Mascarenhas Maya Nina, Chan June Maylin, Vittinghoff Eric, Van Blarigan Erin Lynn, Hecht Frederick
Osher Center for Integrative Medicine, University of California, San Francisco, San Francisco, CA, United States.
Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, United States.
J Med Internet Res. 2018 May 18;20(5):e179. doi: 10.2196/jmir.9310.
Women significantly decrease their activity levels in the transition to motherhood. Digital health technologies are low cost, scalable, and can provide an effective delivery mechanism for behavior change. This is the first study that examines the use of videoconferencing and mobile apps to create exercise groups for mothers.
The aim of the study was to test the feasibility, acceptability, and effectiveness of an individually adaptive and socially supportive physical activity intervention incorporating videoconferencing and mobile apps for mothers.
The Moms Online Video Exercise Study was an 8-week, 2-armed, Web-based randomized trial comparing the effectiveness of a group exercise intervention with a waitlist control. Healthy mothers with at least 1 child under the age of 12 years were recruited through Facebook and email listservs. Intervention participants joined exercise groups using videoconferencing (Google Hangouts) every morning on weekdays and exercised together in real time, guided by exercise mobile apps (eg, Nike+, Sworkit) of their choice. Waitlist control participants had access to recommended mobile apps and an invitation to join an exercise group after the 8-week study period. Main outcomes assessed included changes in self-reported moderate, vigorous, and moderate to vigorous physical activity (MVPA) minutes per week in aggregate and stratified by whether women met Centers for Disease Control and Prevention guidelines for sufficient aerobic activity at baseline. Outcomes were measured through self-assessed Web-based questionnaires at baseline and 8 weeks.
The intervention was effective at increasing exercise for inactive women and proved to be feasible and acceptable to all participants. A total of 64 women were randomized, 30 to intervention and 34 to control. Women attended 2.8 sessions per week. There was a strong, but not statistically significant, trend toward increasing moderate, vigorous, and MVPA minutes for all women. As hypothesized, in the prespecified stratum of women who were inactive at baseline (n=51), intervention participants significantly increased their activity by an average of 50 (95% CI 4.0-95.9, P=.03) MVPA minutes per week more than control participants. They had a corresponding statistically significant net increase of 19 (95% CI 3.2-34.8, P=.02) minutes of vigorous activity. Inactive women in the intervention arm also experienced promising reductions in depression, reporting a statistically significant net decrease in their depression score (-3.8, 95% CI -7.0 to -0.6; P=.02).
We found that a group exercise intervention using videoconferencing and mobile apps was a feasible and acceptable way to deliver a physical activity intervention to mothers. The intervention increased physical activity in inactive mothers. Further studies are needed to better establish how long these changes in physical activity can be maintained and whether these findings can be reproduced in a more diverse population.
ClinicalTrials.gov NCT02805140; https://clinicaltrials.gov/ct2/show/NCT02805140 (Archived by WebCite at http://www.webcitation.org/6yYZwRveg).
女性在向母亲角色转变的过程中，其活动水平会显著下降。数字健康技术成本低、可扩展，并且能够为行为改变提供有效的传播机制。这是第一项研究视频会议和移动应用程序在为母亲们创建锻炼小组方面的应用的研究。
本研究旨在测试一种针对母亲的、结合视频会议和移动应用程序的个性化自适应且具有社会支持性的体育活动干预措施的可行性、可接受性和有效性。
“妈妈在线视频锻炼研究”是一项为期8周的双臂网络随机试验，比较了小组锻炼干预与候补对照组的效果。通过脸书和电子邮件列表招募了至少有一名12岁以下子女的健康母亲。干预组参与者在工作日每天早上使用视频会议（谷歌环聊）加入锻炼小组，并在他们选择的锻炼移动应用程序（如耐克+、Sworkit）的指导下实时一起锻炼。候补对照组参与者可以使用推荐的移动应用程序，并在8周的研究期结束后收到加入锻炼小组的邀请。评估的主要结果包括自我报告的每周中等强度、高强度以及中等至高强度身体活动（MVPA）总分钟数的变化，并根据女性在基线时是否符合疾病控制与预防中心的充足有氧运动指南进行分层。结果通过在基线和8周时基于网络的自我评估问卷进行测量。
该干预措施在增加不活跃女性的锻炼方面是有效的，并且被所有参与者证明是可行的和可接受的。共有64名女性被随机分组，30名进入干预组，34名进入对照组。女性每周参加2.8次课程。所有女性的中等强度、高强度和MVPA分钟数有增加的强烈趋势，但无统计学意义。如假设的那样，在预先设定的基线时不活跃的女性亚组（n = 51）中，干预组参与者的活动量比对照组参与者每周平均显著增加50（95% CI 4.0 - 95.9，P = 0.03）分钟的MVPA。她们相应的高强度活动净增加量有统计学意义，为19（95% CI 3.2 - 34.8，P = 0.02）分钟。干预组中的不活跃女性在抑郁方面也有显著改善，报告其抑郁评分有统计学意义的净下降（-3.8，95% CI -7.0至-0.6；P = 0.02）。
我们发现，使用视频会议和移动应用程序的小组锻炼干预是向母亲们提供体育活动干预的一种可行且可接受的方式。该干预增加了不活跃母亲的身体活动。需要进一步研究以更好地确定这些身体活动变化能够维持多长时间，以及这些结果是否能在更多样化的人群中重现。
ClinicalTrials.gov NCT02805140；https://clinicaltrials.gov/ct2/show/NCT02805140（由WebCite存档于http://www.webcitation.org/6yYZwRveg）
