Abstract
Background: The use of digital interventions can be accurately monitored via log files. However, monitoring engagement with
intervention goals or enactment of the actual behaviors targeted by the intervention is more difficult and is usually evaluated
based on pre-post measurements in a controlled trial.
Objective: The objective of this paper is to evaluate if engaging with 2 digital intervention modules focusing on (1) physical
activity goals and action plans and (2) coping with barriers has immediate effects on the actual physical activity behavior.
Methods: The NoHoW Toolkit (TK), a digital intervention developed to support long-term weight loss maintenance, was
evaluated in a 2 x 2 factorial randomized controlled trial. The TK contained various modules based on behavioral self-regulation
and motivation theories, as well as contextual emotion regulation approaches, and involved continuous tracking of weight and
physical activity through connected commercial devices (Fitbit Aria and Charge 2). Of the 4 trial arms, 2 had access to 2 modules
directly targeting physical activity: a module for goal setting and action planning (Goal) and a module for identifying barriers
and coping planning (Barriers). Module visits and completion were determined based on TK log files and time spent in the module
web page. Seven physical activity metrics (steps; activity; energy expenditure; fairly active, very active and total active minutes;
and distance) were compared before and after visiting and completing the modules to examine whether the modules had immediate
or sustained effects on physical activity. Immediate effect was determined based on 7-day windows before and after the visit,
and sustained effects were evaluated for 1 to 8 weeks after module completion.
Results: Out of the 811 participants, 498 (61.4%) visited the Goal module and 406 (50.1%) visited the Barriers module. The
Barriers module had an immediate effect on very active and total active minutes (very active minutes: before median 24.2, IQR
10.4-43.0 vs after median 24.9, IQR 10.0-46.3; P=.047; total active minutes: before median 45.1, IQR 22.9-74.9 vs after median
46.9, IQR 22.4-78.4; P=.03). The differences were larger when only completed Barriers modules were considered. The Barriers
module completion was also associated with sustained effects in fairly active and total active minutes for most of the 8 weeks
following module completion and for 3 weeks in very active minutes.
Year
2022
Category
Refereed journal