Delivery Of Physical Activity Interventions Research Articles

Implementation of Peer-Assisted Physical Activity Via Telehealth for Adults on the Autism Spectrum: A Mixed Methods Feasibility Study.

Adults on the autism spectrum are at risk for physical inactivity, obesity, and related health conditions. Physical activity provides physical, social, and mental health benefits across the lifespan. Previous research examined feasibility and effectiveness of physical activity intervention in autistic children, but very few studies target autistic adults. This study examined the feasibility and acceptability of Physical Activity Connections via Telehealth, implemented during the coronavirus disease 2019 (COVID-19) pandemic lockdown as an alternative to in-person programming for autistic adults aged 18 to 32. The 10-week intervention utilized telehealth and remote technologies to deliver a theoretically grounded program to improve physical activity. Strategies included peer-guidance, coaching, individualized wellness goals, customized exercise programs, and wearable activity trackers. Feasibility and acceptability were examined using a mixed-methods design including observational and survey data collection, as well as participant interviews. Data were analyzed using descriptive statistics and content analysis. Findings support feasibility and acceptability of telehealth to promote physical activity among autistic adults who have cognitive capacity and ability to utilize remote technology, with applicability beyond pandemic-imposed challenges. Telehealth delivery of physical activity interventions is a viable alternative to in-person programs and may enable autistic adults to overcome barriers to physical activity participation and access. As the rate of autism continues to rise globally, rehabilitation professionals will play a significant role in promoting health and wellness for autistic individuals across the lifespan. Findings promote informed practice based on the health needs of this growing segment of society.

The Healthy and Active Fund: Lessons From the Evaluation Experiences of Community-Based Physical Activity Projects in Wales.

The "Healthy and Active Fund" involved 17 community-based projects focused on the delivery of physical activity interventions, led by a variety of public and third sector organizations. As a novel, direct approach to capturing impact at this level, these organizations were encouraged to robustly evaluate and monitor their own project's outcomes, with core funds allocated to this process. This study aimed to explore project experiences of planning and completing evaluation activities, to better understand how to support community-based practice improvement. In-depth semistructured interviews were completed with individuals who had supported their project's evaluation. Reflexive thematic analysis was used to identify key facilitators and barriers associated with evaluation in this context. Across 3 identified themes, participants (N = 15, 12 projects) referred to a need for greater organizational capacity and expertise, familiarity with evaluation methods, partnership-working, inclusivity, and flexibility, particularly when collecting data from project beneficiaries. Overarching program support (eg,case officers) was viewed as a valuable resource that was disrupted by COVID-19. Participants highlighted the resilience of their projects when engaging with evaluation processes and acknowledged wider learning across organization networks as a result of this success. This study shows that projects may benefit from closer support and external expertise for research and evaluation. There is willingness by third sector and public bodies to adopt research and evaluation methods into routine practice, but significant barriers persist. Future programs should continue to support adaptable approaches to evaluation at community-level, to better progress health and well-being goals for diverse populations.

Physical activity following discharge from inpatient adult mental health settings

BackgroundPeople with severe mental illness are considerably less physically active than the general population and experience a premature mortality of 10–20 years, often attributed to modifiable behaviours, including physical activity. Inpatient environments provide opportunities for people with SMI to become more physically active, however evidence is limited on its sustainability following discharge to community settings. ObjectiveThis review aimed to summarise the published evidence relating to physical activity interventions following discharge from inpatient adult mental health settings. DesignMEDLINE, CINAHL, PsycINFO and AMED databases were searched to identify articles considering physical activity interventions taking place following discharge from an adult (>18) inpatient mental health setting, published after 2007. ResultsOf 3412 unique results, 5 studies were eligible for inclusion. Despite all included studies involving some transition between inpatient and community mental health settings, to-date no study has focused exclusively on physical activity interventions delivered following discharge from inpatient mental health settings. ConclusionsThis review has found insufficient evidence to guide the delivery of physical activity following discharge from inpatient mental health services. Future research is required to improve our knowledge of the optimal forms and delivery of physical activity interventions during this time, alongside quantifying the impact on readmission rates and clinical presentation.

Do fatigue and depression have a bivariate association with device-measured physical activity behavior in persons with multiple sclerosis?

Purpose This study examined the bivariate association between fatigue and depression symptoms and physical activity behavior in persons with multiple sclerosis (MS). Methods The sample of adults with MS completed the Fatigue Severity Scale (FSS) and the Hospital Anxiety and Depression Scale (HADS) and wore a waist mounted accelerometer during waking hours for 7 days. We categorized participants as having elevated fatigue and depression based on cut-points for the FSS (i.e., 4+ as indicative of severe fatigue) and the HADS (i.e., 8+ as indicative of elevated depressive symptoms). We used a two-way multivariate analysis of variance (MANOVA) to examine the contribution of fatigue and depression to volume and pattern of sedentary, light (LPA) and moderate-to-vigorous physical activity (MVPA). Results Results indicated no bivariate association between fatigue and depression and measures of physical activity behavior. The MANOVA indicated there was a significant association between fatigue and MVPA (F = 2.30, p = 0.032) and steps/day (F = 13.6, p < 0.001), independent of depression symptoms. There was no association between depression symptoms and physical activity behavior. Conclusions This study demonstrated an interrelation between fatigue symptoms and MVPA and steps/day in MS, independent of depression symptoms, and this should be considered in the future design and delivery of physical activity interventions in MS. IMPLICATIONS FOR REHABILIATION Fatigue and depression are prevalent and burdensome symptoms of multiple sclerosis (MS). These symptoms can collectively worsen psychological and functional outcomes in MS. Fatigue symptoms may impact ambulatory physical activity to a greater degree than depression symptom status in persons with MS. Fatigue is an important consideration when designing behavior change interventions targeted at promoting physical activity in persons with MS.

Wearable Use in an Observational Study Among Older Adults: Adherence, Feasibility, and Effects of Clinicodemographic Factors.

IntroductionWearables have great potential to improve monitoring and delivery of physical activity interventions to older adults with downstream benefits to multisystem health and longevity; however, benefits obtained from wearables depend on their uptake and usage. Few studies have examined person-specific factors that relate to wearable adherence. We characterized adherence to using a wearable activity tracker for 30 days and examined associations between adherence and demographics, cognitive functioning, brain volumes, and technology familiarity among community-dwelling older adults.MethodsParticipants were 175 older adults enrolled in the UCSF Longitudinal Brain Aging Study who were asked to wear a FitbitTM Flex 2 during waking hours for 30 days. Sixty two of these participants were also asked to sync their devices to the Fitbit smartphone app daily to collect minute-level data. We calculated adherence to wearing the Fitbit daily (i.e., proportion of days with valid activity data) and adherence to daily device syncing (i.e., proportion of days with minute-level activity data). Participants also completed a brain MRI and in-person cognitive testing measuring memory, executive functioning, and processing speed. Spearman correlations, Wilcoxon rank sum tests, and logistic regression tested relationships between wearable adherence and clinicodemographic factors.ResultsParticipants wore the Fitbits for an average of 95% of study days and were 85% adherent to the daily syncing protocol. Greater adherence to wearing the device was related to female sex. Greater adherence to daily device syncing was related to better memory, independent of demographic factors. Wearable adherence was not significantly related to age, education, executive functioning, processing speed, brain gray matter volumes, or self-reported familiarity with technology. Participants reported little-to-no difficulty using the wearable and all reported willingness to participate in another wearable study in the future.ConclusionsOlder adults have overall high adherence to wearable use in the current study protocol. Person-specific factors, however, may represent potential barriers to equitable uptake of wearables for physical activity among older adults, including demographics and cognitive functioning. Future studies and clinical providers utilizing wearable activity trackers with older adults may benefit from implementation of reminders (e.g., texts, calls) for device use, particularly among men and individuals with memory impairment.

Sociodemographic Factors Associated With Objectively Measured Moderate- to Vigorous-intensity Physical Activity in Adults With Type 2 Diabetes: Cross-sectional Results From the Canadian Health Measures Survey (2007 to 2017)

ObjectivesIndividuals with type 2 diabetes should engage in ≥150 min of moderate- to vigorous-intensity physical activity (MVPA) weekly, but most do not meet this guideline. Understanding how social determinants correlate with physical activity in adults with type 2 diabetes may improve development and delivery of physical activity interventions. This study aimed to explore associations between objectively measured MVPA with sociodemographic characteristics in adults with type 2 diabetes. MethodsCross-sectional data from cycles 1 through 5 of the Canadian Health Measures Survey were analyzed. Participants (N=876) 20 to 79 years of age with type 2 diabetes and ≥4 days of valid activity monitor wear were included. Proportions with 95% confidence intervals for objectively measured MVPA were compared according to sociodemographic characteristics. Ordinal logistic regression was used. Secondary outcomes included light-intensity physical activity, screen time and proportion of activity monitor wear time spent sedentary. ResultsOnly 15.5% of women and 26.2% of men met Diabetes Canada physical activity guidelines, and approximately 75% of activity monitor wear time was spent in a sedentary state. Higher odds of achieving low levels of physical activity were observed among women who were former or current smokers (odds ratio [OR], 4.51; p<0.001), and among men who were ≥65 years of age (OR, 2.92; p<0.001), of middle (OR, 2.20; p<0.05) and lowest (OR, 3.06; p<0.05) income tertiles and current or former smokers (OR, 3.01; p<0.05). ConclusionsSociodemographic factors are strongly associated with levels of MVPA in adults with type 2 diabetes. Sociodemographic information should be routinely collected by clinicians and used to inform more tailored and effective interventions for this patient population.

Adolescent time use and mental health: a cross-sectional, compositional analysis in the Millennium Cohort Study

ObjectiveTo examine the association of 24-hour time-use compositions with mental health in a large, geographically diverse sample of UK adolescents.DesignCross-sectional, secondary data analysis.SettingMillennium Cohort Study (sixth survey), a UK-based prospective...

The experiences of peer-facilitators delivering a physical activity intervention for emergency service workers and their families

IntroductionEmergency service workers (e.g. police, fire, ambulance officers) are regularly exposed to occupational stressors and potentially traumatic events, resulting in an increased risk of poor mental and physical health. For example, emergency service workers are twice as likely to experience suicidal thoughts compared to the general population and one in ten will develop posttraumatic stress disorder. Despite this, emergency service workers face barriers to accessing traditional mental healthcare. Physical activity is non-stigmatising and may help improve the mental and physical health of this population; however, novel ways to help people engage are needed. Peers with lived experience may be well-placed to co-deliver physical activity programs alongside health professionals. The aim of this study was to understand the experiences of peer-facilitators co-delivering an online physical activity intervention for emergency service workers and their families. MethodsQualitative interviews were conducted with 6 peer-facilitators. Interviews were audio recorded, transcribed, and analysed using exploratory thematic analysis. ResultsTwo main themes were explored. The first theme related to the value of lived experience that reflected two subthemes, i) credibility and relatedness by virtue of experience; and ii) knowledge and confidence by virtue of experience. The second theme related to the impact of the peer-facilitator role on the peers themselves, whereby peer-facilitators reported an increased sense of purpose and social connection. DiscussionThis qualitative study provides insights into how peer-facilitators can complement health professionals in the delivery of physical activity interventions for emergency service workers. Further research is needed to elucidate training requirements and safety protocols.

Is autonomous motivation the key to maintaining an active lifestyle in first-episode psychosis?

Physical activity has the potential to improve the health of patients with first-episode psychosis (FEP), yet many patients with FEP remain inactive. Exploring the theoretical basis of the motivational processes linked to the adoption and maintenance of physical activity behaviours in FEP patients can assist with the design and delivery of physical activity interventions. Within the self-determination theory and the transtheoretical model (stages of change) frameworks, we investigated motives for physical activity adoption and maintenance in FEP. Overall 56 FEP patients (20♀) (24 ± 4 years) completed the Behavioural Regulation in Exercise Questionnaire 2 to assess exercise motives, and the Patient-Centred Assessment and Counselling for Exercise to determine stage of change. Gender and setting differences in motives for physical activity were compared with unpaired t-tests. The relationship between motives for physical activity and stage of change was investigated using anova with post-hoc Scheffe tests. No significant differences were found according to gender and setting. Multivariate analyses found significantly higher levels of amotivation and lower levels of autonomous motivation in the earlier stages of change. Our results suggest that in FEP patients, autonomous regulations may play an important role in the adoption and maintenance of physical activity behaviours. The study provides a platform for future research to investigate the importance of autonomous motivation within physical activity interventions for this population.

Examining reach, dose, and fidelity of the "Girls on the Move" after-school physical activity club: a process evaluation.

BackgroundAfter-school programs represent a promising opportunity to assist adolescent girls’ in attaining adequate physical activity. Although evaluating the process of intervention implementation is important for determining if an intervention was delivered and received as intended, comprehensive information about process evaluation methods and results are rarely reported. The purpose of this article was to evaluate the reach, dose, and fidelity of a 90-minute after-school physical activity club offered 3 days a week. The club is 1 of 3 components included in a 17-week intervention designed for 5th-8th grade girls, the majority of whom were of minority and/or low socioeconomic status.MethodsA total of 24 schools (12 intervention; 12 control) and 56–67 girls per school (total N = 1519 girls) were included in the Girls on the Move group randomized controlled trial. At the beginning of each of 3 academic years (2012–2015), 8 schools per year were randomized to receive either the intervention (n = 4) or control condition (n = 4). To evaluate the club, data collected via surveys from girls, club coaches and managers, and process evaluators were analyzed. To evaluate the opportunity for physical activity provided by the coaches and managers, process evaluators used an observation tool based on the System for Observing Fitness Instruction Time and Academic Learning Time - Physical Education. Girls wore accelerometers every other week during the club time.ResultsMean attendance was 41 % with the average attendance in year 3 being higher than rates for years 1 or 2. Mean moderate-to-vigorous physical activity time was 21.85 minutes measured via accelerometry and 21.81 minutes observed by process evaluators. Satisfaction with the intervention was high. For the most part, process evaluators perceived the club was delivered as planned and reflected constructs of the Health Promotion Model and Self-Determination Theory. Areas contributing to success included using incentives and offering a variety of activities. Issues negatively impacting implementation included managing behavioral problems, having limited space for moderate-to-vigorous physical activity, dealing with inclement weather, and getting coaches to actively participate in all physical activities with the girls.ConclusionsThis process evaluation provides important information to guide future school-based physical activity intervention delivery. Barriers to implementation have been identified. Ways to overcome them warrant consideration when designing physical activity interventions. Research is needed to test innovative approaches for enhancing attendance and increasing girls’ moderate-to-vigorous physical activity in after-school programs.Trial registrationClinicalTrials.gov Identifier NCT01503333. Registered 23 December, 2011.

Tackling mental health: the role of professional football clubs

In the UK, professional football clubs are being used as settings for the delivery of interventions that promote mental health in a number of ways including (i) the delivery of physical activity interventions to improve the mental health of the general population, (ii) the delivery of physical activity interventions for people experiencing mental illness, and (iii) the delivery of community mental health services within the confines of the football club. This research note offers insights into mental health interventions delivered within, and by, professional football clubs and the available evidence concerning their reach, effectiveness and impact. The findings suggest that professional football clubs can help to facilitate access to mental health services, particularly among young people, for whom accessing such services may be highly stigmatized. Furthermore, the findings highlight that such interventions have a positive impact on health. However, in order to capitalize on this opportunity funding agencies and commissioners must provide appropriate resources (human and financial) for effective delivery and evaluation. Furthermore, a more strategic approach to working towards the mental health agenda must be adopted. It is argued that this change in practice would allow professional football clubs to offer those in need access to high-quality interventions.

Individual characteristics associated with physical activity intervention delivery mode preferences among adults

BackgroundPeople have different preferences on how health behaviour change interventions are delivered to them; intervention implementation, retention and effectiveness may be improved if preferences can be matched.PurposeThis study aims to explore factors related to preference of face-to-face, and group-, print- or web-based physical activity intervention delivery modes among adults recruited from the general population.MethodsA question relating to physical activity intervention preference was included in the telephone administered 2010 Queensland Social Survey. Multinomial regression models were used to explore socio-demographic (e.g., age, marital status, location), health (e.g., BMI, chronic disease status) and behavioral factors (e.g., internet use, physical activity, diet, social networking) related to intervention preferences, using ‘a face-to-face intervention’ as the reference category.Results35.2% of those approached took part in the telephone interviews (n = 1,261). Preference for a web-based intervention was positively associated with being in the 35–44 age group (compared to the 18–34 age group; RR = 2.71), living in a rural area (RR = 2.01), and high internet use (RR = 1.03); and negatively associated with female gender (RR = 0.52), obesity (RR = 0.42), and higher physical activity participation (RR = 0.99). Preference for a print-based intervention was positively associated with older age (RR = 5.50); and negatively associated with female gender (RR = 0.48) and obesity (RR = 0.47). Preference for a group-based program was positively associated with living in a regional town (RR = 1.48) and negatively associated with being separated (RR = 0.45) and obesity (RR =0.56).ConclusionFindings from this study help to delineate what physical activity intervention delivery modes are likely to be appealing for specific target groups, especially in relation to people of different weight status, age, gender and living environment. As such, this information will be useful in the development of interventions targeted at these groups.

The Prediabetes Detection and Physical Activity Intervention Delivery (PRE-PAID) Program

Inspired by increases in the prevalence and incidence of prediabetes, the Pre-diabetes Detection and Physical Activity Intervention Delivery Project (PRE-PAID) is a multiphasic program that identifies persons at high risk for developing type 2 diabetes, provides an opportunity for culturally appropriate, community-based physical activity and facilitates training of qualified exercise professionals on diabetes screening as well as prediabetes-specific training recommendations. This article provides an overview of the PRE-PAID project and includes some preliminary screening data, as well as lessons learned from the implementation of community-based physical activity programs that target specific, high-risk ethnicities. Recommendations and special considerations involving physical activity that targets persons with prediabetes also are discussed. A total of 691 individuals have undergone the PRE-PAID risk-identification process, which involves a brief questionnaire and point-of-care finger-prick hemoglobin A1C testing. The mean hemoglobin A1C level was 6.0±0.90% (mean ± standard deviation). Questionnaire scores showed that, on average, the individuals screened had 3 to 5 typical risk factors for type 2 diabetes, such as high body mass index, waist circumference, physical inactivity or family history of diabetes. Community-specific breakdowns of these results also are presented in this article. Sharing experiences from the PRE-PAID project can help formulate a framework for future prediabetes screening and physical activity interventions that are community based, target persons with prediabetes and are culturally appropriate.

Physical activity for the prevention and treatment of major chronic disease: an overview of systematic reviews

BackgroundThe evidence that higher levels of physical activity and/or lower levels of physical inactivity are associated with beneficial health-related outcomes stems mainly from observational studies. Findings from these studies often differ from randomised controlled trials and systematic reviews currently demonstrate mixed results, due partly to heterogeneity in physical activity interventions, methodologies used and populations studied. As a result, translation into clinical practice has been difficult. It is therefore essential that an overview is carried out to compare and contrast systematic reviews, and to identify those physical activity interventions that are the most effective in preventing and/or treating major chronic disease. This protocol has been registered on PROSPERO 2013: CRD42013003523.MethodsWe will carry out an overview of Cochrane systematic reviews. We will search the Cochrane Database of Systematic Reviews for systematic reviews of randomised controlled trials that have a primary focus on disease-related outcomes. We will restrict reviews to those in selected major chronic diseases. Two authors will independently screen search outputs, select studies, extract data and assess the quality of included reviews using the assessment of multiple systematic reviews tool; all discrepancies will be resolved by discussing and reaching a consensus, or by arbitration with a third author. The data extraction form will summarise key information from each review, including details of the population(s) (for example, disease condition), the context (for example, prevention, treatment or management), the participants, the intervention(s), the comparison(s) and the outcomes. The primary outcomes of interest are the prevention of chronic disease and/or improved outcomes, in the treatment or management of chronic disease. These outcomes will be summarised and presented for individual chronic diseases (for example, any change in blood pressure in hypertension or glucose control in diabetes). Secondary outcomes of interest are to describe the structure and delivery of physical activity interventions across chronic disease conditions and adverse events associated with physical activity.DiscussionWe anticipate that our results could inform researchers, guideline groups and policymakers of the most efficacious physical activity interventions in preventing and/or managing major chronic disease.

Differences between 9–11 year old British Pakistani and White British girls in physical activity and behavior during school recess

BackgroundSchool recess provides an important opportunity for children to engage in physical activity. Previous studies indicate that children and adults of South Asian origin are less active than other ethnic groups in the United Kingdom, but have not investigated whether activity differs within the shared school environment. The aim of this study was to test the hypothesis that British Pakistani girls aged 9–11 years are less active during recess than White British girls.MethodsIn Study One, the proportion of recess spent by 137 White British (N = 70) and British Pakistani (N = 67) girls in sedentary behavior, moderate-to-vigorous activity (MVPA) and vigorous activity (VPA) was determined using accelerometry. In Study Two, 86 White British (N = 48) and British Pakistani (N = 38) girls were observed on the playground using the System for Observing Children’s Activity and Relationships during Play (SOCARP). Accelerometry data were collected during observations to allow identification of activities contributing to objectively measured physical activity.ResultsAccelerometry data indicated that British Pakistani girls spent 2.2% (95% CI: 0.2, 4.3) less of their total recess time in MVPA and 1.3% (95% CI: 0.2, 2.4) less in VPA than White British girls. Direct observation showed that British Pakistani girls spent 12.0% (95% CI: 2.9, 21.1) less playground time being very active, and 12.3% (95% CI: 1.7, 23.0) less time playing games. Time spent being very active according to direct observation data correlated significantly with accelerometer-assessed time spent in MVPA and VPA, and time spent playing games correlated significantly with accelerometer-assessed time spent in VPA, suggesting that differences in behavior observed in Study Two may have contributed to the differences in time spent in MVPA and VPA in Study One.ConclusionsBritish Pakistani girls were less active than White British girls during school recess. Recess has been identified as a potentially important target for the delivery of physical activity interventions; such interventions should consider ways in which the activity levels of British Pakistani girls could be increased.

The comparative effectiveness of a team-based versus group-based physical activity intervention for cancer survivors

Physical activity benefits cancer survivors, but the comparative effectiveness of a team-based delivery approach remains unexplored. The hypothesis tested was that a team-based physical activity intervention delivery approach has added physical and psychological benefits compared to a group-based approach. A team-based sport accessible to survivors is dragon boating, which requires no previous experience and allows for diverse skill levels. In a non-randomized trial, cancer survivors chose between two similarly structured 8-week programs, a dragon boat paddling team (n = 68) or group-based walking program (n = 52). Three separate intervention rounds were carried out in 2007-2008. Pre-post testing measured physical and psychosocial outcomes. Compared to walkers, paddlers had significantly greater (all p < 0.01) team cohesion, program adherence/attendance, and increased upper-body strength. For quality-of-life outcomes, both interventions were associated with pre-post improvements, but with no clear-cut pattern of between-intervention differences. These hypothesis-generating findings suggest that a short-term, team-based physical activity program (dragon boat paddling) was associated with increased cohesion and adherence/attendance. Improvements in physical fitness and psychosocial benefits were comparable to a traditional, group-based walking program. Compared to a group-based intervention delivery format, the team-based intervention delivery format holds promise for promoting physical activity program adherence/attendance in cancer survivors.

Pre-Diabetes Detection and Intervention for High Risk Communities

This article briefly summarizes the “Pre-Diabetes Detection and Intervention Symposium” that described ongoing and past pre-diabetes interventions, and outlined some considerations when deciding to target specific populations with pre-diabetes. The success of type 2 diabetes (T2D) prevention clinical trials provides clear evidence that healthy lifestyle change can prevent the development of T2D in a cost effective manner in high risk individuals. However, who to target and what cut-points should be used to identify individuals who would qualify for these T2D prevention programs are not simple questions. More stringent cut-offs are more efficient in preventing T2D, but less equitable. Interventions will likely need to be adapted and made more economical for local communities and health care centers if they are to be adopted universally. Further, they may need to be adapted to meet the specific needs of certain high-risk populations such as ethnic minorities. The Chronic Disease Management &amp; Prevention Program for Diverse Populations in Alberta and the Pre-diabetes Detection and Physical Activity Intervention Delivery project in Toronto represent 2 examples of specialized interventions that are targeted at certain high risk populations. To reverse the current T2D trends will require continued efforts to develop and refine T2D prevention interventions.

Using the Internet to Promote Physical Activity: A Randomized Trial of Intervention Delivery Modes

A growing number of the population are using the Internet for health information, such as physical activity (PA). The aim of this study was to examine the effectiveness of delivery modes for a behavior change program targeting PA. A randomized trial was conducted with 192 subjects randomly allocated to either a face-to-face, Internet-mediated, or Internet-only arm of a 12-wk intervention. Subjects included inactive adults with Internet access. The primary outcome variable was self-reported PA, assessed at four time points. The results showed no group x time interaction for PA F(6, 567) = 1.64, p > 0.05, and no main effect for group F(2, 189) = 1.58, p > 0.05. However, a main effect for time F(3, 567) = 75.7, p < 0.01 was observed for each group. All groups were statistically equivalent immediately post-intervention (p < 0.05), but not at the follow-up time points (p > 0.05). The Internet-mediated and Internet-only groups showed similar increases in PA to the face-to-face group immediately post-intervention. This study provides evidence in support of the Internet in the delivery of PA interventions and highlights avenues for future research.