|
1
|
Adams MA, Hurley JC, Phillips CB, Todd M, Angadi SS, Berardi V, Hovell MF, Hooker S. Rationale, design, and baseline characteristics of WalkIT Arizona: A factorial randomized trial testing adaptive goals and financial reinforcement to increase walking across higher and lower walkable neighborhoods. Contemp Clin Trials 2019; 81:87-101. [PMID: 31063868 PMCID: PMC6544173 DOI: 10.1016/j.cct.2019.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/19/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Little change over the decades has been seen in adults meeting moderate-to-vigorous physical activity (MVPA) guidelines. Numerous individual-level interventions to increase MVPA have been designed, mostly static interventions without consideration for neighborhood context. Recent technologies make adaptive interventions for MVPA feasible. Unlike static interventions, adaptive intervention components (e.g., goal setting) adjust frequently to an individual's performance. Such technologies also allow for more precise delivery of "smaller, sooner incentives" that may result in greater MVPA than "larger, later incentives". Combined, these factors could enhance MVPA adoption. Additionally, a central tenet of ecological models is that MVPA is sensitive to neighborhood environment design; lower-walkable neighborhoods constrain MVPA adoption and maintenance, limiting the effects of individual-level interventions. Higher-walkable neighborhoods are hypothesized to enhance MVPA interventions. Few prospective studies have addressed this premise. This report describes the rationale, design, intervention components, and baseline sample of a study testing individual-level adaptive goal-setting and incentive interventions for MVPA adoption and maintenance over 2 years among adults from neighborhoods known to vary in neighborhood walkability. We scaled these evidenced-based interventions and tested them against static-goal-setting and delayed-incentive comparisons in a 2 × 2 factorial randomized trial to increase MVPA among 512 healthy insufficiently-active adults. Participants (64.3% female, M age = 45.5 ± 9.1 years, M BMI = 33.9 ± 7.3 kg/m2, 18.8% Hispanic, 84.0% White) were recruited from May 2016 to May 2018 from block groups ranked on GIS-measured neighborhood walkability and socioeconomic status (SES) and classified into four neighborhood types: "high walkable/high SES," "high walkable/low SES," "low walkable/high SES," and "low walkable/low SES." Results from this ongoing study will provide evidence for some of the central research questions of ecological models.
Collapse
Affiliation(s)
- Marc A Adams
- College of Health Solutions, Arizona State University, 425 N. 5(th) Street, Phoenix, AZ 85004, United States of America.
| | - Jane C Hurley
- College of Health Solutions, Arizona State University, 425 N. 5(th) Street, Phoenix, AZ 85004, United States of America
| | - Christine B Phillips
- College of Health Solutions, Arizona State University, 425 N. 5(th) Street, Phoenix, AZ 85004, United States of America
| | - Michael Todd
- College of Nursing and Health Innovations, Arizona State University, 500 North 3rd Street, Phoenix, AZ 85004, United States of America
| | - Siddhartha S Angadi
- College of Health Solutions, Arizona State University, 425 N. 5(th) Street, Phoenix, AZ 85004, United States of America
| | - Vincent Berardi
- Department of Psychology, Crean School of Health and Behavioral Sciences, Chapman University, One University Drive, Orange, CA 92866, United States of America
| | - Melbourne F Hovell
- College of Health and Human Services, San Diego State University, San Diego, CA 92182-4124, United States of America
| | - Steven Hooker
- College of Health and Human Services, San Diego State University, San Diego, CA 92182-4124, United States of America
| |
Collapse
|
|
2
|
Edwards AM, Dutton-Challis L, Cottrell D, Guy JH, Hettinga FJ. Impact of active and passive social facilitation on self-paced endurance and sprint exercise: encouragement augments performance and motivation to exercise. BMJ Open Sport Exerc Med 2018; 4:e000368. [PMID: 30109119 PMCID: PMC6078239 DOI: 10.1136/bmjsem-2018-000368] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The positive effect of an audience on performance is anecdotally well known, but the impact of such social facilitation to both performance and the motivation to exercise have not been thoroughly explored. The aim of this study was therefore to investigate verbal encouragement as a means to promote positive behavioural adherence to exercise and augmented performance. METHODS Twelve untrained but active individuals (seven female), age 24±3 years participated in this study. Exercise conditions with external verbal encouragement (EVE) and without external verbal encouragement (WEVE) were compared in both endurance (20 min) and sprint (2 × 30 s Wingate) cycling tasks in a randomised crossover design. Results were analysed by separate 2 (EVE/WEVE) × 2 (sprint/endurance) within-subjects analyses of variance for each dependent variable. Statistical significance was set at p≤0.05. RESULTS EVE resulted in a significant increase, F(1,11)=15.37, p=0.002, ηp2=0.58 in the average power generated by participants in each exercise bout on the cycle ergometer. EVE also had a significant effect on reported motivation to exercise the next day, F(1,11)=5.5, p=0.04, ηp2 =0.33, which did not differ between type of exercise. CONCLUSION External encouragement in both sprint and endurance activities resulted in large improvements in performance and motivation to continue an exercise regimen the next day, which has important implications for health, adherence and maximising physical performance using a practical intervention.
Collapse
Affiliation(s)
- Andrew Mark Edwards
- Human & Life Sciences, Canterbury Christ Church University, Canterbury, UK
- College of Healthcare Science, James Cook University, Cairns, Queensland, Australia
| | - Lia Dutton-Challis
- College of Healthcare Science, James Cook University, Cairns, Queensland, Australia
| | - David Cottrell
- College of Healthcare Science, James Cook University, Cairns, Queensland, Australia
| | - Joshua H Guy
- Sport & Exercise Science, Central Queensland University, Cairns, Queensland, Australia
| | | |
Collapse
|
|
3
|
Bryan AD, Jakicic JM, Hunter CM, Evans ME, Yanovski SZ, Epstein LH. Behavioral and Psychological Phenotyping of Physical Activity and Sedentary Behavior: Implications for Weight Management. Obesity (Silver Spring) 2017; 25:1653-1659. [PMID: 28948719 PMCID: PMC5657446 DOI: 10.1002/oby.21924] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 06/07/2017] [Accepted: 06/08/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Risk for obesity is determined by a complex mix of genetics and lifetime exposures at multiple levels, from the metabolic milieu to psychosocial and environmental influences. These phenotypic differences underlie the variability in risk for obesity and response to weight management interventions, including differences in physical activity and sedentary behavior. METHODS As part of a broader effort focused on behavioral and psychological phenotyping in obesity research, the National Institutes of Health convened a multidisciplinary workshop to explore the state of the science in behavioral and psychological phenotyping in humans to explain individual differences in physical activity, both as a risk factor for obesity development and in response to activity-enhancing interventions. RESULTS Understanding the behavioral and psychological phenotypes that contribute to differences in physical activity and sedentary behavior could allow for improved treatment matching and inform new targets for tailored, innovative, and effective weight management interventions. CONCLUSIONS This summary provides the rationale for identifying psychological and behavioral phenotypes relevant to physical activity and identifies opportunities for future research to better understand, define, measure, and validate putative phenotypic factors and characterize emerging phenotypes that are empirically associated with initiation of physical activity, response to intervention, and sustained changes in physical activity.
Collapse
Affiliation(s)
| | | | - Christine M. Hunter
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Mary E. Evans
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Susan Z. Yanovski
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, USA
| | - Leonard H. Epstein
- University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| |
Collapse
|
|
4
|
Adams MA, Hurley JC, Todd M, Bhuiyan N, Jarrett CL, Tucker WJ, Hollingshead KE, Angadi SS. Adaptive goal setting and financial incentives: a 2 × 2 factorial randomized controlled trial to increase adults' physical activity. BMC Public Health 2017; 17:286. [PMID: 28356097 PMCID: PMC5372290 DOI: 10.1186/s12889-017-4197-8] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 03/22/2017] [Indexed: 12/29/2022] Open
Abstract
Background Emerging interventions that rely on and harness variability in behavior to adapt to individual performance over time may outperform interventions that prescribe static goals (e.g., 10,000 steps/day). The purpose of this factorial trial was to compare adaptive vs. static goal setting and immediate vs. delayed, non-contingent financial rewards for increasing free-living physical activity (PA). Methods A 4-month 2 × 2 factorial randomized controlled trial tested main effects for goal setting (adaptive vs. static goals) and rewards (immediate vs. delayed) and interactions between factors to increase steps/day as measured by a Fitbit Zip. Moderate-to-vigorous PA (MVPA) minutes/day was examined as a secondary outcome. Results Participants (N = 96) were mainly female (77%), aged 41 ± 9.5 years, and all were insufficiently active and overweight/obese (mean BMI = 34.1 ± 6.2). Participants across all groups increased by 2389 steps/day on average from baseline to intervention phase (p < .001). Participants receiving static goals showed a stronger increase in steps per day from baseline phase to intervention phase (2630 steps/day) than those receiving adaptive goals (2149 steps/day; difference = 482 steps/day, p = .095). Participants receiving immediate rewards showed stronger improvement (2762 step/day increase) from baseline to intervention phase than those receiving delayed rewards (2016 steps/day increase; difference = 746 steps/day, p = .009). However, the adaptive goals group showed a slower decrease in steps/day from the beginning of the intervention phase to the end of the intervention phase (i.e. less than half the rate) compared to the static goals group (−7.7 steps vs. -18.3 steps each day; difference = 10.7 steps/day, p < .001) resulting in better improvements for the adaptive goals group by study end. Rate of change over the intervention phase did not differ between reward groups. Significant goal phase x goal setting x reward interactions were observed. Conclusions Adaptive goals outperformed static goals (i.e., 10,000 steps) over a 4-month period. Small immediate rewards outperformed larger, delayed rewards. Adaptive goals with either immediate or delayed rewards should be preferred for promoting PA. Trial Registration ClinicalTrials.gov ID: NCT02053259 registered prospectively on January 31, 2014.
Collapse
Affiliation(s)
- Marc A Adams
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA. .,Global Institute of Sustainability (GIOS), Arizona State University, Tempe, AZ, 85287, USA.
| | - Jane C Hurley
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| | - Michael Todd
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA.,College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, Phoenix, AZ, 85004, USA
| | - Nishat Bhuiyan
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| | - Catherine L Jarrett
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| | - Wesley J Tucker
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| | - Kevin E Hollingshead
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| | - Siddhartha S Angadi
- College of Health Solutions, Arizona State University, 425 North 5th Street (MC9020), Phoenix, AZ, 85004, USA
| |
Collapse
|
|
5
|
Adams MA, Sallis JF, Norman GJ, Hovell MF, Hekler EB, Perata E. An adaptive physical activity intervention for overweight adults: a randomized controlled trial. PLoS One 2013; 8:e82901. [PMID: 24349392 PMCID: PMC3857300 DOI: 10.1371/journal.pone.0082901] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 11/04/2013] [Indexed: 01/01/2023] Open
Abstract
Background Physical activity (PA) interventions typically include components or doses that are static across participants. Adaptive interventions are dynamic; components or doses change in response to short-term variations in participant's performance. Emerging theory and technologies make adaptive goal setting and feedback interventions feasible. Objective To test an adaptive intervention for PA based on Operant and Behavior Economic principles and a percentile-based algorithm. The adaptive intervention was hypothesized to result in greater increases in steps per day than the static intervention. Methods Participants (N = 20) were randomized to one of two 6-month treatments: 1) static intervention (SI) or 2) adaptive intervention (AI). Inactive overweight adults (85% women, M = 36.9±9.2 years, 35% non-white) in both groups received a pedometer, email and text message communication, brief health information, and biweekly motivational prompts. The AI group received daily step goals that adjusted up and down based on the percentile-rank algorithm and micro-incentives for goal attainment. This algorithm adjusted goals based on a moving window; an approach that responded to each individual's performance and ensured goals were always challenging but within participants' abilities. The SI group received a static 10,000 steps/day goal with incentives linked to uploading the pedometer's data. Results A random-effects repeated-measures model accounted for 180 repeated measures and autocorrelation. After adjusting for covariates, the treatment phase showed greater steps/day relative to the baseline phase (p<.001) and a group by study phase interaction was observed (p = .017). The SI group increased by 1,598 steps/day on average between baseline and treatment while the AI group increased by 2,728 steps/day on average between baseline and treatment; a significant between-group difference of 1,130 steps/day (Cohen's d = .74). Conclusions The adaptive intervention outperformed the static intervention for increasing PA. The adaptive goal and feedback algorithm is a “behavior change technology” that could be incorporated into mHealth technologies and scaled to reach large populations. Trial Registration ClinicalTrials.gov NCT01793064
Collapse
Affiliation(s)
- Marc A. Adams
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona, United States of America
- Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
- * E-mail:
| | - James F. Sallis
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, California, United States of America
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Gregory J. Norman
- Department of Family and Preventive Medicine, University of California San Diego, San Diego, California, United States of America
| | - Melbourne F. Hovell
- Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Eric B. Hekler
- School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona, United States of America
| | - Elyse Perata
- College of Education and Allied Studies, California State University East Bay, Hayward, California, United States of America
| |
Collapse
|
|
6
|
Abstract
PURPOSE The number of youth that meet activity guidelines is decreasing and easy access to reinforcing sedentary behaviors competes with increasing physical activity. In the laboratory, open-loop feedback that used pedometer activity counts to gain access to sedentary alternatives doubled physical activity. This study evaluated the influence of open-loop feedback and reinforcement on physical activity and television (TV) time in a small clinical trial. METHODS Children (8-12 yr old) were randomized to an open-loop feedback plus reinforcement intervention (N = 11) or no feedback, no reinforcement control (N = 7). Subjects wore an accelerometer for 6 wk and attended meetings to download the accelerometer. Accumulating physical activity counts gave subjects in the open-loop group access to TV time, controlled by a TV Allowance device, with 400 counts = 1 h of TV. The control group had no feedback for activity and free access to TV. RESULTS The open-loop group had a 24% increase in physical activity, which was greater (P = 0.02) than the control group. TV time of the open-loop group was reduced by 18% or 20 min x d(-1) whereas the control group increased by 13 min x d(-1), but these were not significant changes. The change in time spent watching television was directly related to the change in BMI z-score (r = 0.69, P = 0.002). CONCLUSION Open-loop feedback increases physical activity in children, thus helping children to achieve physical activity recommendations. Reductions in TV watching may reduce or minimize gains in body weight.
Collapse
Affiliation(s)
- James N Roemmich
- Division of Behavioral Medicine, Department of Pediatrics, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY 14214-3000, USA.
| | | | | |
Collapse
|
|
7
|
Faith MS, Berman N, Heo M, Pietrobelli A, Gallagher D, Epstein LH, Eiden MT, Allison DB. Effects of contingent television on physical activity and television viewing in obese children. Pediatrics 2001; 107:1043-8. [PMID: 11331684 DOI: 10.1542/peds.107.5.1043] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Elevated television (TV) viewing and physical inactivity promote obesity in children. Thus, changes in physical activity and sedentary behavior seem critical to treating childhood obesity. PRESENT STUDY: Using a randomized, 2-arm design, this pilot study tested the effects of contingent TV on physical activity and TV viewing in 10 obese children. TV viewing was contingent on pedaling a stationary cycle ergometer for experimental participants but was not contingent on pedaling for control participants. The study was conducted over 12 weeks, including a 2-week baseline period. RESULTS Multivariate analyses indicated that the intervention significantly increased pedaling and reduced TV-viewing time. During the treatment phase, the experimental group pedaled 64.4 minutes per week on average, compared with 8.3 minutes by controls. The experimental group watched 1.6 hours of TV per week on average, compared with 21.0 hours per week on average by controls during this phase. Secondary analyses indicated that the experimental group showed significantly greater reductions in total body fat and percent leg fat. Total pedaling time during intervention correlated with greater reductions in percent body fat (r = -0.68). CONCLUSIONS Contingencies in the home environment can be arranged to modify physical activity and TV viewing and may have a role in treating childhood obesity. Contingent TV may be one method to help achieve this goal.
Collapse
Affiliation(s)
- M S Faith
- Obesity Research Center, St Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, New York, New York, USA
| | | | | | | | | | | | | | | |
Collapse
|
|
8
|
Coleman KJ, Gonzalez EC, Cooley T. An objective measure of reinforcement and its implications for exercise promotion in sedentary Hispanic and Anglo women. Ann Behav Med 2001; 22:229-36. [PMID: 11126468 DOI: 10.1007/bf02895118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
An objective measure for the assessment of exercise and sedentary activity choices was evaluated for reliability in 38 sedentary women, aged 18-45, in El Paso, TX. Twenty-two Hispanic women and 16 Anglo women participated. An equal number of obese and nonobese women comprised each group of participants. Using five computer-generated slot machine games, participants were allowed to earn points for access to a bicycle/stair stepper or videos/magazines. Exercise alternatives remained easily accessible while the sedentary choices became progressively difficult to access. Two sessions were completed at least 2 weeks apart for reliability. Reliability for choosing to be physically active from session to session was rI = .83 for all participants, rI = .90 for Hispanics, and rI = .74 for Anglos. Hispanic women earned twice the number of points for access to exercise (m = 20 +/- 2; 40% of the available points) as Anglo women (m = 10 +/- 3; 20% of the available points), independent of body mass index (BMI) or socioeconomic status (SES). Hispanic women's choices to exercise were independent of acculturation level; however, Hispanic women of higher SES and lower BMI chose to exercise more than Hispanic women of lower SES and higher BMI. Hispanic women may find exercise more reinforcing than Anglo women, which has important implications for exercise interventions. In addition, results indicated that self-reported liking and enjoyment of exercise were not related to the choice to actually engage in exercise. The behavioral economic methods presented in this study provide preliminary results to support the use of an objective, reliable method to assess the determinants of exercise and sedentary activity choices in sedentary, Hispanic and Anglo women.
Collapse
Affiliation(s)
- K J Coleman
- Psychology Department, University of Texas, El Paso, TX 79968-0553, USA
| | | | | |
Collapse
|
|
9
|
Goldfield GS, Kalakanis LE, Ernst MM, Epstein LH. Open-loop feedback to increase physical activity in obese children. Int J Obes (Lond) 2000; 24:888-92. [PMID: 10918536 DOI: 10.1038/sj.ijo.0801248] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The present study investigated whether making access to sedentary activities contingent on physical activity would increase physical activity. DESIGN Experimental. PARTICIPANTS Thirty-four obese children aged 8-12 y were randomized to one of three groups in which children had to accumulate 750 or 1500 pedometer counts to earn 10 min of access to video games or movies, or to a control group in which access to sedentary behaviors was provided noncontingently. MEASUREMENTS Physical activity in the 20 min experimental session was measured by electronic pedometer and triaxial accelerometer (ie TriTrac(R)). Activity liking was measured by visual analog scales. Anthropometric and demographic characteristics were also assessed. RESULTS Children in the 750 and 1500 count contingency groups engaged in significantly more physical activity and spent more time in moderate intensity activity or higher compared with controls. Children in the Contingent 1500 group engaged in more activity and spent more time in moderate or greater intensity activity compared to children in the Contingent 750 group. CONCLUSION Findings suggest that contingent access to sedentary activities can reinforce physical activity in obese children, and changes in physical activity level depend in part on the targeted physical activity goal.
Collapse
Affiliation(s)
- G S Goldfield
- Department of Psychology, University at Buffalo, Buffalo, NY 14260, USA
| | | | | | | |
Collapse
|