Internet-based exercise intervention systems: Are more interactive designs better?

Abstract The benefits of Internet-based health promotion programmes are much discussed, yet the literature on their feasibility and utility is limited. Here, we evaluate an Internet-based exercise motivation and action support system (Test system), relative to a group receiving no intervention (Reference) and another receiving a less interactive version of the same system (Control). We report results from a 10-week pilot study with 75 participants aged 23–54 years. We found that, relative to the control system and reference group, the more interactive (test) system was more engaging (better user retention), created higher expectations for exercise, greater satisfaction with motivation and increased self-perception of fitness. Seven months after the intervention, participants who used the test system reported greater levels of increase in exercise than the control or reference groups. Our study adds to the growing body of evidence on the benefits of interactive systems and the role they could play in health promotion programmes. However, it should also be noted that not all Web-based systems offer the same level of advantage; careful design is crucial to ensure that key messages are clearly communicated to attentive users. Further research is required to identify the optimum interactive system design principles, across a range of user types.

[1]  J. V. Wood,et al.  Social comparison in adjustment to breast cancer. , 1985, Journal of personality and social psychology.

[2]  Adrian Bauman,et al.  Evaluation of an internet-based physical activity intervention: A preliminary investigation , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[3]  P. Sheeran,et al.  Combining motivational and volitional interventions to promote exercise participation: protection motivation theory and implementation intentions. , 2002, British journal of health psychology.

[4]  L. Festinger A Theory of Social Comparison Processes , 1954 .

[5]  K. Holm,et al.  Validation of a Single-Item Measure of Usual Physical Activity , 2000, Perceptual and Motor Skills.

[6]  B. J. Fogg,et al.  Persuasive technology: using computers to change what we think and do , 2002, UBIQ.

[7]  Youngme Moon,et al.  Personalization and Personality: Some Effects of Customizing Message Style Based on Consumer Personality , 2002 .

[8]  J. Prochaska,et al.  Stages and processes of self-change of smoking: toward an integrative model of change. , 1983, Journal of consulting and clinical psychology.

[9]  D. Tate,et al.  Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. , 2003, JAMA.

[10]  B. Buunk,et al.  The relevance of social comparison processes for prevention and health care. , 2002, Patient education and counseling.

[11]  B. Fogg The ethics of persuasive technology , 2003 .

[12]  Jacob Cohen Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[13]  Ryan E. Rhodes,et al.  Discrepancies in exercise intention and expectation: theoretical and applied issues , 2005 .

[14]  E. Maris Covariance adjustment versus gain scores-revisited , 1998 .

[15]  Icek Ajzen,et al.  From Intentions to Actions: A Theory of Planned Behavior , 1985 .

[16]  J. Andrews,et al.  Evaluating two self-help interventions for smokeless tobacco cessation. , 2000, Addictive behaviors.

[17]  E. Yeung,et al.  Relations among Physical Activity, Physical Fitness, and Self-Perceived Fitness in Hong Kong Adolescents , 2003, Perceptual and motor skills.

[18]  Sara S Johnson,et al.  Applying the transtheoretical model to regular moderate exercise in an overweight population: validation of a stages of change measure. , 2001, Preventive medicine.

[19]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[20]  C. Abraham,et al.  Interventions to change health behaviours: evidence-based or evidence-inspired? , 2004 .

[21]  John T. Cacioppo,et al.  The Elaboration Likelihood Model of Persuasion , 1986, Advances in Experimental Social Psychology.

[22]  S. Hollis,et al.  What is meant by intention to treat analysis? Survey of published randomised controlled trials , 1999, BMJ.

[23]  A. Stewart,et al.  An evaluation of three self-report physical activity instruments for older adults. , 2001, Medicine and science in sports and exercise.

[24]  T. Robinson,et al.  Physical activity self-report and accelerometry measures from the Girls health Enrichment Multi-site Studies. , 2004, Preventive medicine.

[25]  P. Gollwitzer,et al.  Implementation intentions and effective goal pursuit , 1997 .

[26]  S. Walker,et al.  Development and psychometric evaluation of the exercise benefits/barriers scale. , 1987, Research in nursing & health.

[27]  Ian Watt,et al.  Systematic review of the effectiveness of health behavior interventions based on the transtheoretical model , 2005 .

[28]  F. Jones,et al.  Adherence to an exercise prescription scheme: the role of expectations, self-efficacy, stage of change and psychological well-being. , 2005, British journal of health psychology.

[29]  Robert Rosenthal,et al.  Computing Contrasts, Effect Sizes, and Counternulls on Other People's Published Data: General Procedures for Research Consumers , 1996 .

[30]  D. A. Kenny,et al.  The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. , 1986, Journal of personality and social psychology.

[31]  S. Sutton,et al.  The impact of personal and social comparison information about health risk. , 2004, British journal of health psychology.

[32]  R. Winett,et al.  Using Internet technology to deliver a behavioral weight loss program. , 2001, JAMA.

[33]  J. Cacioppo,et al.  Effects of message repetition and position on cognitive response, recall, and persuasion. , 1979 .

[34]  B. Ainsworth,et al.  International physical activity questionnaire: 12-country reliability and validity. , 2003, Medicine and science in sports and exercise.

[35]  D. Revere,et al.  Review of Computer-generated Outpatient Health Behavior Interventions: , 2001 .

[36]  M. Johnston,et al.  Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods , 2000, International Journal of Obesity.

[37]  I. Janis,et al.  Decision Making: A Psychological Analysis of Conflict, Choice, and Commitment , 1977 .

[38]  P. Gollwitzer Goal Achievement: The Role of Intentions , 1993 .

[39]  L. C. Lyons,et al.  The efficacy of rational-emotive therapy: A quantitative review of the outcome research , 1991 .

[40]  K. Patrick,et al.  Evaluation of physical activity web sites for use of behavior change theories , 2003, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[41]  T. Wadden,et al.  A randomized controlled trial of a commercial internet weight loss program. , 2004, Obesity research.

[42]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[43]  K. Kawakubo,et al.  ASSESSMENT OF DAILY PHYSICAL ACTIVITY BY A PEDOMETER: COMPARISON WITH THE NEWLY DEVELOPED QUANTITATIVE QUESTIONNAIRE , 2001 .

[44]  A. Prentice,et al.  Obesity in Britain: gluttony or sloth? , 1995, BMJ.

[45]  M. Conner,et al.  Efficacy of the Theory of Planned Behaviour: a meta-analytic review. , 2001, The British journal of social psychology.

[46]  L. Sansom,et al.  Do Internet interventions for consumers cause more harm than good? A systematic review , 2002, Health expectations : an international journal of public participation in health care and health policy.

[47]  Scott E. Maxwell,et al.  Designing Experiments and Analyzing Data: A Model Comparison Perspective , 1990 .

[48]  F. Gibbons,et al.  Using Images to Increase Exercise Behavior: Prototypes Versus Possible Selves , 2005, Personality & social psychology bulletin.

[49]  Mark Conner,et al.  The use of implementation intentions and the decision balance sheet in promoting exercise behaviour , 2003 .

[50]  D. Cox,et al.  Internet interventions: In review, in use, and into the future. , 2003 .

[51]  W. Froggatt Rational Emotive Behaviour Therapy , 2005 .

[52]  Johannes Brug,et al.  Past, present, and future of computer-tailored nutrition education. , 2003, The American journal of clinical nutrition.

[53]  A Test of the ABC Model Underlying Rational Emotive Behavior Therapy , 2003, Psychological reports.

[54]  Debra Revere,et al.  Research Paper: Review of Computer-generated Outpatient Health Behavior Interventions: Clinical Encounters "in Absentia" , 2001, J. Am. Medical Informatics Assoc..

[55]  E. McAuley,et al.  Factors affecting the intention-physical activity relationship: intention versus expectation and scale correspondence. , 1994, Research quarterly for exercise and sport.