Elsevier

Preventive Medicine

Volume 47, Issue 5, November 2008, Pages 508-513
Preventive Medicine

User attitudes towards physical activity websites in a randomized controlled trial

https://doi.org/10.1016/j.ypmed.2008.07.020Get rights and content

Abstract

Objective

To better understand the mixed findings regarding the efficacy of Internet-based physical activity interventions, we examined the use and usefulness of particular website components that may lead to improvements in intervention efficacy.

Method

Participants were sedentary individuals from a 12-month randomized controlled physical activity trial conducted in Providence, Rhode Island and Pittsburgh, Pennsylvania from 2003–2006. The present study included participants from the Tailored Internet arm (n = 81; instantaneous web-based tailored feedback to participants) or the Standard Internet arm (n = 82; websites currently available to the public). We obtained objective data via the intervention websites and subjective usefulness data via questionnaires.

Results

The Tailored Internet arm logged onto their website significantly more times than the Standard Internet arm (median 50 vs. 38; p < .05). Among participants in the Tailored Internet arm, the self-monitoring feature (i.e., logging) followed by goal setting were rated as the most useful website components.

Conclusion

Logins in the current study were substantially higher compared to previous studies. Participants endorsed goal setting and self-monitoring as being most useful, which are critical components for health behavior change. Future studies should continue to examine these features and improve the perceived usefulness of other theory-based strategies.

Introduction

Despite the many health benefits associated with physical activity, approximately 55% of Americans do not engage in physical activity at the recommended levels (Macera et al., 2005, United States. Public Health Service. Office of the Surgeon General, 1996). Given the cost and time associated with face-to-face and telephone interventions, it is not feasible to reach this large sedentary population using these channels. However, theory-based physical activity interventions delivered through the Internet may be a cost-effective channel for reaching this large population of sedentary adults. Research on the efficacy of Internet-based interventions for physical activity is mixed. Specifically, four studies have indicated positive results (Hurling et al., 2007, Napolitano et al., 2003, Rovniak et al., 2005, Spittaels et al., 2007b) while other studies have found no differences between groups (Hageman et al., 2005, Marcus et al., 2007a, Marshall et al., 2003, Spittaels et al., 2007a, Steele et al., 2007).

Sciamanna et al. (2002) examined user attitudes towards the intervention website used in the Napolitano et al. (2003) study listed above. In this study, 65 sedentary women were randomly assigned to a three-month motivational stage-targeted, Internet plus email physical activity intervention or to a wait-list control group. The Internet group reported significantly more minutes of physical activity per week than the control group at the one-month follow-up; however, differences were no longer significant at the three-month follow-up. In this study, 79.2% of participants viewed the website as “somewhat helpful” and 12.5% as “very helpful.” Additionally, 83.3% of the participants used the website more than once during the three-month intervention. In another study, Leslie et al. (2005) examined user attitudes in a study examining the efficacy of an eight-week stage-targeted intervention delivered via the Internet or print (mailed) among 655 adults (Marshall et al., 2003). Results indicated a non-significant trend toward increased physical activity in both groups with no significant differences between conditions. A follow-up study reported that only 46% of the participants visited the website at least once (Leslie et al., 2005). Furthermore, among the participants recalling the website, only 50% thought the website was moderately to extremely useful (Leslie et al., 2005). Additional research is needed to better understand user attitudes towards Internet-based physical activity interventions to help elucidate critical treatment components.

The purpose of this paper is to examine use patterns and user attitudes towards the Internet-based interventions in a recent study conducted by Marcus et al., 2007a, Marcus et al., 2007b. In this study, participants were randomly assigned to one of three 12-month interventions: (1) Motivationally-Tailored Internet (i.e., Tailored Internet); (2) Motivationally-Tailored Print (i.e., Tailored Print); or (3) six researcher-selected websites currently available to the public (i.e., Standard Internet) (Marcus et al., 2007a, Marcus et al., 2007b). Participants in all three groups increased their physical activity; however, there were no significant differences between groups (Marcus et al., 2007a). Specifically, the Tailored Internet arm increased from a median of 0 min of physical activity per week at baseline to a median of 120.0 (mean = 161.4, SD = 217.5) at 6 months and 90.0 (125.1, SD = 159.0) at 12 months. The Tailored Print arm increased from a median of 0 at baseline to 112.5 (mean = 123.1, SD = 107.8) at 6 months and 90.0 (mean = 123.2, SD 124.9) at 12 months. The Standard Internet arm increased from a median of 10.0 at baseline to 90.0 (mean = 122.3, SD = 126.9) at 6 months and 80.0 (mean = 114.1, SD = 132.5) at 12 months.

For this paper, the following four objectives were addressed: 1) To examine differences in use patterns and perceived website usefulness between the Tailored Internet and Standard Internet arms; (2) To examine if use patterns and perceived usefulness of the intervention websites predicted physical activity behavior change; 3) In the Tailored Internet arm, to determine which website components were used the most and which were rated as most useful; and 4) In the Standard Internet arm, to examine which of the six standard website were rated as most useful. Related to the first two objectives, we predicted that participants in the Tailored Internet arm would log onto the study website significantly more times than the Standard Internet arm and that higher rates of logging onto the study website would be significantly related to higher levels of physical activity.

Section snippets

Participants

Participants were healthy, sedentary (90 min or less of physical activity per week) adults, ages 18 and older (n = 249) who participated in a randomized controlled trial examining the efficacy of Internet and print-based physical activity interventions (see Fig. 1). The sample size was based on the assumption of a 30-minute difference at 12 months between the Tailored Print and Tailored Internet arms. The sample was mostly women (82.7%) and Caucasian (76.3%). Participants were recruited primarily

Objective 1: differences in use patterns and perceived website usefulness for the Tailored Internet and Standard Internet conditions

The median number of logins to the study website, regardless of group, was 44 times over the 12-month study. Participants in the Tailored Internet arm logged onto the study website significantly more times than the Standard Internet group, z = 2.21, p < .05 (median of 50 times for Tailored Internet and 38 times for Standard Internet). The number of logins by month is presented for both groups in Table 1 and Fig. 1. Individuals in the Tailored Internet arm reported their website to be more useful,

Discussion

As hypothesized, participants in the Tailored Internet arm logged on significantly more times throughout the year than participants in the Standard Internet arm. This difference could be attributed to the fact that the Tailored Internet intervention was specifically designed to promote return visits to the website. For example, new tips of the day were displayed on the homepage daily throughout the year. Additionally, the Tailored Internet website contained interactive and instantaneous

Conclusions

In summary, our study indicated that participants found the various components of our tailored website useful. Additionally, participants logged onto our study website more times than in previous studies, perhaps due to the interactivity and change of content over time. Although participants found our study website to be more useful than websites currently available to the public, given the efficacy of our Standard Internet arm, we recommend that practitioners suggest that their patients access

Conflict of interest statement

The authors have no conflicts of interest to declare.

Acknowledgments

This research was supported in part through a grant from the National Heart, Lung, and Blood Institute (#HL69866) awarded to B. Marcus. We would like to thank Drs. Abby King and Deborah Tate for their assistance in the design of this study. Additionally, we thank Santina Ficara, B.S., Maureen Hamel, B.S., Jaime Longval, M.S., Regina Traficante, Ph.D., Kenny McParlin, and Susan Pinheiro, B.A., for their contributions to the conduct of this study.

References (26)

  • HagemanP.A. et al.

    Tailored versus standard internet-delivered interventions to promote physical activity in older women

    J. Geriatr. Phys. Ther.

    (2005)
  • HurlingR. et al.

    Using internet and mobile phone technology to deliver an automated physical activity program: randomized controlled trial

    J. Med. Internet Res.

    (2007)
  • MaceraC.A. et al.

    Prevalence of physical activity in the United States: Behavioral Risk Factor Surveillance System, 2001

    Prev. Chronic Dis.

    (2005)
  • Cited by (27)

    • Design of a novel digital intervention to promote healthy weight management among postpartum African American women

      2019, Contemporary Clinical Trials Communications
      Citation Excerpt :

      Branding advances theories of behavior change by specifying a mechanism underlying social role modeling [50,51]. The brand equity construct has been measured through positive associations with what the brand represents [52,53]. We hypothesize that BeFAB social support and peer modeling of HEAL and weight loss will improve behavioral (improved nutrition and increased physical activity) and weight management outcomes.

    View all citing articles on Scopus
    View full text