Student Projects | 2014

On this page, you can find the abstracts of the students projects within the Active2Gether project that took place in the academic year of 2013-2014.

Promoting physical activity among healthy young adults (18-30 years): Associations between social factors and physical activity, preferences for behaviour change techniques targeting these factors and ethical issues hindering the implementation of these techniques in mobile apps.

Shereen Khodabaks, Master in Health Sciences

Background: There is a lack in literature evidence about practical translations of social factors by a mobile physical activity application in young adults. Furthermore, it remains unclear whether personality and exercise self-identity are moderators in the association between social factors and physical activity. In addition, no previous research assessed preferences of behaviour change techniques and practical translations of these techniques into mobile physical activity application features. Lastly, when using (mobile) technology to target behaviour change, several ethical issues need to be taken into account.

Aims: First, to investigate the relationship between social factors and physical activity and possible effect moderation by personality and exercise self-identity among healthy young adults (18-30years). Second, to assess preferences of these adults for behaviour change techniques that could be implemented in mobile physical activity applications. Third, to examine the association between ethical issues (autonomy and privacy) and the acceptance and intention to use a mobile physical activity application.

Methods: The design of this study is a cross-sectional online survey. The study sample consisted of 178 participants (18-30 years) who completed a Dutch questionnaire. This questionnaire was developed by using validated existing questionnaires. Data were analysed by conducting descriptive and regression analysis.

Results: The findings showed that the majority of participants were highly educated, native Dutch female students, of which most complied with the Dutch physical activity guidelines and used a physical activity smartphone application. Several significant associations were found between social support, social comparison and physical activity. In addition, significant effect moderation by personality traits such as extraversion, agreeableness, neuroticism and openness was found for these associations. However, no significant moderation was detected for these associations by exercise self-identity. Furthermore, results showed that preferences for behaviour change techniques ‘rewards’ and ‘incentives’ in mobile physical application features differed significantly between categories of social comparison (downwards, equal, upwards). Participants with low or high perceived playfulness for a mobile physical activity application differed significantly in preferences for the behaviour change techniques ‘rewards, ‘incentives’, ‘outcome of feedback’ and ‘self-monitoring of the behaviour’. Lastly, feelings of control of privacy and autonomy were significantly related to the acceptance and intention to use a mobile physical activity application. Participants who feel more in control of using and sharing private information via a mobile physical activity application are more intented to accept and use the application.

Conclusion: Overall, our findings provide more insight in the translation of social factors and behaviour change techniques into mobile physical activity application features. In order to tailor these application features to the needs and preferences of the user, several personality traits and ethical issues such as autonomy and privacy need to be taken into account.

Exercise self-efficacy and the promotion of physical activity among young adults: Preferences for behaviour change techniques in a smartphone app and young adults’ acceptance of physical activity apps.

Laura Belmon, Master in Health Sciences

Background: Physical inactivity is a major public health problem. Young adults are at risk to become inactive and stay inactive when going into adulthood. Interventions delivered through new technology devices, such as smartphones, seem an effective method to reach this population, as they comprise a large number of smartphone adopters. Previous research showed exercise self-efficacy to be an important predictor of physical activity (PA). Therefore, exploration of this association among young adults seems evident. As the field of smartphone interventions is relatively new, it may also be particularly interesting to get insight in young adults´ acceptance of PA apps and their preferences for theory-based behaviour change techniques aimed to increase exercise self-efficacy and PA to advice future app developers.

Objective: This study aims to explore the association between exercise self-efficacy and PA among young adults and get insight in their acceptance of PA apps and preferences for potential effective behaviour change techniques aimed to increase exercise self-efficacy and PA behaviour.

Methods: Cross-sectional online survey among healthy young adults 18-30 years. Participants who had physical impairments and who did not complete the survey were excluded, leaving 179 eligible participants for analyses. The survey was developed upon research on behaviour change theory and the Unified theory of Acceptance and Use of Technology (UTAUT). Self-reported total, light, moderate, and vigorous intensity PA were measured. Moreover, the determinants included were exercise self-efficacy, personality traits, exercise self-identity, constructs obtained from the UTAUT, and preferences for behaviour change techniques aimed to increase exercise self-efficacy and PA.

Results: The analysis between exercise self-efficacy (scale 12-60) and total PA (min/week) showed no significant association (B=17.6, 95%CI -4.46 – 39.70). Only a high level of vigorous intensity PA was significantly positively associated with exercise self-efficacy (OR=1.07, 95%CI 1.03 – 1.12). In general, high preferences were found for behaviour change techniques aimed to improve exercise self-efficacy and PA, except for techniques addressing social support. A limited number of differences in preferences for behaviour change techniques were found between individual differences in participant characteristics, such as exercise self-efficacy, personality and exercise self-identity. The acceptance of PA apps was relatively high (M=31.4, SD=5.4 on a scale of 8-40).

Conclusions: Exercise self-efficacy seems an important construct to target in interventions aimed to improve vigorous intensity PA participation. Moreover, it seems promising that potential effective behaviour change techniques are also highly appreciated. Future intervention developers should not focus on tailoring behaviour change techniques to the preferences of young adults. As scientific evidence on effective behaviour change techniques for apps is lacking, future research should focus on what behaviour change techniques are effective in app-based interventions to increase exercise self-efficacy and PA behaviour.

This thesis was transformed into a scientific article, that was published in the Journal of Medical Internet Research - mHealth and uHealth under the title "Dutch Young Adults Ratings of Behavior Change Techniques Applied in Mobile Phone Apps to Promote Physical Activity: A Cross-Sectional Survey".

Determinanten van actief transport bij Nederlandse jong volwassenen

Gabrielle Jongeneel, Bachelor in Health Sciences

Achtergrond: Voldoende fysieke activiteit is belangrijk voor de gezondheid en het welbevinden voor mensen van alle leeftijden. Het verhogen van fysieke activiteit is een prioriteit voor de volksgezondheid om hiermee het ontstaan van chronische ziekten zoals hart- en vaatziekten, diabetes, kanker, depressie en overgewicht te voorkomen. De mate van fysieke activiteit is in Nederland in de afgelopen jaren in alle leeftijdsgroepen afgenomen, maar het sterkst in de groep van jong volwassenen. Actief transport lijkt een makkelijk middel om de fysieke activiteit te verhogen, omdat het makkelijk inpasbaar is in het dagelijks leven van jong volwassenen. Er heerst echter veel onbekendheid over welke determinanten de meeste invloed hebben op de keuze voor actief transport. Het doel van deze studie is dan ook het inzicht krijgen in motivationele en sociale en fysieke mogelijkheden van actief transport bij jong volwassenen in Nederland.

Methode: Cross-sectionele gegevens zijn verzameld van 190 participanten met behulp van een online vragenlijst die vragen bevatte over de volgende determinanten: Plezier in bewegen, sociale steun, eigen-effectiviteit, verwachte effecten, sport-identiteit en barrières. Deze zijn via multiple lineaire regressie analyse in verband gebracht met de mate van actief transport (min/week). Hierin is gecorrigeerd voor mogelijke moderatoren en confounders. Verder is via de Chi kwadraat toets onderzocht welke voorkeuren jong volwassenen hebben ten aanzien van gedragsveranderings-technieken om actief transport te stimuleren en of deze voorkeuren gerelateerd zijn aan geslacht, sport-identiteit of het wel of niet halen van de beweegnorm. Door missings op bepaalde vragen verschillen de onderzoekspopulaties per analyse.

Resultaten: In de regressieanalyse zijn 86 participanten meegenomen met een gemiddeld actief transport van 280 min/week. De regressieanalyses rapporteerden significante verbanden voor de relaties tussen sociale support van vrienden en actief transport (B=8,0 & 95% BI 0,1;15,9) en eigen-effectiviteit en actief transport (B=-16,0 & 95% BI -23,9;-1,6). Eigen-effectiviteit wordt gemodereerd door fysieke activiteit. De relatie tussen eigen-effectiviteit en actief transport is sterker voor de deelnemers die de beweegnorm niet halen dan voor de deelnemers die de beweegnorm wel halen. Er heerst geen duidelijke voorkeur voor één bepaalde gedragsveranderingstechniek en voorkeuren voor gedragsveranderingstechnieken worden niet beïnvloed door geslacht, sport-identiteit of het wel of niet halen van de beweegnorm.

Conclusie: De belangrijkste determinanten van actief transport onder jong volwassen in deze studie waren eigen-effectiviteit en sociale support van vrienden. Een duidelijke voorkeur voor een gedragsveranderingstechniek lijkt er niet te zijn. De 4 categorieën van technieken, het stellen van doelen, maken van plannen, het ontvangen van feedback en het zelf monitoren zijn alle vier erg hoog gewaardeerd in de vragenlijst.

The potential determinants of stair use among Dutch young adults

Noor Buitenhuis, Bachelor in Health Sciences

Background: Physical inactivity is the fourth leading risk factor for mortality worldwide and has been identified to cause an estimated 3.2 million deaths globally. Previous studies reported a decline in physical activity through young adulthood and beyond. In order to promote total physical activity, specific physical activity sub-behaviours can be promoted, such as stair use. In order to promote stair use, an insight of the underlying determinants that influence physical activity in general and stair use in particular, is needed. In the current study, we will study the possible determinants of physical activity and especially stair use by using the Motivation- Ability -Opportunity (MAO) model. The objective is to evaluate the association of different potential determinants on stair use among Dutch young adults between the age of 18 and 30 years. Furthermore, we aim to explore potential effect modification by overall physical activity level and gender. We hypothesize that motivations, opportunities and abilities are associated with stair use and that these associations differ by overall physical activity level and gender.

Design and methods: 190 participants were recruited through a cross sectional survey link on Facebook and through other strategies (e.g. flyers, personal contacts and online adds). The participants were healthy young adults living in the Netherlands. We collected self-reported stair use by means of a self-developed questionnaire in which the participants had to estimate how many times on average they used the stairs within a typical week and the average number of floors they covered with each time they used the stairs. Potential determinants of stair use included questions about enjoyment, social support, barriers, expectation, self-efficacy, self-identity and motivation. The associations of these determinants with stair use were assessed by means of linear regression analysis. As the dependent variable, i.e. stair use, was not normally distributed, stair use was log-transformed. Furthermore, the preferences of the participants with regard to behavioural change techniques (BCTs) is described.

Results: Linear regression analysis showed that the majority of the tested determinants, like enjoyment, social support(family), barriers, outcome-expectations, self-identity and motivation, had no significant association with stair use among Dutch young adults. The association between the determinants enjoyment, social support(friends), self-efficacy and the outcome variable stair use was modified by gender. For men, the determinant social support (friends) showed a significant association with stair use (B = 7,15, 95% CI = 1,45 – 35,27), when adjusted for physical activity and BMI. The determinant self-efficacy also showed a significant association (B = 2,46, 95% - CI = 1,61 – 3,76) with stair use for men when adjusted for physical activity, age and BMI. For every BCT, more than 50% of the participants scored high on preference.

Conclusion: There were no significant associations found between the determinants enjoyment, social support(family), barriers, outcome-expectations, self-identity, motivation and stair use. However, the result of the current study might indicate that stair use among male Dutch young adults could be increased by taking care of the social support(friends) and self-efficacy. The participants did not have a preference for a particular BCT, but the overall score for BCTs was high.