Use of a Smartphone App to Increase Physical Activity Levels in Insufficiently Active Adults: Feasibility Sequential Multiple Assignment Randomized Trial (SMART)

Autor(es):Mostrar menos -

Gonze, Barbara De Barros ^[1] ; Padovani, Ricardo Da Costa ^[2] ; Simoes, Maria Do Socorro ^[1] ; Lauria, Vinicius ^[1] ; Proenca, Neli Leite ^[1] ; Sperandio, Evandro Fornias ^[1] ; Valentim Di Paschoale Ostolin, Thatiane Lopes ^[1] ; De Oliveira Gomes, Grace Angelica ^[3] ; Castro, Paula Costa ^[3] ; Romiti, Marcello ^[4] ; Gagliardi, Antonio ^[4] ; Arantes, Rodolfo Leite ^[4] ; Dourado, Victor Zuniga ^{[1, 5]}

Afiliação do(s) autor(es)

^[1] Univ Fed Sao Paulo, Dept Human Movement Sci, Lab Epidemiol & Human Movement EPIMOV, Rua Silva Jardim 136, BR-11015020 Santos, SP - Brazil

^[2] Univ Fed Sao Paulo, Dept Hlth Educ & Soc, Santos, SP - Brazil

^[3] Univ Fed Sao Carlos, Dept Gerontol, Sao Carlos - Brazil

^[4] Angiocorpore Inst Cardiovasc Med, Santos, SP - Brazil

^[5] Harvard TH Chan Sch Publ Hlth, Cardiovasc Hlth Program, Boston, MA - USA

• Tipo de documento: Artigo Científico
• Fonte: JOURNAL OF MEDICAL INTERNET RESEARCH; v. 22, n. 10 OCT 23 2020.
• Citações Web of Science: 0

Resumo

Background: The sequential multiple assignment randomized trial (SMART) design allows for changes in the intervention during the trial period. Despite its potential and feasibility for defining the best sequence of interventions, so far, it has not been utilized in a smartphone/gamified intervention for physical activity. Objective: We aimed to investigate the feasibility of the SMART design for assessing the effects of a smartphone app intervention to improve physical activity in adults. We also aimed to describe the participants perception regarding the protocol and the use of the app for physical activity qualitatively. Methods: We conducted a feasibility 24-week/two-stage SMART in which 18 insufficiently active participants (<10,000 steps/day) were first randomized to group 1 (smartphone app only), group 2 (smartphone app + tailored messages), and a control group (usual routine during the protocol). Participants were motivated to increase their step count by at least 2000 steps/day each week. Based on the 12-week intermediate outcome, responders continued the intervention and nonresponders were rerandomized to subsequent treatment, including a new group 3 (smartphone app + tailored messages + gamification) in which they were instructed to form groups to use several game elements available in the chosen app (Pacer). We considered responders as those with any positive slope in the linear relationship between weeks and steps per day at the end of the first stage of the intervention. We compared the accelerometer-based steps per day before and after the intervention, as well as the slopes of the app-based steps per day between the first and second stages of the intervention. Results: Twelve participants, including five controls, finished the intervention. We identified two responders in group 1. We did not observe relevant changes in the steps per day either throughout the intervention or compared with the control group. However, the rerandomization of five nonresponders led to a change in the slope of the steps per day (median -198 steps/day {[}IQR -279 to -103] to 20 steps/day {[}IQR -204 to 145]; P=.08). Finally, in three participants from group 2, we observed an increase in the number of steps per day up to the sixth week, followed by an inflection to baseline values or even lower (ie, a quadratic relationship). The qualitative analysis showed that participants reports could be classified into the following: (1) difficulty in managing the app and technology or problems with the device, (2) suitable response to the app, and (3) difficulties to achieve the goals. Conclusions: The SMART design was feasible and changed the behavior of steps per day after rerandomization. Rerandomization should be implemented earlier to take advantage of tailored messages. Additionally, difficulties with technology and realistic and individualized goals should be considered in interventions for physical activity using smartphones. (AU)

• Processo FAPESP: 16/50249-3 - Vida urbana ativa impulsionada por jogos digitais lúdicos
• Beneficiário: Victor Zuniga Dourado
• Modalidade de apoio: Auxílio à Pesquisa - Regular
• Processo FAPESP: 18/11817-1 - Utilização de um aplicativo para smartphone combinado com beacons e gamificação para aumentar o nível de atividade física de adultos e idosos: ensaio clínico randomizado com alocações sequenciais múltiplas
• Beneficiário: Maria Do Socorro Morais Pereira Simões
• Modalidade de apoio: Bolsas no Brasil - Programa Capacitação - Treinamento Técnico