Applying the behaviour change wheel to assess the theoretical underpinning of a novel smartphone application to increase physical activity in adults with spinal cord injuries

Abstract

Background: People with spinal cord injuries (SCI) are physically inactive. Smartphone applications (or apps) may prove as one strategy to overcome this. This study examines the theoretical underpinning of a novel mHealth intervention that aims to improve physical activity in people with SCI, namely, the Accessercise smartphone app, using the behaviour change wheel (BCW).Methods: Accessercise was evaluated using the BCW in eight steps across the following three stages: (I) understanding the behaviour, (II) identifying intervention options, and (III) identifying content and implementation options.Results: Thirteen target behaviours were identified to improve physical activity and reduce sedentary behaviours in adults with SCI, including goal setting and monitoring, increasing self-confidence, interest and motivation for undertaking physical activity, improving the knowledge/awareness of available physical activity opportunities and resources, and reducing stigma and negative attitudes associated with physical activity. Accessercise incorporates the necessary components for adults with SCI to be physically and psychologically capable of undertaking physical activity, offering social and physical opportunities to reduce sedentary behaviours, and supports automatic and reflective motivation.Conclusions: This systematic approach of assessing the theoretical underpinning of Accessercise in the context of the BCW has revealed potential mechanisms of action for improving physical activity in adults with SCI. This serves as a blueprint to inform further intervention development, as well as high-quality effectiveness studies, namely, randomised controlled trials, assessing whether fitness apps can improve physical and psychological health outcomes in individuals with SCI.

Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI

“…In the next section, we will describe the world of physical activity carried out via tele-exercise. [5,17,45] Figure 1 illustrates the exponential growth of the number of papers published on the topic of "tele-exercise". The results indicate a varying number of publications on the topic of "tele-exercise" over the years.…”

Designing Mobile Phone Text Messages Using the Behavior Change Wheel Framework to Influence Food Literacy in Adults With Type 2 Diabetes in Kenya: Protocol for a Systematic Development Study

“…In this study, we used the Behavior Change Wheel (BCW) framework [15] to systematically develop intervention components. Given that the BCW framework has been used widely to design and evaluate several behavior change interventions [16][17][18][19][20], we used it to develop text messages. Specifically, the BCW framework helps in the systematic identification of target behaviors that need to be changed to improve health outcomes and to select appropriate intervention functions, policy categories, and behavior change techniques (BCTs) based on the analysis of the sources of behavior (capability, opportunity, and motivation) [14].…”

Tele-health, tele-exercise and tele-assessment: an example of a fitness app for individuals with spinal cord injury

“…Haley et al ( 1 ) published an interesting study about the use of smartphone application (Accessercise) to encourage physical activity in individuals with spinal cord injuries (SCI). The Accessercise offered users the capability, opportunity, and motivation to undertake physical activity and reduce sedentary behaviors.…”

“…The smartphone application Accessercise, presented by Haley et al ( 1 ), is one of the innovative possibilities for physical activity proposals to population with impairment. Other synchronous and asynchronous tele-exercise programs and tele-assessment can be found in the literature.…”