Skip to main content
Top
Published in: BMC Public Health 1/2019

Open Access 01-12-2019 | Study protocol

App-technology to improve lifestyle behaviors among working adults - the Health Integrator study, a randomized controlled trial

Authors: Stephanie E. Bonn, Marie Löf, Claes-Göran Östenson, Ylva Trolle Lagerros

Published in: BMC Public Health | Issue 1/2019

Login to get access

Abstract

Background

Mobile health, mHealth is recognized as a strategy to improve lifestyle behaviors. Research targeting specific lifestyle behaviors has shown that interventions using smartphones can be effective. However, few studies have evaluated solutions with multicomponent interventions, tailoring the intervention to the specific needs of the participant using a combination of mHealth and conventional treatment. To accomplish this, we developed Health Integrator, an mHealth platform with services and offers in the areas of diet, physical activity, sleeping habits, stress, alcohol and tobacco use. In the system, the user selects an area of intervention together with a health coach and set weekly goals. This study protocol presents the design and methodology of the Health Integrator Study, a randomized controlled trial to promote improved lifestyle behaviors.

Methods

A three-arm parallel randomized controlled trial (1:1:1) is conducted in the Stockholm County, Sweden. In total, 209 employees at a four different companies representing both white and blue collar workers, have been recruited.
Participants are randomized to either a control group or to one of two intervention groups receiving a 3-month lifestyle behavior change program including either 1) use of Health Integrator and monthly health coaching sessions or 2) only Health Integrator.
At baseline and follow-up after 3- and 6-months, all participants answer questionnaires assessing lifestyle behaviors and quality of life. At baseline and the 3-month follow-up (end of intervention period), weight, height, waist circumference and blood pressure are measured, and all participants wear an Actigraph accelerometer for 7 days to assess physical activity. Blood lipid profile and HbA1c are measured among all participants at baseline. If baseline measures fall outside the normal range, a second measurement is done after 3 months.

Discussion

The Health Integrator Intervention Study will evaluate if a personalized intervention combining mHealth and conventional programs for lifestyle change, with or without additional health coach sessions, can improve lifestyle behaviors and quality of life. Based on the results from this trial, Health Integrator can easily be implemented within a broad public.

Trial registration

ClinicalTrials.​gov Identifier: NCT03579342. Retrospectively registered, first submitted May 8, 2018.
Literature
1.
go back to reference Schroeder SA, Shattuck Lecture. We can do better--improving the health of the American people. N Engl J Med. 2007;357(12):1221–8.CrossRef Schroeder SA, Shattuck Lecture. We can do better--improving the health of the American people. N Engl J Med. 2007;357(12):1221–8.CrossRef
2.
go back to reference WHO. mHealth: New horizons for health through mobile technologies: second global survey on eHealth.; 2011. WHO. mHealth: New horizons for health through mobile technologies: second global survey on eHealth.; 2011.
3.
go back to reference Silva BM, Rodrigues JJ, de la Torre Diez I, Lopez-Coronado M, Saleem K. Mobile-health: a review of current state in 2015. J Biomed Inform. 2015;56:265–72.CrossRef Silva BM, Rodrigues JJ, de la Torre Diez I, Lopez-Coronado M, Saleem K. Mobile-health: a review of current state in 2015. J Biomed Inform. 2015;56:265–72.CrossRef
5.
go back to reference Burton J. WHO Healthy workplace framework: background and supporting literature and practices.: WHO headquarters, Geneva, Switzerland 2010. Burton J. WHO Healthy workplace framework: background and supporting literature and practices.: WHO headquarters, Geneva, Switzerland 2010.
6.
go back to reference Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRef Chan AW, Tetzlaff JM, Altman DG, Laupacis A, Gotzsche PC, Krleza-Jeric K, et al. SPIRIT 2013 statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–7.CrossRef
7.
go back to reference Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRef Chan AW, Tetzlaff JM, Gotzsche PC, Altman DG, Mann H, Berlin JA, et al. SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials. BMJ. 2013;346:e7586.CrossRef
8.
go back to reference Eysenbach G. CONSORT-EHEALTH: implementation of a checklist for authors and editors to improve reporting of web-based and mobile randomized controlled trials. Stud Health Technol Inform. 2013;192:657–61.PubMed Eysenbach G. CONSORT-EHEALTH: implementation of a checklist for authors and editors to improve reporting of web-based and mobile randomized controlled trials. Stud Health Technol Inform. 2013;192:657–61.PubMed
9.
go back to reference Jeppsson JO, Kobold U, Barr J, Finke A, Hoelzel W, Hoshino T, et al. Approved IFCC reference method for the measurement of HbA1c in human blood. Clin Chem Lab Med. 2002;40(1):78–89.CrossRef Jeppsson JO, Kobold U, Barr J, Finke A, Hoelzel W, Hoshino T, et al. Approved IFCC reference method for the measurement of HbA1c in human blood. Clin Chem Lab Med. 2002;40(1):78–89.CrossRef
10.
go back to reference Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470–5.PubMed Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974;20(4):470–5.PubMed
11.
go back to reference Lintsi M, Kaarma H, Kull I. Comparison of hand-to-hand bioimpedance and anthropometry equations versus dual-energy X-ray absorptiometry for the assessment of body fat percentage in 17-18-year-old conscripts. Clin Physiol Funct Imaging. 2004;24(2):85–90.CrossRef Lintsi M, Kaarma H, Kull I. Comparison of hand-to-hand bioimpedance and anthropometry equations versus dual-energy X-ray absorptiometry for the assessment of body fat percentage in 17-18-year-old conscripts. Clin Physiol Funct Imaging. 2004;24(2):85–90.CrossRef
12.
go back to reference Lee JA, Williams SM, Brown DD, Laurson KR. Concurrent validation of the Actigraph gt3x+, polar active accelerometer, Omron HJ-720 and Yamax Digiwalker SW-701 pedometer step counts in lab-based and free-living settings. J Sports Sci. 2015;33(10):991–1000.CrossRef Lee JA, Williams SM, Brown DD, Laurson KR. Concurrent validation of the Actigraph gt3x+, polar active accelerometer, Omron HJ-720 and Yamax Digiwalker SW-701 pedometer step counts in lab-based and free-living settings. J Sports Sci. 2015;33(10):991–1000.CrossRef
13.
go back to reference Meyer U, Ernst D, Schott S, Riera C, Hattendorf J, Romkes J, et al. Validation of two accelerometers to determine mechanical loading of physical activities in children. J Sports Sci. 2015;33(16):1702–9. Meyer U, Ernst D, Schott S, Riera C, Hattendorf J, Romkes J, et al. Validation of two accelerometers to determine mechanical loading of physical activities in children. J Sports Sci. 2015;33(16):1702–9.
14.
go back to reference Martin E, Ruf E, Landgraf R, Hauner H, Weinauer F, Martin S. FINDRISK questionnaire combined with HbA1c testing as a potential screening strategy for undiagnosed diabetes in a healthy population. Horm Metab Res. 2011;43(11):782–7.CrossRef Martin E, Ruf E, Landgraf R, Hauner H, Weinauer F, Martin S. FINDRISK questionnaire combined with HbA1c testing as a potential screening strategy for undiagnosed diabetes in a healthy population. Horm Metab Res. 2011;43(11):782–7.CrossRef
15.
go back to reference Westerlund A, Lagerros YT, Kecklund G, Axelsson J, Akerstedt T. Relationships between questionnaire ratings of sleep quality and polysomnography in healthy adults. Behav Sleep Med. 2016;14(2):185–99.CrossRef Westerlund A, Lagerros YT, Kecklund G, Axelsson J, Akerstedt T. Relationships between questionnaire ratings of sleep quality and polysomnography in healthy adults. Behav Sleep Med. 2016;14(2):185–99.CrossRef
16.
go back to reference Messerer M, Johansson SE, Wolk A. The validity of questionnaire-based micronutrient intake estimates is increased by including dietary supplement use in Swedish men. J Nutr. 2004;134(7):1800–5.CrossRef Messerer M, Johansson SE, Wolk A. The validity of questionnaire-based micronutrient intake estimates is increased by including dietary supplement use in Swedish men. J Nutr. 2004;134(7):1800–5.CrossRef
17.
go back to reference Sepp H, Becker W. Enkätfrågor om kost och fysisk aktivitet bland vuxna – Underlag till urval av frågor i befolkningsinriktade enkäter. [Swedish] The National Food Agency, Sweden. 2004. Sepp H, Becker W. Enkätfrågor om kost och fysisk aktivitet bland vuxna – Underlag till urval av frågor i befolkningsinriktade enkäter. [Swedish] The National Food Agency, Sweden. 2004.
18.
go back to reference Karlsson J, Persson LO, Sjostrom L, Sullivan M. Psychometric properties and factor structure of the three-factor eating questionnaire (TFEQ) in obese men and women. Results from the Swedish obese subjects (SOS) study. Int J Obes Relat Metab Disord. 2000;24(12):1715–25.CrossRef Karlsson J, Persson LO, Sjostrom L, Sullivan M. Psychometric properties and factor structure of the three-factor eating questionnaire (TFEQ) in obese men and women. Results from the Swedish obese subjects (SOS) study. Int J Obes Relat Metab Disord. 2000;24(12):1715–25.CrossRef
19.
go back to reference Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33(5):350–7.CrossRef Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33(5):350–7.CrossRef
20.
go back to reference Scheier MF, Wrosch C, Baum A, Cohen S, Martire LM, Matthews KA, et al. The life engagement test: assessing purpose in life. J Behav Med. 2006;29(3):291–8.CrossRef Scheier MF, Wrosch C, Baum A, Cohen S, Martire LM, Matthews KA, et al. The life engagement test: assessing purpose in life. J Behav Med. 2006;29(3):291–8.CrossRef
21.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983;24(4):385–96.CrossRef
22.
go back to reference Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48.CrossRef Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot. 1997;12(1):38–48.CrossRef
23.
go back to reference Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376(7):641–51.CrossRef Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Aminian A, Brethauer SA, et al. Bariatric surgery versus intensive medical therapy for diabetes - 5-year outcomes. N Engl J Med. 2017;376(7):641–51.CrossRef
24.
go back to reference WHO. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. 2013. WHO. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. 2013.
25.
go back to reference Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.CrossRef Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.CrossRef
26.
go back to reference Zarski AC, Lehr D, Berking M, Riper H, Cuijpers P, Ebert DD. Adherence to internet-based Mobile-supported stress management: a pooled analysis of individual participant data from three randomized controlled trials. J Med Internet Res. 2016;18(6):e146.CrossRef Zarski AC, Lehr D, Berking M, Riper H, Cuijpers P, Ebert DD. Adherence to internet-based Mobile-supported stress management: a pooled analysis of individual participant data from three randomized controlled trials. J Med Internet Res. 2016;18(6):e146.CrossRef
27.
go back to reference Appel LJ, Clark JM, Yeh HC, Wang NY, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365(21):1959–68.CrossRef Appel LJ, Clark JM, Yeh HC, Wang NY, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365(21):1959–68.CrossRef
28.
go back to reference Robertson L, Smith M, Castle D, Tannenbaum D. Using the internet to enhance the treatment of depression. Australas Psychiatry. 2006;14(4):413–7.CrossRef Robertson L, Smith M, Castle D, Tannenbaum D. Using the internet to enhance the treatment of depression. Australas Psychiatry. 2006;14(4):413–7.CrossRef
29.
go back to reference Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRef Michie S, Richardson M, Johnston M, Abraham C, Francis J, Hardeman W, et al. The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions. Ann Behav Med. 2013;46(1):81–95.CrossRef
Metadata
Title
App-technology to improve lifestyle behaviors among working adults - the Health Integrator study, a randomized controlled trial
Authors
Stephanie E. Bonn
Marie Löf
Claes-Göran Östenson
Ylva Trolle Lagerros
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2019
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-019-6595-6

Other articles of this Issue 1/2019

BMC Public Health 1/2019 Go to the issue