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BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Study protocol

Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults

Authors: Mitch J. Duncan, Corneel Vandelanotte, Stewart G. Trost, Amanda L. Rebar, Naomi Rogers, Nicola W. Burton, Beatrice Murawski, Anna Rayward, Sasha Fenton, Wendy J. Brown

Published in: BMC Public Health | Issue 1/2016

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Abstract

Background

Many adults are insufficiently physically active, have prolonged sedentary behaviour and report poor sleep. These behaviours can be improved by interventions that include education, goal setting, self-monitoring, and feedback strategies. Few interventions have explicitly targeted these behaviours simultaneously or examined the relative efficacy of different self-monitoring methods.

Methods/Design

This study aims to compare the efficacy of two self-monitoring methods in an app-based multi-behaviour intervention to improve objectively measured physical activity, sedentary, and sleep behaviours, in a 9 week 2–arm randomised trial. Participants will be adults (n = 64) who report being physically inactive, sitting >8 h/day and frequent insufficient sleep (≥14 days out of last 30). The “Balanced” intervention is delivered via a smartphone ‘app’, and includes education materials (guidelines, strategies to promote change in behaviour), goal setting, self-monitoring and feedback support. Participants will be randomly allocated to either a device-entered or user-entered self-monitoring method. The device-entered group will be provided with a activity tracker to self-monitor behaviours. The user-entered group will recall and manually record behaviours. Assessments will be conducted at 0, 3, 6, and 9 weeks. Physical activity, sedentary behaviour and sleep-wake behaviours will be measured using the wrist worn Geneactiv accelerometer. Linear mixed models will be used to examine differences between groups and over time using an alpha of 0.01.

Discussion

This study will evaluate an app-based multi-behavioural intervention to improve physical activity, sedentary behaviour and sleep; and the relative efficacy of two different approaches to self-monitoring these behaviours. Outcomes will provide information to inform future interventions and self-monitoring targeting these behaviours.

Trial registration

ACTRN12615000182​594 (Australian New Zealand Clinical Trials Registry. Registry URL: www.​anzctr.​org.​au; registered prospectively on 25 February 2015).
Literature
1.
Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quantity and Quality of Sleep and Incidence of Type 2 Diabetes A systematic review and meta-analysis. Diabetes Care. 2010;33(2):414–20.CrossRefPubMed
2.
Chau JY, Grunseit AC, Chey T, Stamatakis E, Brown WJ, Matthews CE, Bauman AE, van der Ploeg HP. Daily sitting time and all-cause mortality: a meta-analysis. PLoS One. 2013;8(11):e80000.CrossRefPubMedPubMedCentral
3.
Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219–29.CrossRefPubMedPubMedCentral
4.
Shankar A, Syamala S, Kalidindi S. Insufficient Rest or Sleep and Its Relation to Cardiovascular Disease, Diabetes and Obesity in a National. Multiethnic Sample PLoS One. 2010;5(11):e14189.CrossRefPubMed
5.
Alvaro PK, Roberts RM, Harris JK. A Systematic Review Assessing Bidirectionality between Sleep Disturbances, Anxiety, and Depression. Sleep. 2013;36(7):1059–68.CrossRefPubMedPubMedCentral
6.
7.
8.
Bonke J. Trends in short and long sleep in Denmark from 1964 to 2009, and the associations with employment, SES (socioeconomic status) and BMI. Sleep Med. 2015;16(3):385–90.CrossRefPubMed
9.
Jean-Louis G, Williams N, Sarpong D, Pandey A, Youngstedt S, Zizi F, Ogedegbe G. Associations between inadequate sleep and obesity in the US adult population: analysis of the national health interview survey (1977–2009). BMC Public Health. 2014;14(1):290.CrossRefPubMedPubMedCentral
10.
Bauman A, Ainsworth BE, Sallis JF, Hagströmer M, Craig CL, Bull FC, Pratt M, Venugopal K, Chau J, Sjöström M. The Descriptive Epidemiology of Sitting: A 20-Country Comparison Using the International Physical Activity Questionnaire (IPAQ). Am J Prev Med. 2011;41(2):228–35.CrossRefPubMed
11.
12.
Duncan M, Kline CE, Rebar A, Vandelanotte C, Short C. Associations between variability in time to sleep and waking times and lifestyle behaviours. J Public Health. 2016;24:31–40.CrossRefPubMed
13.
Rezende LFM, Sá TH, Mielke GI, Viscondi JYK, Rey-López JP, Garcia LMT. All-Cause Mortality Attributableto Sitting Time. Am J Prev Med.
14.
Filion AJ, Darlington G, Chaput JP, Ybarra M, Haines J. Examining the influence of a text message-based sleep and physical activity intervention among young adult smokers in the United States. BMC Public Health. 2015;15:671.CrossRefPubMedPubMedCentral
15.
Ashton LM, Hutchesson MJ, Rollo ME, Morgan PJ, Collins CE. A scoping review of risk behaviour interventions in young men. BMC Public Health. 2014;14(1):1–23.CrossRef
16.
King K, Meader N, Wright K, Graham H, Power C, Petticrew M, White M, Sowden AJ. Characteristics of Interventions Targeting Multiple Lifestyle Risk Behaviours in Adult Populations: A Systematic Scoping Review. PLoS One. 2015;10(1):e0117015.CrossRefPubMedPubMedCentral
17.
Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. J Behav Med. 2015;38(3):427–49.CrossRefPubMed
18.
Kline CE. The bidirectional relationship between exercise and sleep: Implications for exercise adherence and sleep improvement. Am J Lifestyle Med. 2014;8(6):375–379.CrossRefPubMedPubMedCentral
19.
Madden KM, Ashe MC, Lockhart C, Chase JM. Sedentary behavior and sleep efficiency in active community-dwelling older adults. Sleep Sci. 2014;7(2):82–8.CrossRefPubMedPubMedCentral
20.
Lambiase MJ, Gabriel KP, Kuller LH, Matthews KA. Temporal relationships between physical activity and sleep in older women. Med Sci Sports Exerc. 2013;45(12):2362–8.CrossRefPubMed
21.
Johnson SS, Paiva AL, Mauriello L, Prochaska JO, Redding C, Velicer WF. Coaction in multiple behavior change interventions: consistency across multiple studies on weight management and obesity prevention. Health Psychology Off J Div Health Psychol Am Psychol Assoc. 2014;33(5):475–80.
22.
Mc Sharry J, Olander EK, French DP. Do single and multiple behavior change interventions contain different behavior change techniques? A comparison of interventions targeting physical activity in obese populations. Health psychology : official journal of the Division of Health Psychology, American Psychological Association. 2015;34(9):960–965.
23.
Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009;28:690–701.CrossRefPubMed
24.
Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: the CALO-RE taxonomy. Psychol Health. 2011;26(11):1479–98.CrossRefPubMed
25.
Alley S, Schoeppe S, Guertler D, Jennings CA, Duncan MJ, Vandelannote C. Interest and preferences for using advanced physical activity tracking devices: results of a national cross sectional survey. BMJ Open. 2016;6(7):e011243.
26.
Davies C, Spence J, Vandelanotte C, Caperchione C, Mummery W. Meta-analysis of internet-delivered interventions to increase physical activity levels. Int J Beh Nut Phys Act. 2012;9(1):52.CrossRef
27.
Bandura A. Theories of Cognitive Self-RegulationSocial cognitive theory of self-regulation. Organ Behav Hum Decis Process. 1991;50(2):248–87.CrossRef
28.
Duncan M, Vandelanotte C, Kolt GS, Rosenkranz RR, Caperchione CM, George ES, Ding H, Hooker C, Karunanithi M, Maeder AJ et al. Effectiveness of a web- and mobile phone-based intervention to promote physical activity and healthy eating in middle-aged males: randomized controlled trial of the ManUp study. JMIR. 2014;16(6):e136.PubMedPubMedCentral
29.
Morgan PJ, Lubans DR, Collins CE, Warren JM, Callister R. 12-month outcomes and process evaluation of the SHED-IT RCT: An internet-based weight loss program targeting men. Obesity. 2011;19(1):142–51.CrossRefPubMed
30.
Kirwan M, Duncan MJ, Vandelanotte C, Kerry Mummery W. Using smartphone technology to monitor physical activity in the 10,000 steps program: A matched case–control trial. J Med Internet Res. 2012;14(2):176–85.CrossRef
31.
Espie CA, Kyle SD, Williams C, Ong JC, Douglas NJ, Hames P, Brown JS. A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep. 2012;35(6):769–81.CrossRefPubMedPubMedCentral
32.
Christensen H, Batterham PJ, Gosling JA, Ritterband LM, Griffiths KM, Thorndike FP, Glozier N, O’Dea B, Hickie IB, Mackinnon AJ. Effectiveness of an online insomnia program (SHUTi) for prevention of depressive episodes (the GoodNight Study): a randomised controlled trial. Lancet Psychiatry. 2016;3(4):333–341.CrossRefPubMed
33.
Compernolle S, Vandelanotte C, Cardon G, De Bourdeaudhuij I, De Cocker K. Effectiveness of a Web-Based, Computer-Tailored, Pedometer-Based Physical Activity Intervention for Adults: A Cluster Randomized Controlled Trial. J Med Internet Res. 2015;17(2):e38.CrossRefPubMedPubMedCentral
34.
Ferguson T, Rowlands A, Olds T, Maher C. The validity of consumer-level, activity monitors in healthy adults worn in free-living conditions: a cross-sectional study. Int J Behav Nutr Phys Act. 2015;12(1):42.CrossRefPubMedPubMedCentral
35.
Bort Roig J, Gilson ND, Puig-Ribera A, Contreras RS, Trost SG. Measuring and influencing physical activity with smartphone technology: a systematic review. Sports Medicine (Auckland, NZ). 2014;44(5):671–86.CrossRef
36.
Vandelanotte C, Müller AM, Short CE, Hingle M, Nathan N, Williams SL, Lopez ML, Parekh S, Maher CA. Past, Present, and Future of eHealth and mHealth Research to Improve Physical Activity and Dietary Behaviors. J Nutr Educ Behav. 2016;48(3):219–28:e211.CrossRefPubMed
37.
Cheng SK, Dizon J. Computerised cognitive behavioural therapy for insomnia: a systematic review and meta-analysis. Psychother Psychosom. 2012;81(4):206–16.CrossRefPubMed
38.
39.
Donkin L, Hickie IB, Christensen H, Naismith SL, Neal B, Cockayne NL, Glozier N. Rethinking the Dose–response Relationship Between Usage and Outcome in an Online Intervention for Depression: Randomized Controlled Trial. J Med Internet Res. 2013;15(10):e231.CrossRefPubMedPubMedCentral
40.
Department of Health. Australia’s Physical Activity and Sedentary Behaviour Guidelines for Adults (18–64 years). Canberra: Australian Government; 2014.
41.
van der Ploeg HP, Chey T, Korda RJ, Banks E, Bauman A. Sitting time and all-cause mortality risk in 222 497 Australian adults. Arch Intern Med. 2012;172(6):494–500.CrossRefPubMed
42.
George ES, Rosenkranz RR, Kolt GS. Chronic disease and sitting time in middle-aged Australian males: findings from the 45 and Up Study. Int J Behav Nutr Phys Act. 2013;10(1):1–8.CrossRef
43.
Kirwan M, Duncan MJ, Vandelanotte C, Mummery WK. Design, Development, and Formative Evaluation of a Smartphone Application for Recording and Monitoring Physical Activity Levels: The 10,000 Steps “iStepLog”. Health Educ Behav. 2013;40(2):140–151.CrossRefPubMed
44.
Davies CA, Spence JC, Vandelanotte C, Caperchione CM, Mummery WK. Meta-analysis of internet-delivered interventions to increase physical activity levels. IJBNPA. 2012;9:52.PubMedPubMedCentral
45.
Webb T, Joseph J, Yardley L, Michie S. Using the internet to promote health behavior change: a systematic review and metaanalysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. J Med Internet Res. 2010;12(1):e4.CrossRefPubMedPubMedCentral
46.
Bandura A. Social Cognitive Theory of self-regulation. Organi Behav Hum Decis. 1991;50.
47.
Maes S, Karoly P. Self-Regulation Assessment and Intervention in Physical Health and Illness: A Review. Applied Psychology. 2005;54(2):267–299.
48.
Commonwealth of Australia. Australia’s Physical Activity and Sedentary Behaviour Guidelines for Adults (18–64 years). Canberra: Commonwealth of Australia; 2014.
49.
Duncan MJ, Gilson N, Vandelanotte C. Which population groups are most unaware of CVD risks associated with sitting time? Prev Med. 2014;65:103–8.CrossRefPubMed
50.
Vandelanotte C, Duncan MJ, Hanley C, Mummery WK. Identifying population subgroups at risk for underestimating weight health risks and overestimating physical activity health benefits. J Health Psychol. 2011;16(5):760–9.CrossRefPubMed
51.
Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev. 2015;22:23–36.CrossRefPubMed
52.
Buman MP, Hekler EB, Bliwise DL, King AC. Exercise Effects on Night-to-Night Fluctuations in Self-rated Sleep among Older Adults with Sleep Complaints. J Sleep Res. 2011;20(1 Pt 1):28–37.CrossRefPubMedPubMedCentral
53.
Sleep Health Foundation. Good Sleep Habits. Blacktown, NSW: Sleep Health Foundation; 2011.
54.
55.
Marteau TM, Hollands GJ, Fletcher PC. Changing human behavior to prevent disease: the importance of targeting automatic processes. Science. 2012;337(6101):1492–5.CrossRefPubMed
56.
Tudor-Locke C, Sisson SB, Collova T, Lee SM, Swan PD. Pedometer-determined step count guidelines for classifying walking intensity in a young ostensibly healthy population. Can J Appl Physiol. 2005;30(6):666–76.CrossRefPubMed
57.
Marshall SJ, Levy SS, Tudor-Locke CE, Kolkhorst FW, Wooten KM, Ji M, Macera CA, Ainsworth BE. Translating physical activity recommendations into a pedometer-based step goal: 3000 steps in 30 minutes. Am J Prev Med. 2009;36(5):410–5.CrossRefPubMed
58.
Wong SL, Colley R, Connor Gorber S, Tremblay M. Actical accelerometer sedentary activity thresholds for adults. J Phys Act Health. 2011;8(4):587–91.CrossRefPubMed
59.
60.
61.
van Hees VT, Sabia S, Anderson KN, Denton SJ, Oliver J, Catt M, Abell JG, Kivimaki M, Trenell MI, Singh-Manoux A. A Novel, Open Access Method to Assess Sleep Duration Using a Wrist-Worn Accelerometer. PLoS One. 2015;10(11):e0142533.CrossRefPubMedPubMedCentral
62.
Hildebrand M, VT VANH, Hansen BH, Ekelund U. Age group comparability of raw accelerometer output from wrist- and hip-worn monitors. Med Sci Sports Exerc. 2014;46(9):1816–24.CrossRefPubMed
63.
Sabia S, van Hees VT, Shipley MJ, Trenell MI, Hagger-Johnson G, Elbaz A, Kivimaki M, Singh-Manoux A. Association between questionnaire- and accelerometer-assessed physical activity: the role of sociodemographic factors. Am J Epidemiol. 2014;179(6):781–90.CrossRefPubMedPubMedCentral
64.
65.
Buysse DJ, Cheng Y, Germain A, Moul DE, Franzen PL, Fletcher M, Monk TH. Night-to-night sleep variability in older adults with and without chronic insomnia. Sleep Med. 2010;11(1):56–64.CrossRefPubMed
66.
Brown WJ, Bauman A, Chey T, Trost S, Mummery K. Comparison of surveys used to measure physical activity. Aust N Z J Public Health. 2004;28(2):128–34.CrossRefPubMed
67.
Brown WJ, Bauman A, Trost S, Mummery WK, Owen N. Test-retest reliability of four physical activity measures used in population surveys. J Sci Med Sport. 2004;7(2):205–15.CrossRefPubMed
68.
Reeves MM, Marshall AL, Owen N, Winkler EAH, Eakin EG. Measuring physical activity change in broad-reach intervention trials. J Phys Act Health. 2010;7(2):194–202.CrossRefPubMed
69.
Chau JY, van der Ploeg HP, Dunn S, Kurko J, Bauman AE. A tool for measuring workers’ sitting time by domain: the Workforce Sitting Questionnaire. Br J Sports Med. 2011;45(15):1216–22.CrossRefPubMed
70.
Buysse DJ, Reynolds 3rd CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.CrossRefPubMed
71.
(CDC). CfDCaP. Behavioral Risk Factor Surveillance System Survey Questionnaire. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009.
72.
Monk TH, Buysse DJ, Kennedy KS, Pods JM, DeGrazia JM, Miewald JM. Measuring sleep habits without using a diary: the sleep timing questionnaire. Sleep. 2003;26(2):208–12.PubMed
73.
Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–43.CrossRefPubMed
74.
Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 1998;10(2):176.CrossRef
75.
Rebar AL, Stanton R, Geard D, Short C, Duncan MJ, Vandelanotte C. A meta-meta-analysis of the effect of physical activity on depression and anxiety in non-clinical adult populations. Health Psychol Rev. 2015;9(3):366–378.CrossRefPubMed
76.
Rebar AL, Vandelanotte C, Van Uffelen J, Short C, Duncan MJ. Associations of overall sitting time and sitting time in different contexts with depression, anxiety, and stress symptoms. Ment Health Phys Act. 2014;7(2):105–10.CrossRef
77.
Porkka Heiskanen T, Zitting KM, Wigren HK. Sleep, its regulation and possible mechanisms of sleep disturbances. Acta Physiol (Oxford, England). 2013;208(4):311–28.CrossRef
78.
Centres for Disease Control and Prevention. Measuring Healthy Days. Atlanta, Georgia: Centres for Disease Control and Prevention; 2000.
79.
Andresen EM, Catlin TK, Wyrwich KW, Jackson-Thompson J. Retest reliability of surveillance questions on health related quality of life. J Epidemiol Community Health. 2003;57(5):339–43.CrossRefPubMedPubMedCentral
80.
Moriarty DG, Zack MM, Kobau R. The Centers for Disease Control and Prevention’s Healthy Days Measures - population tracking of perceived physical and mental health over time. Health Qual Life Outcomes. 2003;1:37.CrossRefPubMedPubMedCentral
81.
Gardner B, Abraham C, Lally P, de Bruijn G-J. Towards parsimony in habit measurement: Testing the convergent and predictive validity of an automaticity subscale of the Self-Report Habit Index. Int J Behav Nutr Phys Act. 2012;9(1):102.CrossRefPubMedPubMedCentral
82.
Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006;29(3):223–7.CrossRefPubMed
83.
Dewar DL, Lubans DR, Morgan PJ, Plotnikoff RC. Development and evaluation of social cognitive measures related to adolescent physical activity. J Phys Act Health. 2013;10(4):544–55.CrossRefPubMed
84.
Brooke J. US: A “quick and dirty” usability scale. London: Taylor and Francis; 1996.
85.
Kessler RC, Ames M, Hymel PA, Loeppke R, McKenas DK, Richling DE, Stang PE, Ustun TB. Using the World Health Organization Health and Work Performance Questionnaire (HPQ) to evaluate the indirect workplace costs of illness. J Occupational Environ Med/Am College Occupational Environ Med. 2004;46(6 Suppl):S23–37.CrossRef
86.
Kessler RC, Barber C, Beck A, Berglund P, Cleary PD, McKenas D, Pronk N, Simon G, Stang P, Ustun TB et al. The World Health Organization Health and Work Performance Questionnaire (HPQ). J Occupational Environ Med/Am College Occupational Environ Med. 2003;45(2):156–74.CrossRef
87.
Aguiar EJ, Morgan PJ, Collins CE, Plotnikoff RC, Young MD, Callister R. The PULSE (Prevention Using LifeStyle Education) trial protocol: a randomised controlled trial of a Type 2 Diabetes Prevention programme for men. Contemporary Clin Trials. 2014;39(1):132–44.CrossRef
88.
89.
Pepin V, Boucetta S, Chan-Thim E, Parwanta Z, Gouin J-P, Dang-Vu TT. The Role of Sleep and Physical Activity on the Risk for Cardiovascular Disease. Curr Cardiovasc Risk Reports. 2014;8(12):1–10.CrossRef
90.
Chennaoui M, Arnal PJ, Sauvet F, Leger D. Sleep and exercise: a reciprocal issue? Sleep Med Rev. 2015;20:59–72.CrossRefPubMed
91.
O’Reilly S, McCann L. Development and validation of the Diet Quality Tool for use in cardiovascular disease prevention settings. Aust J Primary Health. 2012;18:138–47.CrossRef
92.
Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMed
93.
Cadmus-Bertram LA, Marcus BH, Patterson RE, Parker BA, Morey BL. Randomized Trial of a Fitbit-Based Physical Activity Intervention for Women. Am J Prev Med. 2015;49(3):414–8.CrossRefPubMedPubMedCentral
94.
Hillman DR, Lack LC. Public health implications of sleep loss: the community burden. Med J Aust. 2013;199(8):7–10.CrossRef
Metadata
Title
Balanced: a randomised trial examining the efficacy of two self-monitoring methods for an app-based multi-behaviour intervention to improve physical activity, sitting and sleep in adults
Authors
Mitch J. Duncan
Corneel Vandelanotte
Stewart G. Trost
Amanda L. Rebar
Naomi Rogers
Nicola W. Burton
Beatrice Murawski
Anna Rayward
Sasha Fenton
Wendy J. Brown
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3256-x

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