Effectiveness of a 3-Month Mobile Phone–Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial

Abstract

Background Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking. Objective The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA). Methods For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months. Results No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day. Conclusions No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA. Trial Registration ClinicalTrials.gov NCT03086837; https://clinicaltrials.gov/ct2/show/NCT03086837 International Registered Report Identifier (IRRID) RR2-10.1186/s12889-018-5658-4

User Perception of a Smartphone App to Promote Physical Activity Through Active Transportation: Inductive Qualitative Content Analysis Within the Smart City Active Mobile Phone Intervention (SCAMPI) Study

“…Furthermore, the entire intervention group and the participants in the interviews lived in similar residential areas (urban) of Stockholm County. At baseline, there was a wide range in their use of active transportation, as reported previously [ 24 ], and no difference between the entire group and the participants in this qualitative study (intervention group: n=127; mean AT 58 min/day, SD 29; qualitative study: n=17; mean AT 55 min/day, SD 22; P =.68). Informed consent was obtained at the start of the interview.…”

“…Self-monitoring is also one of 3 steps in the behavior change process, according to Bandura’s social cognitive theory [ 31 ]. This is important, as the quantitative outcome of this project showed an increase in moderate-to-vigorous PA at the 6-month follow-up [ 24 ]. By creating awareness, the app might have initiated a process of behavior change that was first seen after 6 months.…”

“…The SCAMPI trial was conducted between September 2017 and September 2018 in Stockholm County, Sweden (N=254) [ 23 ]. Full details on the trial’s design and methods, as well as the main intervention results, are published elsewhere [ 23 , 24 ]. Briefly, all participants downloaded the TRavelVU app and used it for baseline and follow-up measurements of their AT.…”

“…Recently, the main results from the Smart City Active Mobile Phone Intervention (SCAMPI) randomized controlled trial (ClinicalTrials.gov NCT03086837) [ 23 ] were published [ 24 ]. The SCAMPI trial aimed to evaluate the effectiveness of a 3-month behavior change program delivered through a mobile phone app to promote AT (TRavelVU Plus app) on moderate-to-vigorous PA.…”

“…The SCAMPI trial aimed to evaluate the effectiveness of a 3-month behavior change program delivered through a mobile phone app to promote AT (TRavelVU Plus app) on moderate-to-vigorous PA. The results showed that there was a moderate effect of the intervention on moderate-to-vigorous PA at 6 months after baseline, which corresponded to around 30% of the weekly recommendation [ 24 ]. In this qualitative study, we examine the acceptance and user experience of the app used to promote AT in the SCAMPI trial (ie, the TRavelVU Plus app).…”