Keadle Sarah K, Hasanaj Kristina, Leonard Krista S, Fernandez Arlene, Freid Lena, Weiss Skylar, Legato Maria, Anand Harsh, Hagobian Todd A, Phillips Siobhan M, Phelan Suzanne, Guastaferro Kate, Seltzer Ryan G N, Buman Matthew P
Department of Kinesiology and Public Health & Center for Health Research, California Polytechnic State University, San Luis Obispo, CA, USA.
College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
Int J Behav Nutr Phys Act. 2025 Jun 13;22(1):77. doi: 10.1186/s12966-025-01771-2.
Using the multiphase optimization strategy (MOST) framework, we aimed to identify an optimized mHealth-delivered intervention for reducing recreational sedentary screen time (rSST) by at least 60 min/day among adults.
Eligible participants were 23-64 years old and self-reported elevated rSST (> 3 h/day). Following a 7-day baseline, participants received a core mHealth application (self-monitoring and 50% reduction target and educational materials) and were randomly assigned to three additional components set to on/off in a full-factorial (2) experiment: LOCKOUT: rSST electronically restricted; TEXT: rSST reduction prompts; and EARN: rSST through physical activity. rSST was assessed at baseline and 16 weeks via an integrated measure that included objectively assessed sedentary time (activPAL accelerometer) and screen time (TV Wifi plugs and tablet usage). We used a linear mixed effect model to evaluate the change in rSST for the three intervention components and their interactions.
A total of 82% of the randomized participants (N = 110) were female, with a mean ± SD age of 41 ± 11.7 y and a BMI of 29.7 ± 7.8 kg/m2, and their mean (95% CI) rSST was 184.7 (172.8, 196.5) min/day at baseline. The expected difference (baseline vs. 16 weeks) in rSST was greatest for the intervention versions with the core plus EARN on with an average reduction of -118.1 (-163.0, -73.1) min/day and for core plus LOCKOUT, TEXT, & EARN on (-125.7 [-172.0, -79.3] min/day).
We identified several promising intervention versions that exceeded our optimization objective. This study provides important evidence on efficacious multicomponent interventions that should be moved forward to the evaluation phase of the MOST framework to test the effect of rSST reductions on health outcomes.
(clinicaltrials.gov NCT04464993).
我们旨在运用多阶段优化策略（MOST）框架，确定一种通过移动健康（mHealth）提供的优化干预措施，以减少成年人每天至少60分钟的娱乐性久坐屏幕时间（rSST）。
符合条件的参与者年龄在23至64岁之间，且自我报告rSST升高（>3小时/天）。在为期7天的基线期后，参与者收到一个核心移动健康应用程序（自我监测、50%的减少目标和教育材料），并被随机分配到另外三个在全因子（2）实验中设置为开启/关闭的组件：锁定：电子限制rSST；短信：rSST减少提示；以及赚取：通过体育活动减少rSST。在基线期和16周时，通过一种综合测量方法评估rSST，该方法包括客观评估的久坐时间（activPAL加速度计）和屏幕时间（电视WiFi插头和平板电脑使用情况）。我们使用线性混合效应模型来评估三种干预组件及其相互作用对rSST的变化。
共有82%的随机参与者（N = 110）为女性，平均年龄±标准差为41±11.7岁，BMI为29.7±7.8kg/m²，基线时他们的平均（95%CI）rSST为184.7（172.8，196.5）分钟/天。对于核心加赚取开启的干预版本，rSST的预期差异（基线与16周）最大，平均减少-118.1（-163.0，-73.1）分钟/天，对于核心加锁定、短信和赚取开启的版本（-125.7[-172.0，-79.3]分钟/天）。
我们确定了几个超过优化目标的有前景的干预版本。本研究为有效的多组件干预提供了重要证据，这些干预应推进到MOST框架的评估阶段，以测试减少rSST对健康结果的影响。
（clinicaltrials.gov NCT04464993）
