Abstract
BackgroundProlonged sitting is an independent risk behavior for the development of chronic disease. With most interventions focusing on physical activity and exercise, there is a separate need for investigation into innovative and accessible interventions to decrease sedentary behavior throughout the day. Twitter is a social media platform with application for health communications and fostering of social support for health behavior change.ObjectiveThis pilot study aims to test the feasibility, acceptability, and preliminary efficacy of delivering daily behavior change strategies within private Twitter groups to foster peer-to-peer support and decrease sedentary behavior throughout the day in women. The Twitter group was combined with a Fitbit for self-monitoring activity and compared to a Fitbit-only control group.MethodsIn a 2-group design, participants were randomized to a Twitter + Fitbit treatment group or a Fitbit-only control group. Participants were recruited via the Stanford Research Repository System, screened for eligibility, and then invited to an orientation session. After providing informed consent, they were randomized. All participants received 13 weeks of tailored weekly step goals and a Fitbit. The treatment group participants, placed in a private Twitter support group, received daily automated behavior change “tweets” informed by theory and regular automated encouragement via text to communicate with the group. Fitbit data were collected daily throughout the treatment and follow-up period. Web-based surveys and accelerometer data were collected at baseline, treatment end (13 weeks), and at 8.5 weeks after the treatment.ResultsThe initial study design funding was obtained from the Women’s Heart Clinic and the Stanford Clayman Institute. Funding to run this pilot study was received from the National Institutes of Health’s National Heart, Lung, and Blood Institute under Award Number K01HL136702. All procedures were approved by Stanford University’s Institutional Review Board, #32127 in 2018, prior to beginning data collection. Recruitment for this study was conducted in May 2019. Of the 858 people screened, 113 met the eligibility criteria, 68 came to an information session, and 45 consented to participate in this pilot study. One participant dropped out of the intervention, and complete follow-up data were obtained from 39 of the 45 participants (87% of the sample). Data were collected over 6 months from June to December 2019. Feasibility, acceptability, and preliminary efficacy results are being analyzed and will be reported in the winter of 2021.ConclusionsThis pilot study is assessing the feasibility, acceptability, and preliminary efficacy of delivering behavior change strategies in a Twitter social support group to decrease sedentary behavior in women. These findings will inform a larger evaluation. With an accessible, tailorable, and flexible platform, Twitter-delivered interventions offer potential for many treatment variations and titrations, thereby testing the effects of different behavior change strategies, peer-group makeups, and health behaviors of interest.Trial RegistrationClinicalTrials.gov NCT02958189, https://clinicaltrials.gov/ct2/show/NCT02958189International Registered Report Identifier (IRRID)DERR1-10.2196/20926
Highlights
BackgroundSedentary behavior is a major risk factor for heart disease and early mortality, among women [1,2,3,4,5,6]
Compared to physical activity interventions, relatively few interventions have addressed prolonged sitting [13,14], and there is a need for more controlled trials to target reductions in objectively measured prolonged sedentary behavior [14,15], especially in women at risk or with extant heart disease [1,2,3,4,5,6]
The major inclusion criteria on the screener were being female, older than 18 years, willing to participate in daily tweets or texts for up to 13 weeks, having an active email account to receive study communications, having a mobile phone with unlimited texting and internet to receive text and Twitter messages, being familiar with communicating on Twitter, Facebook, or other social media, English-speaking, and answer No to all 7 of the Physical Activity Readiness Questionnaire questions
Summary
BackgroundSedentary behavior is a major risk factor for heart disease and early mortality, among women [1,2,3,4,5,6]. Compared to physical activity interventions, relatively few interventions have addressed prolonged sitting [13,14], and there is a need for more controlled trials to target reductions in objectively measured prolonged sedentary behavior [14,15], especially in women at risk or with extant heart disease [1,2,3,4,5,6]. Can social media deliver in-context health information with broad reach, customizability, and easy access [18,19], it can allow users to react and add to the content and provide social support to other users (an evidence-based behavior change technique [16,20,21,22]). Twitter is a social media platform with application for health communications and fostering of social support for health behavior change
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