Abstract
Background The Internet has potential as a medium for health behavior change programs, but no controlled studies have yet evaluated the impact of a fully automated physical activity intervention over several months with real-time objective feedback from a monitor.Objective The aim was to evaluate the impact of a physical activity program based on the Internet and mobile phone technology provided to individuals for 9 weeks.Methods A single-center, randomized, stratified controlled trial was conducted from September to December 2005 in Bedfordshire, United Kingdom, with 77 healthy adults whose mean age was 40.4 years (SD = 7.6) and mean body mass index was 26.3 (SD = 3.4). Participants were randomized to a test group that had access to an Internet and mobile phone–based physical activity program (n = 47) or to a control group (n = 30) that received no support. The test group received tailored solutions for perceived barriers, a schedule to plan weekly exercise sessions with mobile phone and email reminders, a message board to share their experiences with others, and feedback on their level of physical activity. Both groups were issued a wrist-worn accelerometer to monitor their level of physical activity; only the test group received real-time feedback via the Internet. The main outcome measures were accelerometer data and self-report of physical activity.Results At the end of the study period, the test group reported a significantly greater increase over baseline than did the control group for perceived control (P < .001) and intention/expectation to exercise (P < .001). Intent-to-treat analyses of both the accelerometer data (P = .02) and leisure time self-report data (P = .03) found a higher level of moderate physical activity in the test group. The average increase (over the control group) in accelerometer-measured moderate physical activity was 2 h 18 min per week. The test group also lost more percent body fat than the control group (test group: −2.18, SD = 0.59; control group: −0.17, SD = 0.81; P = .04).Conclusions A fully automated Internet and mobile phone–based motivation and action support system can significantly increase and maintain the level of physical activity in healthy adults.
Highlights
This is the first Surgeon General’s report to address physical activity and health
Public health recommendations have evolved from emphasizing vigorous activity for cardiorespiratory fitness to including the option of moderate levels of activity for numerous health benefits
It is acknowledged that for most people, greater health benefits can be obtained by engaging in physical activity of more vigorous intensity or of longer duration
Summary
The main message of this report is that Americans can substantially improve their health and quality of life by including moderate amounts of physical activity in their daily lives. Health benefits from physical activity are achievable for most Americans, including those who may dislike vigorous exercise and those who may have been previously discouraged by the difficulty of adhering to a program of vigorous exercise. For those who are already achieving regular moderate amounts of activity, additional benefits can be gained by further increases in activity level. It is hoped that this different emphasis on moderate amounts of activity, and the flexibility to vary activities according to personal preference and life circumstances, will encourage more people to make physical activity a regular and sustainable part of their lives
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