Translating promoting factors and behavior change principles into the blended and technology supported intervention “Foxfit” to stimulate physical activity in children with asthma: Design study (Preprint)

BACKGROUND Children with asthma can decrease the impact of their disease by improving their physical activity (PA). However, healthcare providers lack in interventions for children with asthma that effectively increase their PA levels and achieve behavior change regarding PA. A technology supported approach can positively influence PA and physical functioning in children. OBJECTIVE The aim of this study was to develop a technology supported intervention that facilitates healthcare providers in promoting PA for children with asthma and to systematically describe this developmental process. METHODS Intervention mapping (IM) was applied to develop a blended and technology supported intervention in co-creation with children with asthma, their parents, and healthcare providers. According to the IM framework, the following steps were performed: 1) conduct a needs assessment; 2) define the intervention outcome, performance objectives, and change objectives; 3) select theory based intervention methods and strategies; 4) create components of the intervention and conduct pilot tests; 5) create an implementation plan; and 6) create an evaluation plan. RESULTS We developed the blended intervention “Foxfit” that consists of an app with a physical activity monitor (PAM) for children with asthma, and a web-based dashboard for their healthcare provider. The intervention focusses on PA in everyday life to improve social participation. Foxfit contains components based on behavior change principles and gamification: goal setting, rewards, action planning, (self-)monitoring, shaping knowledge, a gamified story, personal coaching and feedback, and a tailored approach. CONCLUSIONS The IM framework was very useful to systematically develop a technology supported intervention and to describe the translational process from scientific evidence, the needs and wishes of future users, and behavior change principles into this intervention. This has led to the technology supported intervention Foxfit that facilitates healthcare providers in promoting PA in children with asthma. The structured description of the development process and functional components shows the way behavior change techniques are incorporated in the intervention. CLINICALTRIAL Dutch Trial Register: NTR6658

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Promoting Factors for Physical Activity in Children with Asthma Explored through Concept Mapping

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16224467 ◽

2019 ◽

Vol 16 (22) ◽

pp. 4467 ◽

Cited By ~ 1

Author(s):

Annette Brons ◽

Katja Braam ◽

Annieck Timmerman ◽

Aline Broekema ◽

Bart Visser ◽

...

Keyword(s):

Physical Activity ◽

Concept Mapping ◽

Healthcare Providers ◽

Personal Factors ◽

Mapping Study ◽

Physically Active ◽

Children With Asthma ◽

And Cluster Analysis ◽

Study Participants ◽

The Impact

For children with asthma, physical activity (PA) can decrease the impact of their asthma. Thus far, effective PA promoting interventions for this group are lacking. To develop an intervention, the current study aimed to identify perspectives on physical activity of children with asthma, their parents, and healthcare providers. Children with asthma between 8 and 12 years old (n = 25), their parents (n = 17), and healthcare providers (n = 21) participated in a concept mapping study. Participants generated ideas that would help children with asthma to become more physically active. They sorted all ideas and rated their importance on influencing PA. Clusters were created with multidimensional scaling and cluster analysis. The researchers labelled the clusters as either environmental or personal factors using the Physical Activity for people with a Disability model. In total, 26 unique clusters were generated, of which 17 were labelled as environmental factors and 9 as personal factors. Important factors that promote physical activity in children with asthma according to all participating groups are asthma control, stimulating environments and relatives, and adapted facilities suiting the child’s needs. These factors, supported by the future users, enable developing an intervention that helps healthcare providers to promote PA in children with asthma.

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Baby Steps: Using Intervention Mapping to Develop a Sustainable Perinatal Physical Activity Healthcare Intervention

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18115869 ◽

2021 ◽

Vol 18 (11) ◽

pp. 5869

Author(s):

Anna M. Dieberger ◽

Mireille N. M. van Poppel ◽

Estelle D. Watson

Keyword(s):

Physical Activity ◽

Behavior Change ◽

Community Health ◽

Community Health Workers ◽

Health Workers ◽

Intervention Mapping ◽

Healthcare Intervention ◽

Activity Levels ◽

Major Barrier ◽

Practical Applications

While the benefits of physical activity (PA) during and after pregnancy have been established, many women do not reach the recommended PA levels during this time. A major barrier found in the literature is a lack of counselling by healthcare providers (HCPs), which is partly caused by the limited knowledge on the topic. The aim of this study was to develop an intervention to improve the promotion of PA by HCPs. We used Intervention Mapping (IM), a theory-based framework to develop an intervention, called “Baby steps”, in a high-income (Austria) and a low-to-middle-income country (South Africa). We applied the following IM steps: (1) A needs assessment to determine the barriers and enablers of PA promotion by HCPs, including a scoping literature review and community needs assessments (qualitative interviews, questionnaires, and focus groups with midwives, obstetricians, and community health workers) to determine the desired outcomes of the intervention. (2) Performance and change objectives were formulated, describing the behaviors that need to change for the intervention to succeed. (3) Based on these objectives, theory-based behavior change techniques were selected, and practical applications were developed. (4) The applications were combined into two evidence-based interventions tailored to each country’s needs. Step (5) and (6) consist of an implementation and evaluation plan, respectively. The intervention is aimed at HCPs, such as midwives and community health workers, consisting of a two-day training course, including practical resources. Combining didactic and interactive education, it addresses both PA knowledge and the skills needed to transfer knowledge and facilitate behavior change. In the future, the intervention’s effect on women’s activity levels during and after pregnancy needs to be studied.

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Determining the Impact of an Educational Intervention on Family Medicine Residents’ Social Cognitions and Behavior for Discussing Physical Activity

Teaching and Learning in Medicine ◽

10.1080/10401334.2021.1891542 ◽

2021 ◽

pp. 1-16

Author(s):

Stephanie M. Flood ◽

Katrina A. D’Urzo ◽

Scott Shallow ◽

Sarah Dobrowolski ◽

Kelly Howse ◽

...

Keyword(s):

Physical Activity ◽

Family Medicine ◽

Educational Intervention ◽

Social Cognitions ◽

And Behavior ◽

The Impact ◽

Family Medicine Residents

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Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review

10.21203/rs.3.rs-39460/v2 ◽

2020 ◽

Author(s):

Janis Fiedler ◽

Tobias Eckert ◽

Kathrin Wunsch ◽

Alexander Woll

Keyword(s):

Physical Activity ◽

Behavior Change ◽

Sedentary Behavior ◽

Healthy Eating ◽

Social Contexts ◽

Just In Time ◽

Umbrella Review ◽

Behavior Change Techniques ◽

Adaptive Interventions ◽

The Impact

Abstract Background: Electronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology.Methods: PubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized.Results: The systematic search reveled eleven systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions.Conclusion: Findings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions.Trial registration: The protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

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Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – an umbrella review

BMC Public Health ◽

10.1186/s12889-020-09700-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Janis Fiedler ◽

Tobias Eckert ◽

Kathrin Wunsch ◽

Alexander Woll

Keyword(s):

Physical Activity ◽

Behavior Change ◽

Sedentary Behavior ◽

Healthy Eating ◽

Social Contexts ◽

Just In Time ◽

Umbrella Review ◽

Behavior Change Techniques ◽

Adaptive Interventions ◽

The Impact

Abstract Background Electronic (eHealth) and mobile (mHealth) health interventions can provide a large coverage, and are promising tools to change health behavior (i.e. physical activity, sedentary behavior and healthy eating). However, the determinants of intervention effectiveness in primary prevention has not been explored yet. Therefore, the objectives of this umbrella review were to evaluate intervention effectiveness, to explore the impact of pre-defined determinants of effectiveness (i.e. theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions), and to provide recommendations for future research and practice in the field of primary prevention delivered via e/mHealth technology. Methods PubMed, Scopus, Web of Science and the Cochrane Library were searched for systematic reviews and meta-analyses (reviews) published between January 1990 and May 2020. Reviews reporting on e/mHealth behavior change interventions in physical activity, sedentary behavior and/or healthy eating for healthy subjects (i.e. subjects without physical or physiological morbidities which would influence the realization of behaviors targeted by the respective interventions) were included if they also investigated respective theoretical foundations, behavior change techniques, social contexts or just-in-time adaptive interventions. Included studies were ranked concerning their methodological quality and qualitatively synthesized. Results The systematic search revealed 11 systematic reviews and meta-analyses of moderate quality. The majority of original research studies within the reviews found e/mHealth interventions to be effective, but the results showed a high heterogeneity concerning assessment methods and outcomes, making them difficult to compare. Whereas theoretical foundation and behavior change techniques were suggested to be potential positive determinants of effective interventions, the impact of social context remains unclear. None of the reviews included just-in-time adaptive interventions. Conclusion Findings of this umbrella review support the use of e/mHealth to enhance physical activity and healthy eating and reduce sedentary behavior. The general lack of precise reporting and comparison of confounding variables in reviews and original research studies as well as the limited number of reviews for each health behavior constrains the generalization and interpretation of results. Further research is needed on study-level to investigate effects of versatile determinants of e/mHealth efficiency, using a theoretical foundation and additionally explore the impact of social contexts and more sophisticated approaches like just-in-time adaptive interventions. Trial registration The protocol for this umbrella review was a priori registered with PROSPERO: CRD42020147902.

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Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

American Journal of Men s Health ◽

10.1177/1557988315587550 ◽

2015 ◽

Vol 11 (4) ◽

pp. 1096-1123 ◽

Cited By ~ 13

Author(s):

Clare Robertson ◽

Alison Avenell ◽

Fiona Stewart ◽

Daryll Archibald ◽

Flora Douglas ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Weight Loss ◽

Confidence Interval ◽

Behavior Change ◽

Randomized Controlled Trials ◽

Controlled Trials ◽

Behavior Change Techniques ◽

Randomized Controlled ◽

And Behavior

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

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Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors

American Journal of Lifestyle Medicine ◽

10.1177/1559827616661490 ◽

2016 ◽

Vol 12 (3) ◽

pp. 184-199 ◽

Cited By ~ 8

Author(s):

Steve Amireault ◽

Angela J. Fong ◽

Catherine M. Sabiston

Keyword(s):

Physical Activity ◽

Health Behavior ◽

Behavior Change ◽

Cancer Survivors ◽

Healthy Eating ◽

Health Behavior Change ◽

Cochrane Library ◽

Multiple Health Behavior Change ◽

The Impact ◽

Multiple Health

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.

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Evaluation of a Cognitive Tool for Enhanced Decision Making and Personal Change among College Students

NACADA Journal ◽

10.12930/0271-9517-32.1.18 ◽

2012 ◽

Vol 32 (1) ◽

pp. 18-29 ◽

Cited By ~ 6

Author(s):

Crystal Mata Kreitler ◽

Donald F. Dansereau ◽

Timothy M. Barth ◽

Gregory T. Repasky ◽

James Miller

Keyword(s):

College Students ◽

Decision Making ◽

Treatment Group ◽

Behavior Change ◽

Cognitive Tool ◽

Personal Change ◽

Writing Group ◽

And Behavior ◽

The Impact ◽

Spatial Display

Many college students have difficulty with decision making and personal change. In this study, we examine the impact of a fill-in-the-node spatial display that college students complete while considering alternatives and action plans related to dilemmas and behavior change. College students who utilized the cognitive tool reported greater positive expectations for future decision making and personal change than did those in a problem-based writing group and a no treatment group. Implications for academic advisors are discussed.

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Mental and Emotional Self-Help Technology Apps: Cross-Sectional Study of Theory, Technology, and Mental Health Behaviors

JMIR Mental Health ◽

10.2196/mental.7262 ◽

2017 ◽

Vol 4 (4) ◽

pp. e45 ◽

Cited By ~ 8

Author(s):

Benjamin T Crookston ◽

Joshua H West ◽

P Cougar Hall ◽

Kaitana Martinez Dahle ◽

Thomas L Heaton ◽

...

Keyword(s):

Mental Health ◽

Behavior Change ◽

Health Behaviors ◽

Emotional Health ◽

Actual Behavior ◽

Cross Sectional ◽

Health Apps ◽

Self Help ◽

And Behavior ◽

The Impact

Background Mental and emotional self-help apps have emerged as potential mental illness prevention and treatment tools. The health behavior theory mechanisms by which these apps influence mental health–related behavior change have not been thoroughly examined. Objective The objective of this study was to examine the association between theoretical behavior change mechanisms and use of mental and emotional self-help apps and whether the use of such apps is associated with mental health behaviors. Methods This study utilized a cross-sectional survey of 150 users of mental or emotional health apps in the past 6 months. Survey questions included theory-based items, app engagement and likeability items, and behavior change items. Stata version 14 was used to calculate all statistics. Descriptive statistics were calculated for each of the demographic, theory, engagement, and behavior variables. Multiple regression analysis was used to identify factors associated with reported changes in theory and separately for reported changes in actual behavior after controlling for potentially confounding variables. Results Participants reported that app use increased their motivation, desire to set goals, confidence, control, and intentions to be mentally and emotionally healthy. Engagement (P<.001) was positively associated with the reported changes in theory items, whereas perceived behavior change was positively associated with theory (P<.001), engagement (P=.004), frequency of use of apps (P=.01), and income (P=.049). Conclusions Participants reported that app use increased their motivation, desire to set goals, confidence, control, and intentions to be mentally and emotionally healthy. This increase in perceptions, beliefs, and attitudes surrounding their mental and emotional health was considerably associated with perceived change in behavior. There was a positive association between the level of engagement with the app and the impact on theory items. Future efforts should consider the value of impacting key theoretical constructs when designing mental and emotional health apps. As apps are evaluated and additional theory-based apps are created, cost-effective self-help apps may become common preventative and treatment tools in the mental health field.

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