Effects of Three Motivationally Targeted Mobile Device Applications on Initial Physical Activity and Sedentary Behavior Change in Midlife and Older Adults: A Randomized Trial

Abby C King, Eric B Hekler, Lauren A Grieco, Sandra J Winter, Jylana L Sheats, Matthew P Buman, Banny Banerjee, Thomas N Robinson, Jesse Cirimele, Abby C King, Eric B Hekler, Lauren A Grieco, Sandra J Winter, Jylana L Sheats, Matthew P Buman, Banny Banerjee, Thomas N Robinson, Jesse Cirimele

Abstract

Background: While there has been an explosion of mobile device applications (apps) promoting healthful behaviors, including physical activity and sedentary patterns, surprisingly few have been based explicitly on strategies drawn from behavioral theory and evidence.

Objective: This study provided an initial 8-week evaluation of three different customized physical activity-sedentary behavior apps drawn from conceptually distinct motivational frames in comparison with a commercially available control app.

Study design and methods: Ninety-five underactive adults ages 45 years and older with no prior smartphone experience were randomized to use an analytically framed app, a socially framed app, an affectively framed app, or a diet-tracker control app. Daily physical activity and sedentary behavior were measured using the smartphone's built-in accelerometer and daily self-report measures.

Results: Mixed-effects models indicated that, over the 8-week period, the social app users showed significantly greater overall increases in weekly accelerometry-derived moderate to vigorous physical activity relative to the other three arms (P values for between-arm differences = .04-.005; Social vs. Control app: d = 1.05, CI = 0.44,1.67; Social vs. Affect app: d = 0.89, CI = 0.27,1.51; Social vs. Analytic app: d = 0.89, CI = 0.27,1.51), while more variable responses were observed among users of the other two motivationally framed apps. Social app users also had significantly lower overall amounts of accelerometry-derived sedentary behavior relative to the other three arms (P values for between-arm differences = .02-.001; Social vs. Control app: d = 1.10,CI = 0.48,1.72; Social vs. Affect app: d = 0.94, CI = 0.32,1.56; Social vs. Analytic app: d = 1.24, CI = 0.59,1.89). Additionally, Social and Affect app users reported lower overall sitting time compared to the other two arms (P values for between-arm differences < .001; Social vs. Control app: d = 1.59,CI = 0.92, 2.25; Social vs. Analytic app: d = 1.89,CI = 1.17, 2.61; Affect vs. Control app: d = 1.19,CI = 0.56, 1.81; Affect vs. Analytic app: d = 1.41,CI = 0.74, 2.07).

Conclusion: The results provide initial support for the use of a smartphone-delivered social frame in the early induction of both physical activity and sedentary behavior changes. The information obtained also sets the stage for further investigation of subgroups that might particularly benefit from different motivationally framed apps in these two key health promotion areas.

Trial registration: ClinicalTrials.gov NCT01516411.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1. Study Enrollment and Retention Flowchart.
Fig 1. Study Enrollment and Retention Flowchart.
Fig 2. Changes in Accelerometer-Derived MVPA by…
Fig 2. Changes in Accelerometer-Derived MVPA by Study Arm.
Fig 3. Changes in Accelerometer-derived Sedentary Behavior…
Fig 3. Changes in Accelerometer-derived Sedentary Behavior by Study Arm.
Fig 4. Changes in EMA-Assessed Sitting Time…
Fig 4. Changes in EMA-Assessed Sitting Time by Study Arm.

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