Effectiveness of a 3-Month Mobile Phone-Based Behavior Change Program on Active Transportation and Physical Activity in Adults: Randomized Controlled Trial

Anna Ek, Christina Alexandrou, Emmie Söderström, Patrick Bergman, Christine Delisle Nyström, Artur Direito, Ulf Eriksson, Pontus Henriksson, Ralph Maddison, Ylva Trolle Lagerros, Marcus Bendtsen, Marie Löf, Anna Ek, Christina Alexandrou, Emmie Söderström, Patrick Bergman, Christine Delisle Nyström, Artur Direito, Ulf Eriksson, Pontus Henriksson, Ralph Maddison, Ylva Trolle Lagerros, Marcus Bendtsen, Marie Löf

Abstract

Background: Active transportation (AT; ie, walking and cycling as a mode for transportation) has been associated with decreased morbidity and mortality; however, low-cost and scalable intervention programs are lacking.

Objective: The goal of the research was to determine the effectiveness of a 3-month behavior change program delivered via a mobile phone app to promote AT (TravelVu Plus) on time spent in moderate-to-vigorous physical activity (MVPA).

Methods: For this 2-arm parallel randomized controlled trial, we recruited a population-based sample of 254 adults from Stockholm County who were aged 20 to 65 years and had access to a smartphone. On completion of 1-week baseline measures, the 254 participants were randomized to either the control or intervention group (1:1 ratio). Both groups had access to the standard TravelVu app (Trivector AB) for monitoring their AT for 6 months. The intervention group also received a 3-month behavior change program to promote AT (TravelVu Plus app). Assessors of outcomes were blinded to group allocation. Outcomes were objectively measured MVPA at 3 (primary) and 6 months. Secondary outcomes were AT, attitudes toward AT, and health-related quality of life at 3 and 6 months.

Results: No effect on MVPA was observed after 3 months (P=.29); however, at 6 months the intervention group had a greater improvement in MVPA than the controls (6.05 minutes per day [95% CI 0.36 to 11.74; P=.04]). A Bayesian analyses showed that there was a 98% probability that the intervention had any effect at 6 months, and a 63% probability that this effect was >5 minute MVPA per day.

Conclusions: No effect on MVPA immediately after the intervention period (at 3 months) was observed; however, there was a delayed effect on MVPA (6 minutes per day) at 6 months, which corresponds to approximately 30% of the weekly MVPA recommendation. Our findings suggest that a behavior change program promoting AT delivered via an app may have a relevant effect on PA.

Trial registration: ClinicalTrials.gov NCT03086837; https://ichgcp.net/clinical-trials-registry/NCT03086837.

International registered report identifier (irrid): RR2-10.1186/s12889-018-5658-4.

Keywords: active transportation; behavior change; mobile phone app; mobile phone intervention; physical activity; smartphone app.

Conflict of interest statement

Conflicts of Interest: The authors have no conflict of interest. MB owns a private company (Alexit AB), which develops and disseminates eHealth apps to health organizations and professionals in both the private and public sector; however, Alexit AB was not involved in any part of this study.

©Anna Ek, Christina Alexandrou, Emmie Söderström, Patrick Bergman, Christine Delisle Nyström, Artur Direito, Ulf Eriksson, Pontus Henriksson, Ralph Maddison, Ylva Trolle Lagerros, Marcus Bendtsen, Marie Löf. Originally published in JMIR mHealth and uHealth (http://mhealth.jmir.org), 08.06.2020.

Figures

Figure 1
Figure 1
Description of the study design of the Smart City Active Mobile Phone Intervention trial.
Figure 2
Figure 2
Flowchart of the Smart City Active Mobile Phone Intervention trial.
Figure 3
Figure 3
Intervention effect on moderate-to-vigorous physical activity and moderate physical activity at 3 and 6 months.
Figure 4
Figure 4
Bayesian analysis of the intervention effect on moderate-to-vigorous physical activity at 3 and 6 months.

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