Efficacy and causal mechanism of an online social media intervention to increase physical activity: Results of a randomized controlled trial

Objective: To identify what features of social media – promotional messaging or peer networks – can increase physical activity. Method: A 13-week social media-based exercise program was conducted at a large Northeastern university in Philadelphia, PA. In a randomized controlled trial, 217 graduate students from the University were randomized to three conditions: a control condition with a basic online program for enrolling in weekly exercise classes led by instructors of the University for 13 weeks, a media condition that supplemented the basic program with weekly online promotional media messages that encourage physical activity, and a social condition that replaced the media content with an online network of four to six anonymous peers composed of other participants of the program, in which each participant was able to see their peers' progress in enrolling in classes. The primary outcome was the number of enrollments in exercise classes, and the secondary outcomes were self-reported physical activities. Data were collected in 2014. Results: Participants enrolled in 5.5 classes on average. Compared with enrollment in the control condition (mean = 4.5), promotional messages moderately increased enrollment (mean = 5.7, p = 0.08), while anonymous social networks significantly increased enrollment (mean = 6.3, p = 0.02). By the end of the program, participants in the social condition reported exercising moderately for an additional 1.6 days each week compared with the baseline, which was significantly more than an additional 0.8 days in the control condition. Conclusion: Social influence from anonymous online peers was more successful than promotional messages for improving physical activity. Clinical Trial Registration: ClinicalTrials.gov: NCT02267369.

[1]  Damon Centola An Experimental Study of Homophily in the Adoption of Health Behavior , 2011, Science.

[2]  S. Shapiro,et al.  An Analysis of Variance Test for Normality (Complete Samples) , 1965 .

[3]  N. Owen,et al.  Too little exercise and too much sitting: Inactivity physiology and the need for new recommendations on sedentary behavior , 2008, Current cardiovascular risk reports.

[4]  K. Viswanath,et al.  Lessons learned from public health mass media campaigns: marketing health in a crowded media world. , 2004, Annual review of public health.

[5]  B. Efron Nonparametric estimates of standard error: The jackknife, the bootstrap and other methods , 1981 .

[6]  David W. Dunstan,et al.  Too much sitting--a health hazard. , 2012, Diabetes research and clinical practice.

[7]  W. Kroeze,et al.  A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors , 2006, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[8]  W. Chou,et al.  Web 2.0 for health promotion: reviewing the current evidence. , 2013, American journal of public health.

[9]  R J Shephard,et al.  Revision of the Physical Activity Readiness Questionnaire (PAR-Q). , 1992, Canadian journal of sport sciences = Journal canadien des sciences du sport.

[10]  Treatment of Obesity in Adults Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults--The Evidence Report. National Institutes of Health. , 1998, Obesity research.

[11]  Ben Kirman,et al.  Motivating physical activity at work: using persuasive social media for competitive step counting , 2010, MindTrek.

[12]  Annie Y. S. Lau,et al.  The influence of social networking sites on health behavior change: a systematic review and meta-analysis , 2015, J. Am. Medical Informatics Assoc..

[13]  Jane D. Brown,et al.  A social media-based physical activity intervention: a randomized controlled trial. , 2012, American journal of preventive medicine.

[14]  Jennifer L. Pomeranz,et al.  The Delivery of Public Health Interventions via the Internet: Actualizing Their Potential , 2011 .

[15]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[16]  B. Franks YMCA youth fitness test manual , 1989 .

[17]  J. Holmes,et al.  Health, United States, 2013 : with special feature on prescription drugs , 2014 .

[18]  L. G. Doak,et al.  The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. , 2006, Patient education and counseling.

[19]  C. Jackson,et al.  Health communication on the Internet: an effective channel for health behavior change? , 1998, Journal of health communication.

[20]  Damon Centola,et al.  The Spread of Behavior in an Online Social Network Experiment , 2010, Science.

[21]  Nicholas A. Christakis,et al.  Social contagion theory: examining dynamic social networks and human behavior , 2011, Statistics in medicine.

[22]  K. Reynolds,et al.  Effects of Physical Activity and Sedentary Time on the Risk of Heart Failure , 2014, Circulation. Heart failure.

[23]  Jianwen Cai,et al.  A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors , 2013, Journal of Cancer Survivorship.

[24]  G. Dunton,et al.  A tailored Internet-plus-email intervention for increasing physical activity among ethnically-diverse women. , 2008, Preventive medicine.

[25]  Noah J. Goldstein,et al.  Social influence: compliance and conformity. , 2004, Annual review of psychology.

[26]  H. Korda,et al.  Harnessing Social Media for Health Promotion and Behavior Change , 2013, Health promotion practice.

[27]  G. Bennett,et al.  Using facebook and text messaging to deliver a weight loss program to college students , 2013, Obesity.

[28]  S. Shott,et al.  Nonparametric Statistics , 2018, The Encyclopedia of Archaeological Sciences.

[29]  Kim Walsh-Childers,et al.  Public Health Communication: Evidence for Behavior Change , 2003 .

[30]  D. French,et al.  What are the most effective intervention techniques for changing physical activity self-efficacy and physical activity behaviour--and are they the same? , 2011, Health education research.

[31]  N. Mutrie,et al.  Physical activity intervention: a transtheoretical model-based intervention designed to help sedentary young adults become active. , 2002, Health education research.

[32]  Penny Gordon-Larsen,et al.  Longitudinal physical activity and sedentary behavior trends: adolescence to adulthood. , 2004, American journal of preventive medicine.

[33]  Damon Centola Damon Centola Behavior An Experimental Study of Homophily in the Adoption of Health , 2011 .

[34]  Damon Centola Social Media and the Science of Health Behavior , 2013, Circulation.

[35]  Gary L. Kreps,et al.  New directions in eHealth communication: opportunities and challenges. , 2010, Patient education and counseling.

[36]  Elizabeth Goodman,et al.  Approaches to the prevention and management of childhood obesity: the role of social networks and the use of social media and related electronic technologies: a scientific statement from the American Heart Association. , 2013, Circulation.

[37]  M. Fishbein,et al.  The Attentional Mechanism of Message Sensation Value: Interaction between Message Sensation Value and Argument Quality on Message Effectiveness , 2006 .

[38]  R. Lefebvre,et al.  Digital social networks and health. , 2013, Circulation.

[39]  B. Lewis,et al.  Methods of using real-time social media technologies for detection and remote monitoring of HIV outcomes. , 2014, Preventive medicine.

[40]  Robert B. Cialdini,et al.  Descriptive Social Norms as Underappreciated Sources of Social Control , 2007 .

[41]  Jun Shao,et al.  Last observation carry‐forward and last observation analysis , 2003, Statistics in medicine.

[42]  N. Owen,et al.  Sedentary behaviors and subsequent health outcomes in adults a systematic review of longitudinal studies, 1996-2011. , 2011, American journal of preventive medicine.

[43]  G. Tell,et al.  Predictors and tracking of body mass index from adolescence into adulthood: follow-up of 18 to 20 years in the Oslo Youth Study. , 2003, Archives of pediatrics & adolescent medicine.

[44]  P. Williams,et al.  Physical activity and public health. , 1995, JAMA.

[45]  D. Warburton,et al.  Health benefits of physical activity: the evidence , 2006, Canadian Medical Association Journal.

[46]  W. W. Daniel Applied Nonparametric Statistics , 1979 .

[47]  D. Mozaffarian,et al.  Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association , 2012, Circulation.

[48]  C. Vandelanotte,et al.  Are Health Behavior Change Interventions That Use Online Social Networks Effective? A Systematic Review , 2014, Journal of medical Internet research.