Effectiveness of sequentially delivered web-based interventions on promoting physical activity and fruit-vegetable consumption among college students: A mixed-methods approach (Preprint)

2021 ◽  
Author(s):  
Yanping Duan ◽  
Wei Liang ◽  
Yanping Wang ◽  
Sonia Lippke ◽  
Zhihua Lin ◽  
...  
Keyword(s):  
College Students ◽  
Behavior Change ◽  
Qualitative Data ◽  
Vegetable Consumption ◽  
Behavior Intervention ◽  
Control Group ◽  
Delivery Mode ◽  
Web Based ◽  
Chinese College Students ◽  
Health Related

BACKGROUND Evidence indicated a high prevalence of physical inactivity and insufficient consumption of fruit and vegetables among college students. Web-based interventions for multiple health behavior change (MHBC) appears to be a promising approach to change the unhealthy habit. Limited research has tested this assumption in promoting physical activity (PA) and fruit-vegetable consumption (FVC) among Chinese college students. Moreover, the best sequential delivery mode of MHBC intervention needs to be addressed. OBJECTIVE From both quantitative and qualitative perspectives, this study aimed to examine (1) the effectiveness of two sequentially delivered 8-week web-based interventions on PA, FVC and health-related outcomes, and (2) which sequential timing is superior in behavior change. The intervention content was based on the health action process approach. Self-reported data were evaluated including PA, FVC, and health-related outcomes (Body Mass Index (BMI), depression and quality of life). METHODS In a randomized controlled trial (RCT), 552 eligible college students (Mean = 19.99 ± 1.04 years, 58.3% female) were randomly assigned to one of three groups: PA-first (4 weeks of PA followed by 4 weeks of FVC intervention), FVC-first (4 weeks of FVC followed by 4 weeks of PA intervention), and a control group (8 weeks of placebo treatment unrelated to PA and FVC). A total of 4 web-based assessments were conducted, including at baseline (T1, n = 565), after 4 weeks (T2, after the first behavior intervention, n = 486), after 8 weeks (T3, after the second behavior intervention, n = 420), and after 12 weeks (T4, 1-month post-intervention follow-up, n = 348). In addition, after the completion of the entire 8-week intervention, 18 participants (Mean = 19.56 ± 1.04 years, 55.6% female) who completed the whole program were immediately invited to attend one-to-one and face-to-face semi-structured interviews. The participants were asked about their experience of participating in this program regarding their changes in health behaviors and health-related outcomes. The entire study was conducted throughout the fall semester of 2017. RESULTS Both quantitative and qualitative data supported superior effects on PA, FVC and BMI in two sequential intervention groups compared to the control group. In addition, the quantitative data found no significant behavior change differences between two sequential intervention groups after 8 weeks. But FVC-first group contributed to more maintenance of FVC compared to the PA-first group after 12 weeks. Findings from the qualitative study revealed that both intervention groups reported superior effects for the first addressed behavior after 8 weeks. CONCLUSIONS This study provides comprehensive evidence for the effectiveness of sequentially delivered web-based MHBC interventions on PA and FVC among Chinese college students. The efficacy of two sequential timing interventions on behavior change is mixed in quantitative and qualitative data. The delivery mode of MHBC interventions in the future is discussed. CLINICALTRIAL ClinicalTrials.gov NCT03627949(posted on April 18, 2019). INTERNATIONAL REGISTERED REPORT RR2-10.1186/s12889-019-7438-1

scholarly journals Maintaining or Losing Intervention-Induced Health-Related Behavior Change. A Mixed Methods Field Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Frida Skarin ◽  
Erik Wästlund ◽  
Henrik Gustafsson
Keyword(s):  
Mixed Methods ◽  
Behavior Change ◽  
Field Study ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Goal Achievement ◽  
Body Measurements ◽  
Behavior Change Interventions ◽  
Health Related

The aim of this mixed methods field study was to gain a better understanding of how psychological factors can contribute to success in intervention-induced behavior change over time. While it can be difficult to change behavior, the use of interventions means that most participants succeed in change during the intervention. However, it is rare for the immediate change to automatically transform into maintained behavior changes. Most research conducted on health-related behavior change interventions contains quantitative studies that investigate key intervention components on a group level. Hence, to bring more knowledge about maintained intervention-induced behavior change, there is need for a study approach that enhances the understanding of individual participants' experiences during and after the intervention. Therefore, the present study, which was conducted in Sweden, used a mixed methods design (triangulation) consisting of pre-, post-, and follow-up quantitative data (questionnaires and body measurements) and qualitative data (interviews), where the individuals' accounts are used to broaden the understanding of the intervention and the behavior change process. All study participants were enrolled in a volitional (fee-based and non-manipulated) intervention given by certified gyms. The quantitative data collection included 22 participants who completed questionnaires and body measurements before and after the intervention, plus 13 complete body measurements 6 months after the intervention. The qualitative data included pre-interviews with 12 participants and six follow-up-interviews. The questions in both questionnaires and interviews related to expectations, efficacy, motivation, goals, achievements, behavior change, and future. Overall, the results show that levels of expectations, efficacy, and motivation cannot be used in isolation to predict maintained intervention-induced behavior change. To successfully extend and maintain immediate change, it was crucial to experience goal achievement (but not BMI change). Furthermore, enabling talk was salient in the pre-interviews with participants reporting successful immediate (and maintained) change. By contrast, pre-interview disabling talk turned out to be evident in interviews, with participants not responding to follow-up. When the qualitative and quantitative results are summarized and integrated, it appears that subjective goal achievement, combined with enabling self-talk, were crucial factors in successful maintained behavior change.

scholarly journals Persuasive Effects of Message Framing and Narrative Format on Promoting COVID-19 Vaccination: A Study on Chinese College Students

2021 ◽  
Vol 18 (18) ◽  
pp. 9485
Author(s):  
WeiMing Ye ◽  
Qian Li ◽  
Shubin Yu
Keyword(s):  
College Students ◽  
Message Framing ◽  
Perceived Benefits ◽  
Health Crisis ◽  
Chinese College Students ◽  
Perceived Severity ◽  
Health Related ◽  
Narrative Format ◽  
Gain Loss ◽  
Perceived Costs

During a public health crisis, the provision and dissemination of health-related information are important for the relevant authorities to keep the public informed. By using different types of message framing, the authorities can effectively guide and persuade people to adopt health-related behaviors (such as vaccination). In this study, a web-based experiment using a 2 × 2 (message framing: gain framing versus loss framing) × (message presentation: narrative versus non-narrative) design was conducted to investigate the effects of different message frames on vaccination promotion. In total, 298 college students were recruited to participate in this study. The results suggest that, for message framing, loss-framed (vs. gain-framed) messages lead to higher intentions to get vaccinated. Furthermore, compared with non-narrative messages, narrative messages are more persuasive in promoting vaccination behavior. However, the interaction effect between gain–loss message framing and narrative framing is not significant. Additionally, perceived severity, perceived benefits, and perceived costs mediate the effect of narrative framing on behavioral intentions. In other words, compared with non-narrative messages, narrative messages lead to higher levels of perceived severity and perceived benefits, and a lower level of perceived costs, which in turn increase intentions to get vaccinated. This paper provides insightful implications for both researchers and practitioners.

scholarly journals Delivering Cognitive Behavior Therapy to Young Adults With Symptoms of Depression and Anxiety Using a Fully Automated Conversational Agent (Woebot): A Randomized Controlled Trial

2017 ◽  
Vol 4 (2) ◽  
pp. e19 ◽  
Author(s):  
Kathleen Kara Fitzpatrick ◽  
Alison Darcy ◽  
Molly Vierhile
Keyword(s):  
College Students ◽  
Univariate Analysis ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Conversational Agent ◽  
Conversational Agents ◽  
Significant Group ◽  
Web Based ◽  
Symptoms Of Depression ◽  
Self Help

Background Web-based cognitive-behavioral therapeutic (CBT) apps have demonstrated efficacy but are characterized by poor adherence. Conversational agents may offer a convenient, engaging way of getting support at any time. Objective The objective of the study was to determine the feasibility, acceptability, and preliminary efficacy of a fully automated conversational agent to deliver a self-help program for college students who self-identify as having symptoms of anxiety and depression. Methods In an unblinded trial, 70 individuals age 18-28 years were recruited online from a university community social media site and were randomized to receive either 2 weeks (up to 20 sessions) of self-help content derived from CBT principles in a conversational format with a text-based conversational agent (Woebot) (n=34) or were directed to the National Institute of Mental Health ebook, “Depression in College Students,” as an information-only control group (n=36). All participants completed Web-based versions of the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), and the Positive and Negative Affect Scale at baseline and 2-3 weeks later (T2). Results Participants were on average 22.2 years old (SD 2.33), 67% female (47/70), mostly non-Hispanic (93%, 54/58), and Caucasian (79%, 46/58). Participants in the Woebot group engaged with the conversational agent an average of 12.14 (SD 2.23) times over the study period. No significant differences existed between the groups at baseline, and 83% (58/70) of participants provided data at T2 (17% attrition). Intent-to-treat univariate analysis of covariance revealed a significant group difference on depression such that those in the Woebot group significantly reduced their symptoms of depression over the study period as measured by the PHQ-9 (F=6.47; P=.01) while those in the information control group did not. In an analysis of completers, participants in both groups significantly reduced anxiety as measured by the GAD-7 (F1,54= 9.24; P=.004). Participants’ comments suggest that process factors were more influential on their acceptability of the program than content factors mirroring traditional therapy. Conclusions Conversational agents appear to be a feasible, engaging, and effective way to deliver CBT.

Autonomy support in physical education promotes autonomous motivation towards leisure-time physical activity: evidence from a sample of Chinese college students

2018 ◽  
Vol 35 (1) ◽  
pp. e1-e10 ◽  
Author(s):  
Kahar Abula ◽  
Jürgen Beckmann ◽  
Zhongkai He ◽  
Chengwa Cheong ◽  
Fuquan Lu ◽  
...  
Keyword(s):  
Physical Activity ◽  
College Students ◽  
Physical Education ◽  
Autonomy Support ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Autonomous Motivation ◽  
Control Group ◽  
Chinese College Students ◽  
Perceived Autonomy Support

Summary Based on the trans-contextual model, two studies aimed to test whether autonomy-supportive physical education (PE) promotes autonomous motivation towards leisure-time physical activity among Chinese college students. Study 1 was conducted in September 2015 and used a cross-sectional design. Participants were students who provided data on perceived autonomy support and motivation for physical activity. Regression analysis was used to analyze the data. Study 2 took place from September to December 2015 and employed an experimental design. Participants were PE teachers and their students. The teachers were randomized to either an intervention or a control group and those in the intervention group received a 3-month long autonomy-supportive intervention program. Their students provided data on motivation. The data were analyzed with repeated measurement analysis of variance. A total of 681 students aged 16–26 years participated in Study 1. Perceived autonomy support predicted autonomous motivation in PE (β = 0.18, P = 0.001), which in turn predicted autonomous motivation towards leisure-time physical activity (β = 0.51, P = 0.001). Ten PE teachers (28–53 years) and 258 students (16–26 years) participated in Study 2. Students who were educated by the intervention teachers had significantly stronger autonomous motivation towards leisure-time physical activity than students educated by the control teachers after the intervention, (F = 12.41, P = 0.001). The results suggest that PE may serve as an effective platform to promote an active lifestyle among Chinese college students when teachers provide students with an experience of autonomy.

scholarly journals Relationship between Health-related Fitness and Web-based Physical Activity Records in College Students

2008 ◽  
Vol 14 (2) ◽  
pp. 13-19
Author(s):  
Kuei Yu CHIEN ◽  
Shu Chen CHEN ◽  
Wen Jong LIN ◽  
Hui Tan LO ◽  
Hung Jen CHEN ◽  
...  
Keyword(s):  
Physical Activity ◽  
College Students ◽  
Sedentary Time ◽  
The Body ◽  
Rating Of Perceived Exertion ◽  
Moderate Intensity ◽  
Web Based ◽  
Cardiovascular Endurance ◽  
Health Related ◽  
Health Related Fitness

LANGUAGE NOTE | Document text in English; abstract also in Chinese. The purpose of this study was to investigate the correlation between health-related fitness (HRF) and the physical activity (PA) level from web-based records in college students. The college students (N=221, 18.8±0.6 yr) were recruited. Sedentary time, exercise mode, duration and rating of perceived exertion scale for 7 days were recorded. The body mass index, sit-ups completed in 30 s and 60 s, standing long jump, sit and reach, and 800- or 1600-m run/walk were measured. Spearman correlation and independent t-test were used for statistics. A level of a=0.05 was set for significant on all tests. The results showed that both PA and moderate intensity physical activity were significantly related to HRF, where as cardiovascular endurance was not related. We suggested PA probably affect life movement but not cardiovascular endurance. This study also indicated the correlation patterns were different in gender. The best strategies to promote HRF in college students are to reduce the sedentary time for male and to increase PA intensity for female. 本研究主要探討網路版之身體活動量與大學生健康體適能關聯，本研究招募221位(18.8±0.6歲)大學生記錄7天靜態生活與運動種類、時間以及運動時自覺努力的程度，此外進行健康體適能之身體質量指數、一分鐘仰臥起坐、立定跳遠、坐姿體前彎以及男生1600公尺或是女生之800公尺跑走測驗。以Spearman積差相關進行各變數之關聯度檢定，並以獨立樣本t檢定考驗男生與女生間各變數之差異性，顯著水準定在0.05。結果顯示無論每週平均身體活動時間或是中等強度身體活動時間與非心肺適能之健康適能具顯著的關聯，此結果暗示了身體活動量與日常生活之活動力有關，與心肺適能無關，本研究亦發現身體活動量與健康適能關聯型態因性別不同而有所不同，本校最佳之男性體適能增進策略為減少坐式時間，最佳之女性體適能增進策略為增強運動強度。

A Web-Based Risk Reframing Intervention to Influence Early Childhood Educators’ Attitudes and Supportive Behaviors Toward Outdoor Play: Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Mariana Brussoni ◽  
Christina S Han ◽  
John Jacob ◽  
Fritha Munday ◽  
Megan Zeni ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Early Childhood ◽  
Behavior Change ◽  
Controlled Trial ◽  
Early Childhood Educators ◽  
Outdoor Play ◽  
Control Group ◽  
Web Based ◽  
Children's Play ◽  
Randomized Controlled

BACKGROUND Outdoor play supports children’s physical, social, emotional and intellectual development, yet opportunities for outdoor play are declining in many societies. Early learning and childcare centers (ELCCs) can offer young children critical opportunities for quality outdoor play. There are multiple actual and perceived barriers to outdoor play in ELCCs, ranging from safety fears and lack of familiarity with supporting play outdoors to challenges around diverse perspectives on outdoor play among colleagues, administrators, licensing officers and parents. Building on OutsidePlay.ca, our previous web-based intervention to change parents’ attitudes and behaviors toward risky play, we sought to develop a web-based intervention for Canadian ELCC stakeholders. OBJECTIVE Our study objective was to develop and evaluate a web-based intervention that influences early childhood educators’ (ECEs) and ELCC administrators’ perceptions and practices in support of children’s outdoor play in ELCCs. METHODS Our study was guided by the intervention mapping process. We first completed a needs assessment through focus groups of ELCC educators, administrators and licensing officers. We identified key issues, needs and challenges, opportunities to influence behavior change, and intervention outcomes and objectives. This enabled us to develop design objectives and identify features of the OutsidePlay.ca web-based intervention that are central to addressing ECEs and ELCC administrators’ issues, needs and challenges. We used social cognitive theory and behavior change techniques to select methods, applications and technology to deliver the intervention. A mock-up of the intervention was created and revised based on ELCC stakeholders feedback and recommendations. We will use a two-parallel-group randomized controlled trial (RCT) design to evaluate the efficacy of the intervention. We will recruit 324 ECEs and ELCC administrators to randomize into the intervention or the control group. The control group is reading the Position Statement on Active Outdoor Play. RESULTS The primary outcome is increased tolerance of risk in children’s play, as measured by the Teacher Tolerance of Risk in Play Scale. The secondary outcome is self-reported attainment of a self-developed behavior change goal. We will test the hypothesis that there will be a difference between the experimental and control groups with respect to tolerance of risk in children’s play using mixed-effects models. Differences in goal attainment will be tested using logistic regression. CONCLUSIONS The OutsidePlay.ca web-based intervention guides users through a personalized journey that is split into three chapters. An effective intervention that addresses the barriers to outdoor play in ELCC settings has the potential to improve children’s access to outdoor play and support high quality early childhood education. CLINICALTRIAL ClinicalTrials.gov PRS – NCT04624932

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