Haley James A, Rhind Daniel J A, Maidment David W
School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
Mhealth. 2023 Mar 17;9:10. doi: 10.21037/mhealth-22-52. eCollection 2023.
People with spinal cord injuries (SCI) are physically inactive. Smartphone applications (or apps) may prove as one strategy to overcome this. This study examines the theoretical underpinning of a novel mHealth intervention that aims to improve physical activity in people with SCI, namely, the Accessercise smartphone app, using the behaviour change wheel (BCW).
Accessercise was evaluated using the BCW in eight steps across the following three stages: (I) understanding the behaviour, (II) identifying intervention options, and (III) identifying content and implementation options.
Thirteen target behaviours were identified to improve physical activity and reduce sedentary behaviours in adults with SCI, including goal setting and monitoring, increasing self-confidence, interest and motivation for undertaking physical activity, improving the knowledge/awareness of available physical activity opportunities and resources, and reducing stigma and negative attitudes associated with physical activity. Accessercise incorporates the necessary components for adults with SCI to be physically and psychologically capable of undertaking physical activity, offering social and physical opportunities to reduce sedentary behaviours, and supports automatic and reflective motivation.
This systematic approach of assessing the theoretical underpinning of Accessercise in the context of the BCW has revealed potential mechanisms of action for improving physical activity in adults with SCI. This serves as a blueprint to inform further intervention development, as well as high-quality effectiveness studies, namely, randomised controlled trials, assessing whether fitness apps can improve physical and psychological health outcomes in individuals with SCI.
脊髓损伤（SCI）患者身体活动不足。智能手机应用程序（或应用）可能是克服这一问题的一种策略。本研究使用行为改变轮（BCW），探讨一种旨在改善SCI患者身体活动的新型移动健康干预措施——Accessercise智能手机应用程序的理论基础。
使用BCW分三个阶段的八个步骤对Accessercise进行评估：（I）了解行为，（II）确定干预选项，以及（III）确定内容和实施选项。
确定了13种目标行为，以改善SCI成年患者的身体活动并减少久坐行为，包括目标设定与监测、增强自信心、提高进行身体活动的兴趣和动力、增进对现有身体活动机会和资源的知识/认识，以及减少与身体活动相关的耻辱感和消极态度。Accessercise包含了使SCI成年患者在身体和心理上有能力进行身体活动的必要组成部分，提供了减少久坐行为的社交和身体机会，并支持自动和反思性动机。
这种在BCW背景下评估Accessercise理论基础的系统方法揭示了改善SCI成年患者身体活动的潜在作用机制。这为进一步的干预开发以及高质量的有效性研究（即随机对照试验）提供了蓝图，以评估健身应用程序是否能改善SCI患者的身心健康状况。
