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Effectiveness of a web- and mobile phone-based intervention to promote physical activity and healthy eating in middle-aged males: randomized controlled trial of the ManUp study |
Duncan M, Vandelanotte C, Kolt GS, Rosenkranz RR, Caperchione CM, George ES, Ding H, Hooker C, Karunanithi M, Maeder AJ, Noakes M, Tague R, Taylor P, Viljoen P, Mummery WK |
Journal of Medical Internet Research 2014 Jun;16(6):e136 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males' physical activity and dietary practices. OBJECTIVE: This study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention. METHODS: Participants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35 to 54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants' physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months. RESULTS: A total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (p > 0.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp-beta 1.45, 95% CI 1.09 to 1.95; exp-beta 1.61, 95% CI 1.17 to 2.22) and 9 months (exp-beta 1.55, 95% CI 1.14 to 2.10; exp-beta 1.51, 95% CI 1.15 to 2.00). Overall dietary behaviors improved at 3 months (exp-beta 1.07, 95% CI 1.03 to 1.11) and 9 months (exp-beta 1.10, 95% CI 1.05 to 1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp-beta 2.25, 95% CI 1.29 to 3.92; exp-beta 1.65, 95% CI 1.07 to 2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp-beta 0.48, 95% CI 0.26 to 0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp-beta 1.70, 95% CI 1.02 to 2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively. CONCLUSIONS: The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910.
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