Understanding super engaged users in the 10,000 Steps online physical activity program: A qualitative study

Objective Sustained engagement with Internet-based behavioural interventions is crucial to achieve successful behaviour change outcomes. As this has been problematic in many interventions, a lot of research has focused on participants with little or no engagement. However, few studies have attempted to understand users with continuous long-term engagement, the so called ‘super engaged users’, and why they keep on using programs when everybody else has long stopped. Therefore, the aim of this research was to qualitatively examine characteristics, usage profile and motivations of super engaged users in the 10,000 Steps program. Methods Twenty 10,000 Steps users (10 with more than 1 year of engagement, and 10 with more than 10 years of engagement) participated in semi-structured interviews, that were transcribed and thematically analysed. Results Participants were aged 60 years on average, with more than half being overweight/obese and/or suffering from chronic disease despite logging high step counts (219 million steps per participant on average) on the 10,000 Steps platform. Participants indicated that the reasons for sustained use were that engaging the program had become a habit, that the program kept them motivated, and that it was easy to use. Few participants had suggestions for improvement or expressed there were program elements they did not like. Uptake of program innovations (e.g., app-version, use of advanced activity tracker instead of pedometer) was modest among the super engaged users. Conclusion The findings from this study emphasise the need for digital health programs to incorporate features that will support the development of habits as soon as participants start to engage with the program. While a program’s usability, user-friendliness and acceptability are important to engage and retain new users, habit formation may be more important for sustained long-term engagement with the behaviour and the program.

[1]  M. Hopman,et al.  Patient experiences with the role of physical activity in inflammatory bowel disease: results from a survey and interviews , 2021, BMC Gastroenterology.

[2]  E. Campbell,et al.  Associations Between Digital Health Intervention Engagement, Physical Activity, and Sedentary Behavior: Systematic Review and Meta-analysis , 2020, Journal of medical Internet research.

[3]  C. Vandelanotte,et al.  Are web-based personally tailored physical activity videos more effective than personally tailored text-based interventions? Results from the three-arm randomised controlled TaylorActive trial , 2020, British Journal of Sports Medicine.

[4]  D. Cook,et al.  The effects of step-count monitoring interventions on physical activity: systematic review and meta-analysis of community-based randomised controlled trials in adults , 2020, International Journal of Behavioral Nutrition and Physical Activity.

[5]  Sam Liu,et al.  A systematic review of the dose-response relationship between usage and outcomes of online physical activity weight-loss interventions , 2020, Internet interventions.

[6]  C. Vandelanotte,et al.  The Association Between Logging Steps Using a Website, App, or Fitbit and Engaging With the 10,000 Steps Physical Activity Program: Observational Study , 2020, Journal of medical Internet research.

[7]  C. Vandelanotte,et al.  Every Step Counts: Understanding the Success of Implementing The 10,000 Steps Project. , 2020, Studies in health technology and informatics.

[8]  C. Vandelanotte,et al.  User Engagement and Attrition in an App-Based Physical Activity Intervention: Secondary Analysis of a Randomized Controlled Trial , 2019, Journal of medical Internet research.

[9]  F. Cramp,et al.  Keeping physically active with rheumatoid arthritis: semi-structured interviews to explore patient perspectives, experiences and strategies. , 2019, Physiotherapy.

[10]  C. Vandelanotte,et al.  Patterns of Diet, Physical Activity, Sitting and Sleep Are Associated with Socio-Demographic, Behavioural, and Health-Risk Indicators in Adults , 2019, International journal of environmental research and public health.

[11]  Virginia Braun,et al.  Reflecting on reflexive thematic analysis , 2019, Qualitative Research in Sport, Exercise and Health.

[12]  C. Vandelanotte,et al.  Qualitative Exploration of the Feasibility and Acceptability of Workplace-Based Microgrants to Improve Physical Activity: The 10,000 Steps Pedometer Microgrant Scheme , 2018, Journal of occupational and environmental medicine.

[13]  C. Vandelanotte,et al.  Using Web 2.0 applications to promote health-related physical activity: findings from the WALK 2.0 randomised controlled trial , 2017, British Journal of Sports Medicine.

[14]  C. Vandelanotte,et al.  Interest and preferences for using advanced physical activity tracking devices: results of a national cross-sectional survey , 2016, BMJ Open.

[15]  C. Vandelanotte,et al.  Past, Present, and Future of eHealth and mHealth Research to Improve Physical Activity and Dietary Behaviors. , 2016, Journal of nutrition education and behavior.

[16]  P. Loprinzi,et al.  Does the fat-but-fit paradigm hold true for all-cause mortality when considering the duration of overweight/obesity? Analyzing the WATCH (Weight, Activity and Time Contributes to Health) paradigm. , 2016, Preventive medicine.

[17]  Morwenna Kirwan,et al.  Engagement and Nonusage Attrition With a Free Physical Activity Promotion Program: The Case of 10,000 Steps Australia , 2015, Journal of medical Internet research.

[18]  C. Vandelanotte,et al.  Examining Participant Engagement in an Information Technology-Based Physical Activity and Nutrition Intervention for Men: The Manup Randomized Controlled Trial , 2014, JMIR research protocols.

[19]  Pat Bazeley,et al.  Qualitative Data Analysis: Practical Strategies , 2013 .

[20]  Corneel Vandelanotte,et al.  Can a Website-Delivered Computer-Tailored Physical Activity Intervention Be Acceptable, Usable, and Effective for Older People? , 2012, Health education & behavior : the official publication of the Society for Public Health Education.

[21]  B. Gardner,et al.  Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index , 2012, International Journal of Behavioral Nutrition and Physical Activity.

[22]  Morwenna Kirwan,et al.  Using Smartphone Technology to Monitor Physical Activity in the 10,000 Steps Program: A Matched Case–Control Trial , 2012, Journal of medical Internet research.

[23]  Corneel Vandelanotte,et al.  Prospective Associations Between Intervention Components and Website Engagement in a Publicly Available Physical Activity Website: The Case of 10,000 Steps Australia , 2012, Journal of medical Internet research.

[24]  S. Michie,et al.  A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy , 2011, Psychology & health.

[25]  M. Hagger,et al.  “You Can’t Do It on Your Own”: Experiences of a motivational interviewing intervention on physical activity and dietary behaviour , 2011 .

[26]  S. Marshall,et al.  Effect of Pedometer-Based Physical Activity Interventions , 2009, Research quarterly for exercise and sport.

[27]  S. Blair,et al.  Healthy hearts--and the universal benefits of being physically active: physical activity and health. , 2009, Annals of epidemiology.

[28]  Elaine Toms,et al.  What is user engagement? A conceptual framework for defining user engagement with technology , 2008, J. Assoc. Inf. Sci. Technol..

[29]  C. Vandelanotte,et al.  Website-delivered physical activity interventions a review of the literature. , 2007, American journal of preventive medicine.

[30]  Grant Schofield,et al.  Dissemination of a community-based physical activity project: the case of 10,000 steps. , 2006, Journal of science and medicine in sport.

[31]  G. Eysenbach The Law of Attrition , 2005, Journal of medical Internet research.

[32]  Scott E Crouter,et al.  Accuracy and reliability of 10 pedometers for measuring steps over a 400-m walk. , 2003, Medicine and science in sports and exercise.

[33]  B. Verplanken,et al.  Reflections on past behavior: A self-report index of habit strength , 2003 .

[34]  B. Verplanken The psychology of habit: Theory, mechanisms, change, and contexts , 2018 .

[35]  C. Vandelanotte,et al.  Designing engaging online behaviour change interventions: A proposed model of user engagement , 2015 .

[36]  Grant Schofield,et al.  10,000 Steps Rockhampton : evaluation of a whole community approach to improving population levels of physical activity , 2006 .