CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China.
Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
J Med Internet Res. 2021 Dec 7;23(12):e29167. doi: 10.2196/29167.
Walking is a simple but beneficial form of physical activity (PA). Self-monitoring and providing information about social norms are the 2 most widely used "mobile health (mHealth)" strategies to promote walking behavior. However, previous studies have failed to discriminate the effect of self-monitoring from the combination of the 2 strategies, and provide practical evidence within Chinese culture. Some essential moderators, such as gender and group identity, were also overlooked.
We aimed to investigate the effectiveness of social norm and self-monitoring interventions for walking behavior and assess the moderating effects of gender and group identity, which could guide optimal mHealth intervention projects in China.
In 2 longitudinal tracking studies (study 1, 22 days; study 2, 31 days), Chinese college students wore trackers for at least 8 hours per day (MASAI 3D Pedometer and Xiaomi Wristband 2) to record their daily step counts in baseline, intervention, and follow-up stages. In each study, participants (study 1: n=117, 54% female, mean age 25.60 years; study 2: n=180, 51% female, mean age 22.60 years) were randomly allocated to 1 of the following 3 groups: a self-monitoring group and 2 social norm intervention groups. In the 2 intervention groups and during the intervention stage, participants received different social norm information regarding group member step rankings corresponding to their grouping type of social norm information. In study 1, participants were grouped by within-group member PA levels (PA consistent vs PA inconsistent), and in study 2, participants were grouped by their received gender-specific social norm information (gender consistent vs gender inconsistent). Piece-wise linear mixed models were used to compare the difference in walking steps between groups.
In study 1, for males in the self-monitoring group, walking steps significantly decreased from the baseline stage to the intervention stage (change in slope=-1422.16; P=.02). However, additional social norm information regardless of group consistency kept their walking unchanged. For females, social norm information did not provide any extra benefit beyond self-monitoring. Females exposed to PA-inconsistent social norm information even walked less (slope during the intervention=-122.18; P=.03). In study 2, for males, a similar pattern was observed, with a decrease in walking steps in the self-monitoring group (change in slope=-151.33; P=.08), but there was no decrease in the 2 social norm intervention groups. However, for females, gender-consistent social norm information decreased walking steps (slope during the intervention=-143.68; P=.03).
Both gender and group identity moderated the effect of social norm information on walking. Among females, social norm information showed no benefit for walking behavior and may have exerted a backfire effect. Among males, while walking behavior decreased with self-monitoring only, the inclusion of social norm information held the level of walking behavior steady.
行走是一种简单但有益的身体活动（PA）形式。自我监测和提供有关社会规范的信息是促进行走行为的两种最广泛使用的“移动健康（mHealth）”策略。然而，之前的研究未能区分自我监测和两种策略组合的效果，并且没有在中华文化中提供实际证据。一些重要的调节因素，如性别和群体认同，也被忽视了。
我们旨在研究社会规范和自我监测干预对行走行为的有效性，并评估性别和群体认同的调节作用，这可以为中国的最佳 mHealth 干预项目提供指导。
在两项纵向跟踪研究中（研究 1，22 天；研究 2，31 天），中国大学生每天至少佩戴跟踪器 8 小时（MASAI 3D 计步器和小米手环 2），以记录他们在基线、干预和随访阶段的日常步数。在每项研究中，参与者（研究 1：n=117，54%为女性，平均年龄 25.60 岁；研究 2：n=180，51%为女性，平均年龄 22.60 岁）被随机分配到以下 3 组中的 1 组：自我监测组和 2 个社会规范干预组。在 2 个干预组和干预阶段期间，参与者收到了与他们的分组类型的社会规范信息相对应的不同的社会规范信息。在研究 1 中，参与者根据组内成员的 PA 水平（PA 一致与 PA 不一致）分组，在研究 2 中，参与者根据他们收到的特定于性别的社会规范信息（性别一致与性别不一致）分组。分段线性混合模型用于比较组间行走步数的差异。
在研究 1 中，对于自我监测组的男性，从基线阶段到干预阶段，行走步数明显减少（斜率变化=-1422.16；P=.02）。然而，无论组一致性如何，额外的社会规范信息都没有提供任何额外的好处。暴露于 PA 不一致的社会规范信息的女性甚至走得更少（干预期间的斜率=-122.18；P=.03）。在研究 2 中，对于男性，观察到类似的模式，自我监测组的行走步数减少（斜率变化=-151.33；P=.08），但 2 个社会规范干预组没有减少。然而，对于女性，性别一致的社会规范信息减少了行走步数（干预期间的斜率=-143.68；P=.03）。
性别和群体认同都调节了社会规范信息对行走的影响。在女性中，社会规范信息对行走行为没有好处，甚至可能产生适得其反的效果。在男性中，虽然自我监测会导致行走行为减少，但纳入社会规范信息可以保持行走行为的稳定水平。
