Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial.

Yan Ping Duan,Sonia Lippke,Julian Wienert,Gang Yan Si,Chun Hu

doi:10.2196/jmir.7152

Abstract

BackgroundAmple evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students.ObjectiveOur objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression).MethodsIn a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015.ResultsSignificant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η2) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ21=11.75, P=.001) and FVI (χ21=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F3,492=1.23, η2=.03, P=.02).ConclusionsThis study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention.Trial RegistrationClinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1)

Highlights

Being physically active and eating healthily are known to reduce the risk of developing noncommunicable diseases such as cancer, cardiovascular disease, obesity, and type 2 diabetes [1]
The overall intervention effects were significant for stage progression to the action group from T1 to T2 in physical activity (PA) (χ21=11.75, P=.001) and fruit and vegetable intake (FVI) (χ21=15.64, P=.03)
This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables

Summary

Introduction

Being physically active and eating healthily are known to reduce the risk of developing noncommunicable diseases such as cancer, cardiovascular disease, obesity, and type 2 diabetes [1]. Some studies show that university students and young adults aged 18-24 years consume fewer than the recommended 5 daily servings of fruits and vegetables [4,5]. University students are in the transition stage from late adolescence to adulthood. Some evidence reveals that multiple behavior health interventions can promote both exercise and healthy diets in university students [1,7,8]. Behavioral interventions for university students are required to support long-lasting behavior changes beyond late adulthood. Most of these studies, have been conducted only in Western societies. Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students

Methods

Results

Discussion

Conclusion