Internet-based Physical Activity Intervention Research Articles

Maintenance of physical activity after Internet-based physical activity interventions in patients with rheumatoid arthritis

To investigate the maintenance of physical activity 12 months after two 1-year Internet-based physical activity interventions in patients with RA. This follow-up study was a randomized comparison of an Internet-based individualized training (IT) and a general training (GT) programme in sedentary RA patients. Outcome measures included physical activity (meeting public health recommendations for moderate physical activity, i.e. 30 min for at least 5 days/week; or vigorous physical activity, i.e. 20 min for at least 3 days/week), functional ability and quality of life (QoL). Of the 152 RA patients who completed the initial study, 110 (72%) were available at follow-up. At 24 months, the proportions of patients meeting public health recommendations for moderate intensity physical activity were significantly higher compared with baseline in both the IT and GT groups (19 and 24%, respectively, P < 0.05), whereas the proportions of patients meeting the recommendation for vigorous activity was only significantly higher compared with baseline in the IT group (P < 0.05) but not in the GT group. There were no differences between the IT and GT groups concerning proportions of patients meeting moderate or vigorous physical activity recommendations at 24 months. Apart from a significantly higher RAQoL score in the IT group at 24 months compared with baseline, there were no significant differences within or between the programmes regarding functional ability or QoL. In RA patients, the effectiveness of both an individualized and a general 1-year Internet-based physical activity programme is sustained with respect to moderate intensity physical activity up to 12 months after the interventions.

Using electronic/computer interventions to promote physical activity

The internet has been used as a method to deliver various health interventions (eg, weight management, smoking cessation, increasing physical activity). An electronic search (ie, PubMed, PsycInfo, Web of Science)...

User attitudes towards physical activity websites in a randomized controlled trial

Objective To better understand the mixed findings regarding the efficacy of Internet-based physical activity interventions, we examined the use and usefulness of particular website components that may lead to improvements in intervention efficacy. Method Participants were sedentary individuals from a 12-month randomized controlled physical activity trial conducted in Providence, Rhode Island and Pittsburgh, Pennsylvania from 2003–2006. The present study included participants from the Tailored Internet arm ( n = 81; instantaneous web-based tailored feedback to participants) or the Standard Internet arm ( n = 82; websites currently available to the public). We obtained objective data via the intervention websites and subjective usefulness data via questionnaires. Results The Tailored Internet arm logged onto their website significantly more times than the Standard Internet arm (median 50 vs. 38; p < .05). Among participants in the Tailored Internet arm, the self-monitoring feature (i.e., logging) followed by goal setting were rated as the most useful website components. Conclusion Logins in the current study were substantially higher compared to previous studies. Participants endorsed goal setting and self-monitoring as being most useful, which are critical components for health behavior change. Future studies should continue to examine these features and improve the perceived usefulness of other theory-based strategies.

Internet-based physical activity interventions

The association between sedentary behavior and an increased risk of cardiovascular disease is well known and validated. Unfortunately, most Americans remain completely sedentary or are irregularly active. Research indicates that theory-based behavioral interventions are efficacious for increasing physical activity, but many interventions require personal contact and cannot be easily disseminated. Recent studies suggest that Internetbased physical activity behavioral interventions are comparable to previously established efficacious physical activity interventions. As such, the Internet may offer researchers and clinicians a viable tool to help promote and disseminate a physical activity intervention that can be used to effectively increase physical activity and ultimately reduce cardiovascular disease risk.

Implementation of a physical activity intervention for people with rheumatoid arthritis: A case study

To investigate the potential facilitators and barriers regarding the implementation on a larger scale of an internet-based physical activity intervention which had previously proved to be effective in a randomized, controlled trial concerning sedentary patients with rheumatoid arthritis (RA). Assuming a central delivery of the intervention by two trained physical therapists in four regions in the Netherlands, the following activities were employed: the recruitment of potential participants (RA patients), the acquisition of cooperation from referring rheumatologists and the acquisition of reimbursement from regional health insurance companies. Evaluation was done by means of the Reach, Evaluation, Adoption, Implementation and Maintenance framework, of which the following three dimensions were considered relevant: Reach (the number of potential participants), Adoption (readiness for adopting the programme in real life among rheumatologists) and Implementation (the extent to which the intervention could be delivered as intended). Evaluation measures comprised a postal survey among 927 patients with RA in two regions, a telephone survey among rheumatology centres in four regions and consultations with five regional health insurance companies. Seventy-six out of 461 responding RA patients (20%) met the original study inclusion criteria (being sedentary and having access to the internet) and were interested in participation. However, the potential costs of the purchase of a bicycle ergometer and the interference with patients' current physical therapy were obstacles for eligible patients actually to participate. Rheumatologists in four out of five rheumatology centres were willing to participate. All five health insurance companies were willing to reimburse the guidance and feedback by the physical therapist, and the costs of the internet site (estimated costs 271 euro [203 pound] per patient per year), but not the bicycle ergometer (estimated costs 350 euro [262 pound]), provided that current physical therapy would be discontinued. Facilitators for the implementation of an internet-based physical activity intervention were: (i) a considerable proportion of RA patients were eligible and interested in the programme; (ii) the majority of rheumatologists were willing to refer patients; and (iii) health insurance companies were willing partially to reimburse the intervention. Barriers were the additional costs for patients and their unwillingness to discontinue current physical therapy. These findings underscore the need for additional research into barriers to participation in physical activity interventions among patients with RA, and in reimbursement strategies in particular.

Internet-Based Physical Activity Interventions: A Systematic Review of the Literature

Background Nowadays people are extensively encouraged to become more physically active. The Internet has been brought forward as an effective tool to change physical activity behavior. However, little is known about the evidence regarding such Internet-based interventions.Objective The aim of the study was to systematically assess the methodological quality and the effectiveness of interventions designed to promote physical activity by means of the Internet as evaluated by randomized controlled trials.Methods A literature search was conducted up to July 2006 using the databases PubMed, Web of Science, EMBASE, PsycINFO, and Cochrane Library. Only randomized controlled trials describing the effectiveness of an Internet-based intervention, with the promotion of physical activity among adults being one of its major goals, were included. Data extracted included source and year of publication, country of origin, targeted health behaviors, participants’ characteristics, characteristics of the intervention, and effectiveness data. In addition, the methodological quality was assessed.Results The literature search resulted in 10 eligible studies of which five met at least nine out of 13 general methodological criteria. The majority of the interventions were tailored to the characteristics of the participants and used interactive self-monitoring and feedback tools. Six studies used one or more theoretical models to compose the contents of the interventions. One study used an objective measure to assess the amount of physical activity (activity monitor), and six studies used multiple subjective measures of physical activity. Furthermore, half of the studies employed measures of physical fitness other than physical activity. In three studies, an Internet-based physical activity intervention was compared with a waiting list group. Of these three studies, two reported a significantly greater improvement in physical activity levels in the Internet-based intervention than in the control group. Seven studies compared two types of Internet-based physical activity interventions in which the main difference was either the intensity of contact between the participants and supervisors (4 studies) or the type of treatment procedures applied (3 studies). In one of these studies, a significant effect in favor of an intervention with more supervisor contact was seen.Conclusions There is indicative evidence that Internet-based physical activity interventions are more effective than a waiting list strategy. The added value of specific components of Internet-based physical activity interventions such as increased supervisor contact, tailored information, or theoretical fidelity remains to be established. Methodological quality as well as the type of physical activity outcome measure varied, stressing the need for standardization of these measures.

Step into Motion: A randomized trial examining the relative efficacy of Internet vs. print-based physical activity interventions

Over two-thirds of Americans access the Internet and therefore, the Internet may be an important channel for reaching the large population of sedentary individuals. The purpose of this paper is to describe the methods for a randomized controlled trial examining the efficacy of an Internet-based physical activity intervention relative to a print intervention that has been shown to be effective in previous trials. Specifically, 249 sedentary participants were randomized to receive one of three interventions: 1) Internet-based motivationally-tailored individualized feedback (Tailored Internet); 2) print-based motivationally-tailored individualized feedback (Tailored Print); or 3) physical activity websites currently available to the public (Standard Internet). Participants completed the 7-Day Physical Activity Recall interview, wore an objective physical activity monitor (i.e., ActiGraph), and participated in a treadmill fitness test at baseline, 6, and 12 months. The sample consisted of mostly women (84.2%) and Caucasian individuals (76.4%) who reported exercising an average of 21 min per week at baseline. This is the first study that we are aware of, that has examined the efficacy of a tailored Internet-based physical activity intervention. This study will have implications for the dissemination of Internet-based physical activity interventions.

A Randomized Trial Examining the Relative Efficacy of Internet versus Print-Based Physical Activity Interventions

PURPOSE: To examine the efficacy of a tailored Internet-based physical activity intervention relative to a tailored print intervention. METHODS: Sedentary participants (n=249) were randomized to one of three interventions: 1) Internet-based individually tailored feedback (Tailored Internet; TI); 2) print-based individually tailored feedback (Tailored Print; TP); or 3) physical activity websites available to the public (Standard Internet; SI). Participants completed a sub-maximal exercise treadmill test and the 7-Day Physical Activity Recall interview at baseline, six, and 12 months. The sample consisted of mostly female (82.7%) and Caucasian (81.5%) individuals with a mean age of 44.5 years and mean BMI of 29.4. RESULTS: Estimated VO2 at 85% of age predicted maximum heart rate (ml/kg/min) significantly increased from baseline to 6 and 12 months among the entire sample but no differences were found between groups (TI=25.50 to 26.14 minutes; TP: 24.79 to 26.18 minutes; SI: 24.30 to 25.70 minutes). Similarly, mean physical activity minutes per week significantly increased from baseline to 6 and 12 months but no differences were found between groups (TI= 19.75 to 161.42 minutes per week at 6 months and 125.14 minute at 12 months; TP: 20.94 to 123.12 minutes per week at 6 months and 123.20 minutes at 12 months; SI: 22.62 to 122.33 minutes per week at 6 months and 114.14 minutes at 12 months). CONCLUSIONS: Both the Internet and print interventions increased physical activity, which is important given the potential for the Internet to reach a large proportion of sedentary adults at low-cost.

Engagement and satisfaction with an Internet-based physical activity intervention in patients with rheumatoid arthritis

To assess the engagement in and satisfaction with an Internet-mediated physical activity intervention with individual supervision in patients with rheumatoid arthritis (RA). The intervention studied was one of the two strategies aimed at enhancing physical activity in RA patients that were being compared in a randomized controlled trial. A total of 82 patients, all experienced in using Internet and e-mail and registered at three different rheumatology out-patient clinics, were randomly allocated to the Internet-mediated individualized intervention (52 weeks). They had access to personal physical activity schedules and received individual supervision by a physical therapist by means of weekly e-mail feedback. In addition, telephone contacts, an online discussion forum, six face-to-face group meetings and electronic newsletters were offered. Besides registration of returned physical activity schedules, engagement and satisfaction were measured through questionnaires. The median physical activity schedule return rate of the 82 participants was 55%. The mean number of patients logging into the website at least once a week was 53 (70%) over 12 months. Of all patients, 69 returned the questionnaires (response 84%). Telephone contacts were used by 38/67 patients (57%), the mean (SD) number of attended group meetings was 3.1 (1.5) and the discussion forum comprised 15 posted messages. Overall, the proportions of patients being (very) satisfied with the amount of e-mail contacts, telephone contacts, usefulness of website information, physical activity schedules, group meetings and website layout were >/=85%. A smaller proportion of patients were satisfied with the links to other websites (68%), the newsletters (55%) and the online discussion forum (32%). Physical activity schedules with weekly feedback by e-mail, telephone contacts and a limited number of group meetings were frequently used website tools and modes of communication of an Internet-based physical activity intervention, with high-satisfaction rates from RA patients. Discussion forum and newsletters were less used and appreciated. Caution should be taken when extrapolating the results found to groups of patients who are not experienced Internet and e-mail users or patients with more severe physical disabilities.

Using internet technology to deliver a home‐based physical activity intervention for patients with rheumatoid arthritis: A randomized controlled trial

To compare the effectiveness of 2 Internet-based physical activity interventions for patients with rheumatoid arthritis (RA). A total of 160 physically inactive patients with RA who had a computer with Internet access were randomly assigned to an Internet-based physical activity program with individual guidance, a bicycle ergometer, and group contacts (individualized training [IT] group; n = 82) or to an Internet-based program providing only general information on exercises and physical activity (general training [GT] group; n = 78). Outcome measures included quantity of physical activity (questionnaire and activity monitor), functional ability, quality of life, and disease activity (baseline, 3, 6, 9, and 12 months). The proportion of physically active patients was significantly greater in the IT than in the GT group at 6 (38% versus 22%) and 9 months (35% versus 11%; both P < 0.05) regarding a moderate intensity level for 30 minutes in succession on at least 5 days a week, and at 6 (35% versus 13%), 9 (40% versus 14%), and 12 months (34% versus 10%; all P < 0.005) regarding a vigorous intensity level for 20 minutes in succession on at least 3 days a week. In general, there were no statistically significant differences regarding changes in physical activity as measured with an activity monitor, functional ability, quality of life, or disease activity. An Internet-based physical activity intervention with individually tailored supervision, exercise equipment, and group contacts is more effective with respect to the proportion of patients who report meeting physical activity recommendations than an Internet-based program without these additional elements in patients with RA. No differences were found regarding the total amount of physical activity measured with an activity monitor.