The Effectiveness of a Web-Based Computer-Tailored Physical Activity Intervention Using Fitbit Activity Trackers: Randomized Trial.

Web-based interventions that provide personalized physical activity advice have demonstrated good effectiveness but rely on self-reported measures of physical activity, which are prone to overreporting, potentially reducing the accuracy and effectiveness of the advice provided. This study aimed to examine whether the effectiveness of a Web-based computer-tailored intervention could be improved by integrating Fitbit activity trackers. Participants received the 3-month TaylorActive intervention, which included 8 modules of theory-based, personally tailored physical activity advice and action planning. Participants were randomized to receive the same intervention either with or without Fitbit tracker integration. All intervention materials were delivered on the Web, and there was no face-to-face contact at any time point. Changes in physical activity (Active Australia Survey), sitting time (Workforce Sitting Questionnaire), and body mass index (BMI) were assessed 1 and 3 months post baseline. Advice acceptability, website usability, and module completion were also assessed. A total of 243 Australian adults participated. Linear mixed model analyses showed a significant increase in total weekly physical activity (adjusted mean increase=163.2; 95% CI 52.0-274.5; P=.004) and moderate-to-vigorous physical activity (adjusted mean increase=78.6; 95% CI 24.4-131.9; P=.004) in the Fitbit group compared with the non-Fitbit group at the 3-month follow-up. The sitting time and BMI decreased more in the Fitbit group, but no significant group × time interaction effects were found. The physical activity advice acceptability and the website usability were consistently rated higher by participants in the Fitbit group. Non-Fitbit group participants completed 2.9 (SD 2.5) modules, and Fitbit group participants completed 4.4 (SD 3.1) modules. Integrating physical activity trackers into a Web-based computer-tailored intervention significantly increased intervention effectiveness. Australian New Zealand Clinical Trials Registry ACTRN12616001555448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371793 (Archived by WebCite at http://www.webcitation.org/73ioTxQX2).

Vandelanotte C ，Duncan MJ ，Maher CA ，Schoeppe S ，Rebar AL ，Power DA ，Short CE ，Doran CM ，Hayman MJ ，Alley SJ ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》

The Effectiveness of a Computer-Tailored Web-Based Physical Activity Intervention Using Fitbit Activity Trackers in Older Adults (Active for Life): Randomized Controlled Trial.

Physical activity is an integral part of healthy aging; yet, most adults aged ≥65 years are not sufficiently active. Preliminary evidence suggests that web-based interventions with computer-tailored advice and Fitbit activity trackers may be well suited for older adults. The aim of this study was to examine the effectiveness of Active for Life, a 12-week web-based physical activity intervention with 6 web-based modules of computer-tailored advice to increase physical activity in older Australians. Participants were recruited both through the web and offline and were randomly assigned to 1 of 3 trial arms: tailoring+Fitbit, tailoring only, or a wait-list control. The computer-tailored advice was based on either participants' Fitbit data (tailoring+Fitbit participants) or self-reported physical activity (tailoring-only participants). The main outcome was change in wrist-worn accelerometer (ActiGraph GT9X)-measured moderate to vigorous physical activity (MVPA) from baseline to after the intervention (week 12). The secondary outcomes were change in self-reported physical activity measured by means of the Active Australia Survey at the midintervention point (6 weeks), after the intervention (week 12), and at follow-up (week 24). Participants had a face-to-face meeting at baseline for a demonstration of the intervention and at baseline and week 12 to return the accelerometers. Generalized linear mixed model analyses were conducted with a γ distribution and log link to compare MVPA and self-reported physical activity changes over time within each trial arm and between each of the trial arms. A total of 243 participants were randomly assigned to tailoring+Fitbit (n=78, 32.1%), tailoring only (n=96, 39.5%), and wait-list control (n=69, 28.4%). Attrition was 28.8% (70/243) at 6 weeks, 31.7% (77/243) at 12 weeks, and 35.4% (86/243) at 24 weeks. No significant overall time by group interaction was observed for MVPA (P=.05). There were no significant within-group changes for MVPA over time in the tailoring+Fitbit group (+3%, 95% CI -24% to 40%) or the tailoring-only group (-4%, 95% CI -24% to 30%); however, a significant decline was seen in the control group (-35%, 95% CI -52% to -11%). The tailoring+Fitbit group participants increased their MVPA 59% (95% CI 6%-138%) more than those in the control group. A significant time by group interaction was observed for self-reported physical activity (P=.02). All groups increased their self-reported physical activity from baseline to week 6, week 12, and week 24, and this increase was greater in the tailoring+Fitbit group than in the control group at 6 weeks (+61%, 95% CI 11%-133%). A computer-tailored physical activity intervention with Fitbit integration resulted in improved MVPA outcomes in comparison with a control group in older adults. Australian New Zealand Clinical Trials Registry ACTRN12618000646246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618000646246.

Alley SJ ，van Uffelen J ，Schoeppe S ，Parkinson L ，Hunt S ，Power D ，Waterman N ，Waterman C ，To QG ，Duncan MJ ，Schneiders A ，Vandelanotte C ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》

Engagement, acceptability, usability and satisfaction with Active for Life, a computer-tailored web-based physical activity intervention using Fitbits in older adults.

Preliminary evidence suggests that web-based physical activity interventions with tailored advice and Fitbit integration are effective and may be well suited to older adults. Therefore, this study aimed to examine the engagement, acceptability, usability, and satisfaction with 'Active for Life,' a web-based physical activity intervention providing computer-tailored physical activity advice to older adults. Inactive older adults (n = 243) were randomly assigned into 3 groups: 1) tailoring + Fitbit, 2) tailoring only, or 3) a wait-list control. The tailoring + Fitbit group and the tailoring-only group received 6 modules of computer-tailored physical activity advice over 12 weeks. The advice was informed by objective Fitbit data in the tailoring + Fitbit group and self-reported physical activity in the tailoring-only group. This study examined the engagement, acceptability, usability, and satisfaction of Active for Life in intervention participants (tailoring + Fitbit n = 78, tailoring only n = 96). Wait-list participants were not included. Engagement (Module completion, time on site) were objectively recorded through the intervention website. Acceptability (7-point Likert scale), usability (System Usability Scale), and satisfaction (open-ended questions) were assessed using an online survey at post intervention. ANOVA and Chi square analyses were conducted to compare outcomes between intervention groups and content analysis was used to analyse program satisfaction. At post-intervention (week 12), study attrition was 28% (22/78) in the Fitbit + tailoring group and 39% (37/96) in the tailoring-only group. Engagement and acceptability were good in both groups, however there were no group differences (module completions: tailoring + Fitbit: 4.72 ± 2.04, Tailoring-only: 4.23 ± 2.25 out of 6 modules, p = .14, time on site: tailoring + Fitbit: 103.46 ± 70.63, Tailoring-only: 96.90 ± 76.37 min in total, p = .56, and acceptability of the advice: tailoring + Fitbit: 5.62 ± 0.89, Tailoring-only: 5.75 ± 0.75 out of 7, p = .41). Intervention usability was modest but significantly higher in the tailoring + Fitbit group (tailoring + Fitbit: 64.55 ± 13.59, Tailoring-only: 57.04 ± 2.58 out of 100, p = .003). Participants reported that Active for Life helped motivate them, held them accountable, improved their awareness of how active they were and helped them to become more active. Conversely, many participants felt as though they would prefer personal contact, more detailed tailoring and more survey response options. This study supports web-based physical activity interventions with computer-tailored advice and Fitbit integration as engaging and acceptable in older adults. Australian and New Zealand Clinical Trials Registry: ACTRN12618000646246. Registered April 23 2018, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374901.

Alley SJ ，Schoeppe S ，To QG ，Parkinson L ，van Uffelen J ，Hunt S ，Duncan MJ ，Schneiders A ，Vandelanotte C ... -  《International Journal of Behavioral Nutrition and Physical Activity》

Web-Based Video-Coaching to Assist an Automated Computer-Tailored Physical Activity Intervention for Inactive Adults: A Randomized Controlled Trial.

Alley S ，Jennings C ，Plotnikoff RC ，Vandelanotte C ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》

Effectiveness of a Web 2.0 Intervention to Increase Physical Activity in Real-World Settings: Randomized Ecological Trial.

The translation of Web-based physical activity intervention research into the real world is lacking and becoming increasingly important. To compare usage and effectiveness, in real-world settings, of a traditional Web 1.0 Web-based physical activity intervention, providing limited interactivity, to a Web 2.0 Web-based physical activity intervention that includes interactive features, such as social networking (ie, status updates, online "friends," and personalized profile pages), blogs, and Google Maps mash-ups. Adults spontaneously signing up for the freely available 10,000 Steps website were randomized to the 10,000 Steps website (Web 1.0) or the newly developed WALK 2.0 website (Web 2.0). Physical activity (Active Australia Survey), quality of life (RAND 36), and body mass index (BMI) were assessed at baseline, 3 months, and 12 months. Website usage was measured continuously. Analyses of covariance were used to assess change over time in continuous outcome measures. Multiple imputation was used to deal with missing data. A total of 1328 participants completed baseline assessments. Only 3-month outcomes (224 completers) were analyzed due to high attrition at 12 months (77 completers). Web 2.0 group participants increased physical activity by 92.8 minutes per week more than those in the Web 1.0 group (95% CI 28.8-156.8; P=.005); their BMI values also decreased more (-1.03 kg/m2, 95% CI -1.65 to -0.41; P=.001). For quality of life, only the physical functioning domain score significantly improved more in the Web 2.0 group (3.6, 95% CI 1.7-5.5; P<.001). The time between the first and last visit to the website (3.57 vs 2.22 weeks; P<.001) and the mean number of days the website was visited (9.02 vs 5.71 days; P=.002) were significantly greater in the Web 2.0 group compared to the Web 1.0 group. The difference in time-to-nonusage attrition was not statistically significant between groups (Hazard Ratio=0.97, 95% CI 0.86-1.09; P=.59). Only 21.99% (292/1328) of participants (n=292 summed for both groups) were still using either website after 2 weeks and 6.55% (87/1328) were using either website after 10 weeks. The website that provided more interactive and social features was more effective in improving physical activity in real-world conditions. While the Web 2.0 website was visited significantly more, both groups nevertheless displayed high nonusage attrition and low intervention engagement. More research is needed to examine the external validity and generalizability of Web-based physical activity interventions. Australian New Zealand Clinical Trials Registry: ACTRN12611000253909; https://anzctr.org.au /Trial/Registration/TrialReview.aspx?id=336588&isReview=true (Archived by WebCite at http://www.webcitation.org/6ufzw 2HxD).

Vandelanotte C ，Kolt GS ，Caperchione CM ，Savage TN ，Rosenkranz RR ，Maeder AJ ，Van Itallie A ，Tague R ，Oldmeadow C ，Mummery WK ，Duncan MJ ... -  《JOURNAL OF MEDICAL INTERNET RESEARCH》