds ( 66 % ) of intervention participants completing a post- study survey indicated that they would recommend the program to friends . CONCLUSIONS Use of an online social networking group plus self-monitoring did not produce greater perceptions of social support or physical activity as compared to education-only controls . Given their promising features and potential reach , efforts to further underst and how online social networks can be used in health promotion should be pursued . TRIAL REGISTRATION This study is registered at clinical trials.govNCT01421758
OBJECTIVES It was estimated that approximately 60 % of the world 's population is classified as inactive or insufficiently active .
This meta- analysis investigated the effect of web-based interventions on different types of physical activity ( PA )  measurements in general population and potential moderating variables .