The Effect of Social Norm-based Intervention with Observable Behaviour on Physical Activity among Adolescents: A Randomized Controlled Trial

Jia Jia Lee,Semra Ozdemir,Irene Teo,Nivedita Vikas Nadkarni

doi:10.1186/s13102-020-00202-y

Jia Jia Lee, Semra Ozdemir + Show 2 more

Open Access

https://doi.org/10.1186/s13102-020-00202-y

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Abstract

BackgroundThe rising prevalence of childhood obesity in developing and developed countries poses a major public health challenge to policy makers and an effective strategy to promote physical activity among adolescents is warranted. This study aimed to evaluate the effectiveness of providing descriptive norms messages with personal identification in promoting physical activity among adolescents by measuring step counts via a randomized controlled trial (NCT03081013).MethodsA total of 311 participants aged 13–16 were randomized into two study arms (Onymous and Anonymous Arms). Each arm consisted of 13 groups of 12 participants. During the trial, participants received weekly short message service (SMS) about their past week’s physical activity performance. Participants in the Anonymous Arm received information about step counts of group members ranked from highest to lowest. Participants in the Onymous Arm received the same information with the group members’ full names. Participants’ quality of life, depression, physical activity social support, self-efficacy and enjoyment before and after the intervention were also evaluated. This study adheres to the CONSORT guidelines.ResultsThe number of steps was not higher when descriptive norm message was onymous compared to when it was anonymous. Scores in quality of life, depression, social support, self-efficacy, and enjoyment of physical activity were not significantly different between both arms (p > 0.05).ConclusionsOur findings indicated that the effect of providing descriptive norms messages containing personal identification on physical activity promotion was not evident in the main analysis. Future studies may consider using a more relevant reference group to use social norms as a tool to increase physical activity among adolescents.Trial registrationClinicalTrials.gov - NCT03081013. Registered 15 Mar 2017-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03081013

Highlights

The rising prevalence of childhood obesity in developing and developed countries poses a major public health challenge to policy makers and an effective strategy to promote physical activity among adolescents is warranted
Childhood obesity is a major concern for policy makers because overweight and obese children are likely to remain obese into adulthood [3]
To be eligible for the study, participants must be: (1) Singaporean or Singapore Permanent Resident; (2) between 13 and 16 years old; (3) willing to wear a pedometer for 16 weeks; and (4) English-speaking, which is the dominant language spoken by this age group in Singapore [25,26,27,28]

Summary

Introduction

The rising prevalence of childhood obesity in developing and developed countries poses a major public health challenge to policy makers and an effective strategy to promote physical activity among adolescents is warranted. Childhood obesity is a major concern for policy makers because overweight and obese children are likely to remain obese into adulthood [3]. They are more likely to develop noncommunicable diseases at a younger age and have a shorter life expectancy. A systematic review showed a high prevalence of insufficient physical activity among adolescents needed for the maintenance and development of cardiovascular health and cardiopulmonary fitness [4]. Given that adolescence is a crucial phase to develop and establish healthy lifestyle behaviours, it is important to explore potential interventions that focuses on increasing physical activity during adolescent years [7]

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