Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample

Urs Alexander Fichtner; Iris Tinsel; Matthias Sehlbrede; Phillip Maiwald; Martina Bischoff; Gloria Metzner; Christian Schlett; Judith Brame; Jan Kohl; Daniel König; Rainer Bredenkamp; Ramona Wurst; Erik Farin-Glattacker

doi:10.1016/j.invent.2024.100762

Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample

Urs Alexander Fichtner, Iris Tinsel, Matthias Sehlbrede, Phillip Maiwald, Martina Bischoff, Gloria Metzner, Christian Schlett, Judith Brame, Jan Kohl, Daniel König, Rainer Bredenkamp, Ramona Wurst, Erik Farin-Glattacker

Publications: Contribution to journal › Article › Peer Reviewed

Abstract

BACKGROUND: Physical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed.

OBJECTIVE: This study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information.

METHODS: In a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes.

RESULTS: We achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 % (IG), resp. 74.7 % (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA.

CONCLUSIONS: Both programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods.

TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

Original language	English
Article number	100762
Pages (from-to)	100762
Journal	Internet Interventions
Volume	37
DOIs	https://doi.org/10.1016/j.invent.2024.100762
Publication status	Published - Sept 2024

Funding

This project was funded by the Techniker Krankenkasse (German Health Insurance Company). The project funder had no influence on the planning and implementation of the study, the analysis and interpretation of the data, or the publication of the results. We thank all study participants, who supported our study. Furthermore, we would like to thank Techniker Krankenkasse , represented by Dr. Nicole Knaack, Dr. Kerstin Hofreuter-G\u00E4tgens, and Dagmar K\u00F6ppel, for funding this study. Additionally, our gratitude extends to Irina Kopman and her team at Vilua Healthcare GmbH for IT assistance. We also acknowledge support by the Open Access Publication Fund of the University of Freiburg.

Austrian Fields of Science 2012

303028 Sport science

Keywords

Digital health intervention
Health behavior change
Interactive coaching
Online coaching
Physical fitness
Web-based program

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.invent.2024.100762

Cite this

Fichtner, U. A., Tinsel, I., Sehlbrede, M., Maiwald, P., Bischoff, M., Metzner, G., Schlett, C., Brame, J., Kohl, J., König, D., Bredenkamp, R., Wurst, R., & Farin-Glattacker, E. (2024). Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample. Internet Interventions, 37, 100762. Article 100762. https://doi.org/10.1016/j.invent.2024.100762

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title = "Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample",

abstract = "BACKGROUND: Physical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed.OBJECTIVE: This study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information.METHODS: In a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes.RESULTS: We achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 \% (IG), resp. 74.7 \% (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA.CONCLUSIONS: Both programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods.TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.",

keywords = "Digital health intervention, Health behavior change, Interactive coaching, Online coaching, Physical fitness, Web-based program",

author = "Fichtner, \{Urs Alexander\} and Iris Tinsel and Matthias Sehlbrede and Phillip Maiwald and Martina Bischoff and Gloria Metzner and Christian Schlett and Judith Brame and Jan Kohl and Daniel K{\"o}nig and Rainer Bredenkamp and Ramona Wurst and Erik Farin-Glattacker",

note = "Publisher Copyright: {\textcopyright} 2024",

year = "2024",

month = sep,

doi = "10.1016/j.invent.2024.100762",

language = "English",

volume = "37",

pages = "100762",

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Fichtner, UA, Tinsel, I, Sehlbrede, M, Maiwald, P, Bischoff, M, Metzner, G, Schlett, C, Brame, J, Kohl, J, König, D, Bredenkamp, R, Wurst, R & Farin-Glattacker, E 2024, 'Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample', Internet Interventions, vol. 37, 100762, pp. 100762. https://doi.org/10.1016/j.invent.2024.100762

TY - JOUR

T1 - Effects of a digital intervention on physical activity in adults

T2 - A randomized controlled trial in a large-scale sample

AU - Fichtner, Urs Alexander

AU - Tinsel, Iris

AU - Sehlbrede, Matthias

AU - Maiwald, Phillip

AU - Bischoff, Martina

AU - Metzner, Gloria

AU - Schlett, Christian

AU - Brame, Judith

AU - Kohl, Jan

AU - König, Daniel

AU - Bredenkamp, Rainer

AU - Wurst, Ramona

AU - Farin-Glattacker, Erik

PY - 2024/9

Y1 - 2024/9

N2 - BACKGROUND: Physical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed.OBJECTIVE: This study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information.METHODS: In a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes.RESULTS: We achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 % (IG), resp. 74.7 % (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA.CONCLUSIONS: Both programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods.TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

AB - BACKGROUND: Physical inactivity is associated with health risks, contributing to various diseases and all-cause mortality. Despite recommendations for regular physical activity (PA), many adults remain inactive, influenced by socioeconomic and environmental factors. Digital interventions, particularly web-based PA programs, offer promising possibilities to promote PA across populations. These programs vary in their effectiveness, reflecting differences in design, user engagement, and behavior change techniques employed.OBJECTIVE: This study evaluates the effectiveness of the 12-week multimodal web-based TKFitnessCoach. The PA online program is part of the TK-HealthCoach. This study investigates the program's impact on self-reported PA levels, goal attainment, healthrelated quality of life, body weight, and eating behavior, comparing an interactive personalized web-based intervention and non-interactive web-based health information.METHODS: In a randomized controlled trial (RCT), participants were allocated to either the intervention group (IG), receiving access to the interactive TK-FitnessCoach, or the control group (CG) that was provided a static website with evidence-based information on PA. The study targeted a German-speaking adult population interested in improving health behavior. Data was assessed at T0 (beginning of the study), T1 (postintervention), T2, 6 months, and T3, 12 months follow-ups, focusing on self-reported PA at T3 and on various secondary outcomes.RESULTS: We achieved equally distributed sociodemographics in both the IG and the CG with a mean age of 42.8 (IG), resp. 43.1 years (CG), and female participants of 76.1 % (IG), resp. 74.7 % (CG). PA at baseline was 277.9 min/week in the IG and 273.3 min/week in the CG. Both, the IG (n = 1153 in the Intention-to-treat (ITT) dataset) and CG (n = 1177 in the ITT dataset) exhibited significant increases in PA over time (IG(T3-T0) = 72.92 min/week; CG(T3-T0) = 74.12 min/week).However, the study did not find significant differences in the effectiveness of the interactive TK-FitnessCoach compared to the non-interactive control in terms of improving PA and related health outcomes. The intensity of using the TK-FitnessCoach was not associated with PA.CONCLUSIONS: Both programs were effective in promoting PA among adults, with no significant differences observed between the two RCT groups. This highlights the potential of digital interventions in addressing physical inactivity, suggesting that the effectiveness of such programs may not solely depend on their interactivity but also on the quality and relevance of the information provided. Further research is needed to explore optimization strategies for such interventions, especially for persons with low PA, including user engagement, behavior change techniques, and the integration of objective PA tracking methods.TRIAL REGISTRATION: German Clinical Trials Register DRKS00020249; https://drks.de/search/en/trial/DRKS00020249.

KW - Digital health intervention

KW - Health behavior change

KW - Interactive coaching

KW - Online coaching

KW - Physical fitness

KW - Web-based program

UR - https://www.scopus.com/pages/publications/85200255688

U2 - 10.1016/j.invent.2024.100762

DO - 10.1016/j.invent.2024.100762

M3 - Article

C2 - 39211309

SN - 2214-7829

VL - 37

SP - 100762

JO - Internet Interventions

JF - Internet Interventions

M1 - 100762

ER -

Effects of a digital intervention on physical activity in adults: A randomized controlled trial in a large-scale sample

Abstract

Funding

Austrian Fields of Science 2012

Keywords

UN SDGs

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