Duncan Mitch, Vandelanotte Corneel, Kolt Gregory S, Rosenkranz Richard R, Caperchione Cristina M, George Emma S, Ding Hang, Hooker Cindy, Karunanithi Mohan, Maeder Anthony J, Noakes Manny, Tague Rhys, Taylor Pennie, Viljoen Pierre, Mummery W Kerry
School of Medicine & Public Health, Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.
J Med Internet Res. 2014 Jun 12;16(6):e136. doi: 10.2196/jmir.3107.
The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males' physical activity and dietary practices.
This study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention.
Participants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants' physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months.
A total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively.
The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes.
Australian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6QHIWad63).
大量成年男性身体活动水平较低且饮食习惯不良，这些行为带来的健康风险使得有必要采取广泛的干预策略。基于信息技术（IT）（网络和手机）的干预措施可供大量人群使用，但针对男性身体活动和饮食习惯的基于IT的干预措施报道较少。
本研究旨在检验一项为期9个月的基于IT的干预措施（ManUp）与基于印刷品的干预措施相比，在改善中年男性身体活动、饮食行为和健康素养方面的有效性。
通过线下招募（如报纸广告）参与者，按照2:1的比例随机分为基于IT的干预组或基于印刷品的干预组，倾向于全自动的基于IT的干预组。参与者为年龄在35 - 54岁之间、居住在澳大利亚昆士兰州两个地区城市、能够上网、拥有手机且能够提高其活动水平的成年男性。干预措施ManUp基于社会认知和自我调节理论，专门针对男性设计。提供了教育材料，并促进对身体活动和营养行为的自我监测。两个干预组的干预内容相同；只是交付方式不同。在整个9个月的研究期间都可以获取内容。在基线、3个月和9个月时使用在线调查测量参与者的身体活动、饮食行为和健康素养。
共有301名参与者完成了基线评估，其中基于IT的干预组有205名，基于印刷品的干预组有96名。共有124名参与者完成了所有三项评估。在身体活动和饮食行为方面，两组之间没有显著差异（P≥0.05）。参与者报告在3个月（exp(β)=1.45，95%CI 1.09 - 1.95；exp(β)=1.61，95%CI 1.17 - 2.22）和9个月（exp(β)=1.55，95%CI 1.14 - 2.10；exp(β)=1.51，95%CI 1.15 - 2.00）时，身体活动的分钟数和次数有所增加。总体饮食行为在3个月（exp(β)=1.07，95%CI 1.03 - 1.11）和9个月（exp(β)=1.10，95%CI 1.05 - 1.13）时有所改善。两组中食用高纤维面包和低脂牛奶的参与者比例在3个月时增加（exp(β)=2.25，95%CI 1.29 - 3.92；exp(β)=1.65，95%CI 1.07 - 2.55）。基于IT的干预组参与者不太可能报告每天30分钟的身体活动能改善健康（exp(β)=0.48，95%CI 0.26 - 0.90），而更有可能报告每周进行三次剧烈强度的身体活动至关重要（exp(β)=1.70，95%CI 1.02 - 2.82）。在3个月和9个月时，登录IT平台的平均次数分别为6.99（标准误0.86）和9.22（标准误1.47）。在3个月和9个月时，自我监测条目的平均数量分别为16.69（标准误2.38）和22.51（标准误3.79）。
ManUp干预措施在改善中年男性身体活动和饮食行为方面是有效的，基于IT的交付方式和基于印刷品的交付方式之间没有显著差异。
澳大利亚新西兰临床试验注册中心：ACTRN12611000081910；https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910（由WebCite存档于http://www.webcitation.org/6QHIWad63）。
