Abstract
Backgrounde- and mHealth interventions using self-regulation techniques like action and coping planning have the potential to tackle the worldwide problem of physical inactivity. However, they often use one-week self-regulation cycles, providing support toward an active lifestyle on a weekly basis. This may be too long to anticipate on certain contextual factors that may fluctuate from day to day and may influence physical activity. Consequently, the formulated action and coping plans often lack specificity and instrumentality, which may decrease effectiveness of the intervention. The aim of this study was to evaluate effectiveness of a self-regulation, app-based intervention called ‘MyDayPlan’. “MyDayPlan’ provides an innovative daily cycle in which users are guided towards more physical activity via self-regulation techniques such as goal setting, action planning, coping planning and self-monitoring of behaviour.MethodsAn ABAB single-case design was conducted in 35 inactive adults between 18 and 58 years (M = 40 years). The A phases (A1 and A2) were the control phases in which the ‘MyDayPlan’ intervention was not provided. The B phases (B1 and B2) were the intervention phases in which ‘MyDayPlan’ was used on a daily basis. The length of the four phases varied within and between the participants. Each phase lasted a minimum of 5 days and the total study lasted 32 days for each participant. Participants wore a Fitbit activity tracker during waking hours to assess number of daily steps as an outcome. Single cases were aggregated and data were analysed using multilevel models to test intervention effects and possible carry-over effects.ResultsResults showed an average intervention effect with a significant increase in number of daily steps from the control to intervention phases for each AB combination. From A1 to B1, an increase of 1424 steps (95% CI [775.42, 2072.32], t (1082) = 4.31,p < .001), and from A2 to B2, an increase of 1181 steps (95% CI [392.98, 1968.16], t (1082) = 2.94, p = .003) were found. Furthermore, the number of daily steps decreased significantly (1134 steps) when going from the first intervention phase (B1) to the second control phase (A2) (95% CI [− 1755.60, − 512.38], t (1082) = − 3.58, p < .001). We found no evidence for a difference in trend between the two control (95% CI [− 114.59, 197.99], t (1078) = .52, p = .60) and intervention phases (95% CI [− 128.79,284.22], t (1078) = .74, p = .46). This reveals, in contrast to what was hypothesized, no evidence for a carry-over effect after removing the ‘MyDayPlan’ app after the first intervention phase (B1).ConclusionThis study adds evidence that the self-regulation mHealth intervention, ‘MyDayPlan’ has the capacity to positively influence physical activity levels in an inactive adult population. Furthermore, this study provides evidence for the potential of interventions adopting a daily self-regulation cycle in general.
Highlights
The Global Burden of Disease Study (GBD) estimated that worldwide over 72% of deaths and almost 61% of disability-adjusted life years (DALYs), the number of years lost due to ill-health, disability or early death, are attributed to non-communicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes [1]
Effectiveness of MyDayPlan This study investigated the effect of a self-regulationbased Mobile health (mHealth) intervention, MyDayPlan, on the number of daily steps in a general adult sample
The found effects are congruent with the accepted concept that some activity is better than none, and that some relatively important health benefits may be realized with improvements over the lowest levels [60]. This positive intervention effect on PA is in line with earlier self-regulation based interventions using e- and mHealth revealing increases in MVPA of 16 to 67% depending on the target population and whether self-reported or accelerometer-based assessment of MVPA was used [26,27,28,29]
Summary
The Global Burden of Disease Study (GBD) estimated that worldwide over 72% of deaths and almost 61% of disability-adjusted life years (DALYs), the number of years lost due to ill-health, disability or early death, are attributed to non-communicable diseases (NCDs) such as cardiovascular diseases (heart attacks and stroke), cancers, chronic respiratory diseases and diabetes [1]. In 2018, it was stated in The Lancet Global Health that more than one in four adults worldwide (28% or 1.4 billion people) are physically inactive [3], meaning that they do not meet the health recommendations of at least 150 min of moderate-intensity physical activity, or at least 75 min of vigorous-intensity physical activity throughout the week, or an equivalent combination of both [3] This physical activity recommendation is currently the norm, physical inactivity could be defined as not meeting the equivalent step recommendation to accumulate 10000steps/day [4]. These inactivity rates indicate the need for lifestyle interventions that effectively promote physical activity in a large number of people at low [5, 6]
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