Which behaviour change techniques are effective to promote physical activity and reduce sedentary behaviour in adults: a factorial randomized trial of an e- and m-health intervention

Abstract

Background E- and m-health interventions are promising to change health behaviour. Many of these interventions use a large variety of behaviour change techniques (BCTs), but it’s not known which BCTs or which combination of BCTs contribute to their efficacy. Therefore, this experimental study investigated the efficacy of three BCTs (i.e. action planning, coping planning and self-monitoring) and their combinations on physical activity (PA) and sedentary behaviour (SB) against a background set of other BCTs. Methods In a 2 (action planning: present vs absent) × 2 (coping planning: present vs absent) × 2 (self-monitoring: present vs absent) factorial trial, 473 adults from the general population used the self-regulation based e- and m-health intervention ‘MyPlan2.0’ for five weeks. All combinations of BCTs were considered, resulting in eight groups. Participants selected their preferred target behaviour, either PA (n = 335, age = 35.8, 28.1% men) or SB (n = 138, age = 37.8, 37.7% men), and were then randomly allocated to the experimental groups. Levels of PA (MVPA in minutes/week) or SB (total sedentary time in hours/day) were assessed at baseline and post-intervention using self-reported questionnaires. Linear mixed-effect models were fitted to assess the impact of the different combinations of the BCTs on PA and SB. Results First, overall efficacy of each BCT was examined. The delivery of self-monitoring increased PA (t = 2.735, p = 0.007) and reduced SB (t = − 2.573, p = 0.012) compared with no delivery of self-monitoring. Also, the delivery of coping planning increased PA (t = 2.302, p = 0.022) compared with no delivery of coping planning. Second, we investigated to what extent adding BCTs increased efficacy. Using the combination of the three BCTs was most effective to increase PA (x2 = 8849, p = 0.003) whereas the combination of action planning and self-monitoring was most effective to decrease SB (x2 = 3.918, p = 0.048). To increase PA, action planning was always more effective in combination with coping planning (x2 = 5.590, p = 0.014; x2 = 17.722, p < 0.001; x2 = 4.552, p = 0.033) compared with using action planning without coping planning. Of note, the use of action planning alone reduced PA compared with using coping planning alone (x2 = 4.389, p = 0.031) and self-monitoring alone (x2 = 8.858, p = 003), respectively. Conclusions This study provides indications that different (combinations of) BCTs may be effective to promote PA and reduce SB. More experimental research to investigate the effectiveness of BCTs is needed, which can contribute to improved design and more effective e- and m-health interventions in the future. Trial registration This study was preregistered as a clinical trial (ID number: NCT03274271). Release date: 20 October 2017.

Investigating When, Which, and Why Users Stop Using a Digital Health Intervention to Promote an Active Lifestyle: Secondary Analysis With A Focus on Health Action Process Approach–Based Psychological Determinants

“…This paper addresses these questions through secondary analysis of a digital health intervention that aimed to increase PA or reduce SB among the general population [ 28 , 29 ]. This intervention was developed using the health action process approach (HAPA) model, which describes psychological determinants that guide individuals in changing their behavior [ 30 ].…”

The conceptual framework for a combined food literacy and physical activity intervention to optimize metabolic health among women of reproductive age in urban Uganda

“…Implementation intentions can be achieved through goal setting [ 24 , 34 , 35 ]. Goal setting necessitates competence, which we hypothesised to be attained through a combination of (i) action planning; (ii) guided practice; ii) self-monitoring; iv) feedback on performance and v) planning of coping plans [ 24 , 26 , 34 – 36 ]. To sustain the behavioural goals requires relatedness, which can be achieved using a combination of social support, role modelling, feedback, planning coping responses and motivation interviewing [ 20 , 24 , 34 ].…”

“…Fourth, the intervention is designed with a combination of eleven evidence based BCT, scientifically proven to enact changes in knowledge, skills, self-efficacy, subjective norms, and social support to create a sustainable behaviour change [ 20 , 35 , 36 , 43 ]. The limitation is that the evidence for the effectiveness of the BCT is exclusively from HIC due to lack of evidence in urban SSA.…”

Cue-based versus scheduled feeding for preterm infants transitioning from tube to oral feeding: the Cubs mixed-methods feasibility study

“…On its own, instructions to perform a behaviour that requires effort is not particularly effective. 59 The combination of BCTs is known to make interventions more effective. Of note, one study used nine BCTs, 42 one used six 26 and another used five.…”