Department for Health, University of Bath, Bath, BA2 7AY, UK.
School of Health and Life Sciences, Teesside University, Middlesbrough, UK.
Int J Behav Nutr Phys Act. 2020 Aug 8;17(1):99. doi: 10.1186/s12966-020-00998-5.
Technological progress has enabled the provision of personalised feedback across multiple dimensions of physical activity that are important for health. Whether this multidimensional approach supports physical activity behaviour change has not yet been examined. Our objective was to examine the effectiveness of a novel digital system and app that provided multidimensional physical activity feedback combined with health trainer support in primary care patients identified as at risk of chronic disease.
MIPACT was a parallel-group, randomised controlled trial that recruited patients at medium (≥10 and < 20%) or high (≥20%) risk of cardiovascular disease and/or type II diabetes from six primary care practices in the United Kingdom. Intervention group participants (n = 120) received personal multidimensional physical activity feedback using a customised digital system and web-app for 3 months plus five health trainer-led sessions. All participants received standardised information regarding physical activity. Control group participants (n = 84) received no further intervention. The primary outcome was device-based assessment of physical activity at 12 months.
Mean intervention effects were: moderate-vigorous physical activity: -1.1 (95% CI, - 17.9 to 15.7) min/day; moderate-vigorous physical activity in ≥10-min bouts: 0.2 (- 14.2 to 14.6) min/day; Physical Activity Level (PAL): 0.00 (- 0.036 to 0.054); vigorous physical activity: 1.8 (- 0.8 to 4.2) min/day; and sedentary time: 10 (- 19.3 to 39.3) min/day. For all of these outcomes, the results showed that the groups were practically equivalent and statistically ruled out meaningful positive or negative effects (>minimum clinically important difference, MCID). However, there was profound physical activity multidimensionality, and only a small proportion (5%) of patients had consistently low physical activity across all dimensions.
In patients at risk of cardiovascular disease and/or type II diabetes, MIPACT did not increase mean physical activity. Using a sophisticated multidimensional digital approach revealed enormous heterogeneity in baseline physical activity in primary care patients, and practitioners may need to screen for low physical activity across dimensions rather than rely on disease-risk algorithms that are heavily influenced by age.
This trial is registered with the ISRCTN registry ( ISRCTN18008011 ; registration date 31 July 2013).
技术进步使人们能够提供与身体健康相关的多个维度的个性化反馈。然而，这种多维方法是否能够支持身体活动行为的改变，目前尚未得到验证。我们的目标是研究一种新的数字系统和应用程序，该系统和应用程序在英国的六个基层医疗实践中为被确定为患有慢性疾病风险的患者提供多维身体活动反馈，并结合健康教练的支持，以检验其有效性。
MIPACT 是一项平行组、随机对照试验，从英国的六个基层医疗实践中招募了中等（≥ 10%且<20%）或高（≥ 20%）心血管疾病和/或 2 型糖尿病风险的患者。干预组参与者（n=120）使用定制的数字系统和网络应用程序接受为期 3 个月的个人多维身体活动反馈，以及 5 次健康教练指导的课程。所有参与者都收到了关于身体活动的标准化信息。对照组参与者（n=84）未接受进一步的干预。主要结局是在 12 个月时使用设备评估身体活动。
平均干预效果为：中高强度体力活动：-1.1（95%置信区间，-17.9 至 15.7）分钟/天；中高强度体力活动持续 10 分钟以上的次数：0.2（-14.2 至 14.6）分钟/天；体力活动水平（PAL）：0.00（-0.036 至 0.054）；高强度体力活动：1.8（-0.8 至 4.2）分钟/天；以及久坐时间：10（-19.3 至 39.3）分钟/天。对于所有这些结果，结果表明两组在实践中是等效的，并且在统计学上排除了有意义的积极或消极影响（>最小临床重要差异，MCID）。然而，身体活动的多维性非常明显，只有一小部分（5%）患者在所有维度上的身体活动一直都很低。
在患有心血管疾病和/或 2 型糖尿病风险的患者中，MIPACT 并没有增加平均身体活动。使用复杂的多维数字方法揭示了基层医疗患者中身体活动在基线时存在巨大的异质性，医生可能需要筛查各个维度的低身体活动，而不是依赖于受年龄影响较大的疾病风险算法。
本试验在 ISRCTN 注册中心（ISRCTN8011；注册日期 2013 年 7 月 31 日）注册。
