trips4health: Protocol of a single-blinded randomised controlled trial incentivising adults to use public transport for physical activity gain

Abstract

Background Public transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting. Methods trips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined. Discussion trips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies. Trial registration ACTRN12619001136190. Universal trial number U1111-1233-8050.

Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults

“…Overall 464 unique articles were identified once 14 duplicates were removed. Two reviewers completed title and abstract screening identifiying 29 for full-text screening; of these, 21 met our criteria, 8 are ongoing studies,56–63 8 are completed trials where a process evaluation was conducted but results are not available,64–71 and 5 are completed studies with process evaluation results available 72–76. As with the studies that were synthesised in our review, these included participants from a range of different ages and health conditions for example, insomnia disorder, diabetes, heart disease, hip fracture and obesity and generally focused on increasing physical activity, reducing sedentary behaviour or were lifestyle or weight loss interventions.…”

trips4health: a single-blinded randomised controlled trial incentivising adult public transport use for physical activity gain

“…The trips4health study was a single-blinded RCT involving adults undertaking infrequent public transport use (≤ 2 trips per week) in the state capital (greater Hobart region) of Tasmania, Australia [ 15 ]. Within this region, public transport was comprised of only bus services, predominantly offered by one provider, Metro Tasmania Pty.…”

“…Using an incentive-based intervention, the trips4health study provided an immediate reward (financial gain) as a motivator for the uptake of public transport usage. The study protocol [ 15 ], acceptability and feasibility [ 16 ], and positive impact on bus use in the control vs intervention group [ 17 ] has been described in detail elsewhere; process evaluation findings indicated that the trips4health study demonstrated strong fidelity, feasibility, and acceptability [ 16 ].…”

Incentivising public transport use for physical activity gain: process evaluation of the COVID-19 disrupted trips4health randomised controlled trial

“…Full details of trips4health are outlined in the protocol [ 15 ] and are summarised here. trips4health was a RCT with a 16-week intervention phase and a 6-month follow-up phase targeting infrequent adult bus users.…”

“…Recruitment was through social and local radio and printed media, on-bus and bus exchange advertising, concurrent University of Tasmania travel survey and staff intranet, newsletters of relevant organisation such as state government, and personal and professional networks of the project team. Potential trips4health participants were screened for eligibility via an online or telephone questionnaire (Additional File Table A1 ) [ 15 ]. Key eligibility criteria included residing in the Greater Hobart area, being an adult (age ≥ 18 years), using the bus less than or equal to two trips per week in the past 6 months, and possessing or willingness to obtain a travel smartcard.…”