Move@NUS: a Digital Intervention Cohort Promoting Healthy Movement Behaviours

Move@NUS: Pilot Study of a Digital Intervention Cohort to Promote Healthy Sleep, Screen Viewing, and Physical Activity Habits for Improved Health and Wellbeing

The aim of the Move@NUS pilot study is to determine the feasibility of establishing a digital intervention cohort to monitor and improve the health and wellbeing of students by encouraging them to engage in healthy movement behaviours (i.e., physical activity, sleep, and limiting smartphone-based recreational screentime).

The digital intervention cohort consists of:

• 6-months of continuous monitoring of movement behaviours, wellbeing and related factors via an Apple Watch and repeated bursts of ecological momentary assessments (EMAs).
• 3x embedded randomised controlled trials (RCTs) evaluating the efficacy of small-scale smartphone-based interventions designed to nudge participants toward participating in healthier movement behaviours.

Study Overview

• Status: Not yet recruiting
• Conditions: Sedentary Behavior; Physical Inactivity; Sleep Insufficiency; Well-Being, Psychological
• Intervention / Treatment: Behavioral: educational content (sleep hygiene); Behavioral: sleep hygiene strategies; Behavioral: reminders; Behavioral: review of behavioural goal; Behavioral: goal setting; Behavioral: educational content (sleep guidelines); Behavioral: comparison of current behaviour to ideal behaviour; Behavioral: educational content (Vigorous Intermittent Lifestyle Physical Activity (VILPA)); Behavioral: screentime breaks

Detailed Description

Good overall mental and physical health and wellbeing can be promoted by engaging in healthy movement behaviours - getting adequate sleep, being physically active, and minimising recreational time spent watching a screen or being sedentary. The objectives of this study are to determine the feasibility of:

• establishing a digital cohort study and continuously monitoring health behaviours and wellbeing (and related factors) for 6 months, and
• rapidly evaluating the effects of ecological momentary interventions (EMIs; small-scale interventions that provide support in real-time, delivered via the smartwatch and app) for promoting healthy movement behaviours via a series of embedded RCTs.

The investigators will enrol up to 150 first-year university students into an innovative hybrid study that combines a digital cohort with embedded randomised controlled trials (RCTs). The digital cohort consists of 6 months of continuous observations of movement behaviours, wellbeing, and related factors via a smartwatch (Apple Watch) and repeated bursts of smartphone-based ecological momentary assessment (EMA) surveys. Throughout the 6-month monitoring period, participants are enrolled in 3 embedded RCTs evaluating the effects of EMIs that, in turn, target sleep, physical activity, and smartphone-based recreational screentime. For each embedded-RCT we assess engagement and acceptability outcomes (e.g., whether a push notification is opened, whether it is responded to), and preliminary efficacy (i.e., whether there is a between group difference in the target behaviour from pre- to post-intervention). Participants also complete traditional questionnaires at baseline, 3-, and 6-month follow-up.

• Study Type: Interventional
• Enrollment (Estimated): 150
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sarah M Edney, PhD; Phone Number: +6591709231; Email: sarah.edney@mymail.unisa.edu.au
• Study Contact Backup: Name: Mingyue C Chen; Phone Number: +6591709231; Email: mingyuecchen@u.nus.edu.sg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Participants are eligible to join the study if they:

• are enrolled in the first year of an undergraduate degree at the National University of Singapore,
• own or use an Apple smartphone with a data plan,
• are willing to download and use a smartphone app, and
• have an Apple smartwatch (Series 6/SE or newer) and are willing to wear it continuously for the 6-month study duration.

Participants will be excluded if they are:

• pregnant, or
• planning to be overseas for more than 6 weeks (per trip) during the upcoming semester.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

9

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: RCT 1 - group 1; Sleep Hygiene Ecological Momentary Intervention (EMI)	Behavioral: educational content (sleep hygiene); app-based sleep hygiene-related educational content; Behavioral: sleep hygiene strategies; app-based self-selection of sleep hygiene strategies; Behavioral: reminders; daily reminders sent via push notifications; Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: goal setting; prompt participant to set a goal in relation to targeted behaviour
Experimental: RCT 1 - group 2; Personalised Sleep Guideline EMI	Behavioral: reminders; daily reminders sent via push notifications; Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: goal setting; prompt participant to set a goal in relation to targeted behaviour; Behavioral: educational content (sleep guidelines); app-based educational content on recommended sleep guidelines; Behavioral: comparison of current behaviour to ideal behaviour; use of smartwatch/smartphone data to assess current behaviour and compare it to ideal behaviour
No Intervention: RCT 1 - group 3; Control
Experimental: RCT 2 - group 1; Stair Climbing EMI	Behavioral: reminders; daily reminders sent via push notifications; Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: goal setting; prompt participant to set a goal in relation to targeted behaviour; Behavioral: comparison of current behaviour to ideal behaviour; use of smartwatch/smartphone data to assess current behaviour and compare it to ideal behaviour
Experimental: RCT 2 - group 2; Vigorous Intermittent Lifestyle Physical Activity (VILPA) EMI	Behavioral: reminders; daily reminders sent via push notifications; Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: goal setting; prompt participant to set a goal in relation to targeted behaviour; Behavioral: educational content (Vigorous Intermittent Lifestyle Physical Activity (VILPA)); app-based educational content on VILPA
No Intervention: RCT 2 - group 3; Control
Experimental: RCT 3 - group 1; Screentime Breaktime EMI	Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: comparison of current behaviour to ideal behaviour; use of smartwatch/smartphone data to assess current behaviour and compare it to ideal behaviour; Behavioral: screentime breaks; repeated daily reminders to break up screentime
Experimental: RCT 3 - group 2; Screentime Goal EMI	Behavioral: reminders; daily reminders sent via push notifications; Behavioral: review of behavioural goal; app-based review of behavioural goal; Behavioral: goal setting; prompt participant to set a goal in relation to targeted behaviour; Behavioral: comparison of current behaviour to ideal behaviour; use of smartwatch/smartphone data to assess current behaviour and compare it to ideal behaviour
No Intervention: RCT 3 - group 3; Control

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
RCT 1. Sleep	Sleep duration, as assessed via Apple Watch	week 1 (pre-intervention), week 3 (intervention midpoint), week 5 (post-intervention), and continuously throughout the 6-month study
RCT 2. Physical activity	Step counts, as assessed via Apple Watch	week 6 (pre-intervention), week 8 (intervention midpoint), week 10 (post-intervention), and continuously throughout the 6-month study
RCT 2. Physical activity	Flights of stairs climbed, as assessed via Apple Watch	week 6 (pre-intervention), week 8 (intervention midpoint), week 10 (post-intervention), and continuously throughout the 6-month study
RCT 2. Physical activity	Moderate-to-vigorous physical activity, as assessed via Apple Watch	week 6 (pre-intervention), week 8 (intervention midpoint), week 10 (post-intervention), and continuously throughout the 6-month study
RCT 3. Screentime	Screenshots of passively captured smartphone screentime data	week 6 (pre-intervention), week 8 (intervention midpoint), week 10 (post-intervention), and continuously throughout the 6-month study
Wellbeing	Mental wellbeing, WHO-5 Well-Being Index (WHO-5; World Health Organisation). Min value 0, max value 100; higher scores indicate greater wellbeing.	Continuously over 6-months

Collaborators and Investigators

• Sponsor: National University of Singapore
• Investigators: Principal Investigator: Falk Müller-Riemenschneider, PhD, National University of Singapore

Study record dates

Study Major Dates

• Study Start (Estimated): September 9, 2024
• Primary Completion (Estimated): February 28, 2025
• Study Completion (Estimated): February 28, 2025

Study Registration Dates

• First Submitted: August 30, 2024
• First Submitted That Met QC Criteria: September 12, 2024
• First Posted (Estimated): September 19, 2024

Study Record Updates

• Last Update Posted (Estimated): September 19, 2024
• Last Update Submitted That Met QC Criteria: September 12, 2024
• Last Verified: September 1, 2024

More Information

Terms related to this study

• Keywords: smartphone; digital health; mhealth; Apple Watch; smartwatch; ecological momentary assessment (EMA); ecological momentary intervention (EMI)
• Additional Relevant MeSH Terms: Mental Disorders; Nervous System Diseases; Dyssomnias; Sleep Wake Disorders; Neurologic Manifestations; Sleep Deprivation
• Other Study ID Numbers: NUS-IRB-2023-800

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No