Effectiveness of a web- and mobile phone-based intervention to promote physical activity and healthy eating in middle-Aged males: Randomized controlled trial of the manup study

Background: The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviours, necessitate broad-reaching intervention strategies. IT-based (web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males’ physical activity and dietary practices. Objective: This study examines the effectiveness of a 9-month IT-based intervention to improve the physical activity, dietary behaviours and health literacy in middle-aged males compared to a print-based intervention. Methods: Participants, recruited offline (e.g. newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favour of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in two regional cities in Queensland Australia who could access the internet, owned a mobile phone and were able to increase their activity level. The intervention, ManUp, was informed by social cognitive and self regulation theories and was specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviours was promoted. Intervention content was the same in both intervention arms, only the delivery mode differed, and content could be accessed throughout the 9-month study period. Participants’ physical activity, dietary behaviours, and health literacy were measured using online surveys at baseline, 3 months and 9 months. Results: A total of 301 participants completed baseline assessments, 205 in the ITbased arm and 96 in the print-based arm. A total of 124 participants completed all three assessments. There were no significant between group differences in physical 5 activity and dietary behaviours (p ≥0.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (b(exp)=1.45, 95% CI=1.09-1.95; b(exp)=1.61, 95% CI=1.17-2.22) and 9 months (b(exp)=1.55, 95% CI=1.14-2.10; b(exp)=1.51, 95% CI=1.15-2.00). Overall dietary behaviours improved at 3 months (b(exp)=1.07, 95% CI=1.03-1.11) and 9 months (b(exp)=1.10, 95% CI=1.05-1.13). The proportion of participants in both groups eating higher-fibre bread and low-fat milk increased at 3 months (b(exp) = 2.25, 95% CI = 1.29-3.92; b(exp)=1.65, 95% CI = 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (b(exp)=0.48, 95% CI=0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (b(exp)=1.70, 95% CI=1.02-2.82). The average number of logins to the IT-platform at 3 and 9 months was 6.99 (SE=0.86) and 9.22 (SE=1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE=2.38) and 22.51 (SE=3.79), respectively. Conclusions: The ManUp intervention was effective in improving physical activity and dietary behaviours in middle aged males with no significant differences between IT- and print-based delivery modes

10,000 Steps in the primary school environment a pilot study, 2010. /

This report details the results of six focus groups conducted to determine applicability of the 10,000 Steps program in the primary school environment. Resources were discussed with both teachers (three focus groups) and students (three focus groups) from the participating schools to determine the response and awareness of the 10,000 Steps program, pedometer performance as well as which 10,000 Steps resources were used and their appropriateness for the school environment. Based on the findings, recommendations on how the 10,000 Steps program could be tailored to the primary school environment were proposed

Examining participant engagement in an information technology-based physical activity and nutrition intervention for men: the ManUp randomized controlled trial

Background: Males experience a shorter life expectancy and higher rates of chronic diseases compared to their female counterparts. To improve health outcomes among males, interventions specifically developed for males that target their health behaviors are needed. Information technology (IT)-based interventions may be a promising intervention approach in this population group, however, little is known about how to maximize engagement and retention in Web-based programs. Objective: The current study sought to explore attributes hypothesized to influence user engagement among a subsample of participants from the ManUp study, a randomized controlled trial testing the efficacy of an interactive Web-based intervention for promoting physical activity and nutrition among middle-aged males. Methods: Semistructured interviews were conducted and audiotaped with 20 of the ManUp participants. Interview questions were based on a conceptual model of engagement and centered on why participants took part in the study, what they liked and did not like about the intervention they received, and how they think the intervention could be improved. Interview recordings were transcribed and coded into themes. Results: There were five themes that were identified in the study. These themes were: (1) users’ motives, (2) users’ desired outcomes, (3) users’ positive experiences, (4) users’ negative emotions, and (5) attributes desired by user. Conclusions: There is little research in the field that has explored user experiences in human-computer interactions and how such experiences may relate to engagement, especially among males. Although not conclusive, the current study provides some insight into what personal attributes of middle-aged males (such as their key motives and goals for participating) and attributes of the intervention materials (such as usability, control, and interactivity) may impact on user engagement in this group. These findings will be helpful for informing the design and implementation of future health behavior interventions for males

Understanding super engaged users in the 10,000 Steps online physical activity program: A qualitative study

Objective Sustained engagement with Internet-based behavioural interventions is crucial to achieve successful behaviour change outcomes. As this has been problematic in many interventions, a lot of research has focused on participants with little or no engagement. However, few studies have attempted to understand users with continuous long-term engagement, the so called ‘super engaged users’, and why they keep on using programs when everybody else has long stopped. Therefore, the aim of this research was to qualitatively examine characteristics, usage profile and motivations of super engaged users in the 10,000 Steps program. Methods Twenty 10,000 Steps users (10 with more than 1 year of engagement, and 10 with more than 10 years of engagement) participated in semi-structured interviews, that were transcribed and thematically analysed. Results Participants were aged 60 years on average, with more than half being overweight/obese and/or suffering from chronic disease despite logging high step counts (219 million steps per participant on average) on the 10,000 Steps platform. Participants indicated that the reasons for sustained use were that engaging the program had become a habit, that the program kept them motivated, and that it was easy to use. Few participants had suggestions for improvement or expressed there were program elements they did not like. Uptake of program innovations (e.g., app-version, use of advanced activity tracker instead of pedometer) was modest among the super engaged users. Conclusion The findings from this study emphasise the need for digital health programs to incorporate features that will support the development of habits as soon as participants start to engage with the program. While a program’s usability, user-friendliness and acceptability are important to engage and retain new users, habit formation may be more important for sustained long-term engagement with the behaviour and the program

10,000 Steps Workplaces Evaluation

This report details the results of an evaluation of the 10,000 Steps programs and resources within workplaces. It examines the type of workplaces that utilise the program, how it has been used and the usefulness of the 10,000 Steps resources for promoting physical activity in the workplace. A web-based survey was conducted between April 7 and May 20, 2011 to determine the use and usefulness of the 10,000 Steps program and its resources in workplaces. A sample of 1,698 current 10,000 Steps Providers were invited to participate in the web-based survey. In total, 282 Providers responded with a partial or complete survey that was able to be analysed, resulting in a response rate of 16.6%

10,000 Steps in the primary school environment: A pilot study, 2010

This report details the results of six focus groups conducted to determine applicability of the 10,000 Steps program in the primary school environment. Resources were discussed with both teachers (three focus groups) and students (three focus groups) from the participating schools to determine the response and awareness of the 10,000 Steps program, pedometer performance as well as which 10,000 Steps resources were used and their appropriateness for the school environment. Based on the findings, recommendations on how the 10,000 Steps program could be tailored to the primary school environment were proposed

A mobile phone enabled health promotion program for middle-aged males

The prevalence of chronic diseases among middle aged males outweigh their female counterparts in developed countries. To prevent this, delivery of health promotion programs targeting lifestyle modifications of physical activity and nutrition in middle-aged males has been essential, but often difficult. ManUp health promotion program was a recent initiative that uses current advances in information and communication technology (ICT) to reach the middle-aged males. One of the key components of the ICT approach was the development of smartphone application to enable middle-aged men to uptake the program with their own mobile phone. The smart phone application was aimed at providing varied level of challenges towards physical activity and healthy eating behavior, with interactive and motivational feedback SMS messages. The ManUp program was recently implemented and trialed in a randomized control trial in Gladstone and Rockhampton, Queens. This paper describes the components of the smart phone application integrated within the ManUp health promotion program. © 2013 IEEE

10,000 Steps Workplaces Evaluation

This report details the results of an evaluation of the 10,000 Steps programs and resources within workplaces. It examines the type of workplaces that utilise the program, how it has been used and the usefulness of the 10,000 Steps resources for promoting physical activity in the workplace. A web-based survey was conducted between April 7 and May 20, 2011 to determine the use and usefulness of the 10,000 Steps program and its resources in workplaces. A sample of 1,698 current 10,000 Steps Providers were invited to participate in the web-based survey. In total, 282 Providers responded with a partial or complete survey that was able to be analysed, resulting in a response rate of 16.6%

Exploring the feasibility of implementing a pedometer-based physical activity program in primary school settings : a case study of 10,000 steps

The school environment provides an ideal setting for physical activity programs. The aim of the current research was to explore the feasibility and appropriateness of implementing program resources from a pedometer based physical activity program (10,000 Steps) into the primary school environment

Exploring the feasibility of implementing a pedometer-based physical activity program in primary school settings : a case study of 10,000 steps

The school environment provides an ideal setting for physical activity programs. The aim of the current research was to explore the feasibility and appropriateness of implementing program resources from a pedometer based physical activity program (10,000 Steps) into the primary school environment