Duan Yan Ping, Wienert Julian, Hu Chun, Si Gang Yan, Lippke Sonia
Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).
Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
J Med Internet Res. 2017 Apr 10;19(4):e106. doi: 10.2196/jmir.7152.
Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students.
Our objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression).
In a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015.
Significant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ=11.75, P=.001) and FVI (χ=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F=1.23, η=.03, P=.02).
This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention.
Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1).
大量证据表明，大学生久坐不动以及果蔬摄入量不足（FVI）的风险很高。基于互联网的多种健康行为干预措施在改变这些不健康习惯方面似乎很有前景。有限的随机对照试验在中国大学生中检验了这一假设。
我们的目的是测试一项为期8周的基于网络的干预措施与对照组相比，在改善中国大学生身体活动（PA）和FVI方面的效果。干预内容基于健康行动过程方法，并根据西半球先前的证据制定。我们评估了自我报告的数据，包括PA和FVI、PA和FVI的改变阶段，以及PA和FVI的动机（风险感知、结果期望、自我效能）、意志（行动计划、应对计划、社会支持）和远端（意图、习惯）指标，以及感知到的心理健康结果（生活质量、抑郁）。
在一项随机对照试验中，我们在中国中部地区的一所大学的普通体育课上招募了566名大学生。在随机分配并排除不合适的参与者后，我们将493名学生分配到2组中的1组：（1）干预组：前4周进行PA干预，随后4周进行FVI干预；（２）对照组。我们进行了3次基于网络的评估：在干预开始时（T1，n = 493）、8周干预结束时（T2，n = 337）以及干预后1个月的随访时（T3，n = 142）。整个研究在2015年秋季学期进行。
显著的时间⨯组交互作用显示，干预对FVI、FVI的动机、意志和远端指标以及PA行为变化有更好的效果，效应大小（η）范围为0.08至0.20。此外，从T1到T2，PA（χ = 11.75，P = 0.001）和FVI（χ = 15.64，P = 0.03）向行动组的阶段进展的总体干预效果显著。此外，在生活质量改善方面也观察到了干预效果（F = 1.23，η = 0.03，P = 0.02）。
本研究为在中国大学生中进行的基于网络的多种健康行为干预的效果提供了证据，该干预用不同的结果变量进行了测试。未来的研究应解决高辍学率问题，并优化该干预措施中最有效的组成部分。
Clinicaltrials.gov NCT01909349；https://clinicaltrials.gov/ct2/show/NCT01909349（由WebCite存档于http://www.webcitation.org/6pHV1A0G1）
