Abstract
BackgroundPublic transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting. Methodstrips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined. Discussiontrips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies. Trial registrationACTRN12619001136190. Universal trial numberU1111-1233-8050.
Highlights
Public transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention
Initiatives to redress physical inactivity have principally focused on leisure-time and sporting activities, with much less attention given to other domains of PA such as transport [4]
Drawing on dual process theory, individuals may be more likely to persist with regular PA if it is associated with a habitual pattern, such as travel [11,12,13]
Summary
Physical inactivity is one of the most significant global health con cerns, causing 6–10% of coronary heart disease, type 2 diabetes and breast and colon cancers [1]. Incentive-based strategies have demonstrated some promise for improving health behaviours in adults, but relatively few high-quality studies have focused on PA and none on incentivising pub lic transport use for PA gain [14,15,16,17,18,19,20,21]. In a 2017 survey on travel behaviour and health involving 1091 Australian adults, 42.4% of par ticipants rated an incentive-based strategy as likely/extremely likely to increase their public transport use, ranking it as one of the top three public transport use enhancement strategies in the survey [22]. How best to implement incentive-based strategies to increase public transport use for PA gain in real-world settings is unestablished. The study findings will benefit service providers, poli cymakers and practitioners
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