Effect of commercial wearables and digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas: the RAW-PA cluster-randomised controlled trial

Abstract

Background There has been increasing interest in using wearable activity trackers to promote physical activity in youth. This study examined the short- and longer-term effects of a wearable activity tracker combined with digital behaviour change resources on the physical activity of adolescents attending schools in socio-economically disadvantaged areas. Methods The Raising Awareness of Physical Activity (RAW-PA) Study was a 12-week, multicomponent intervention that combined a Fitbit Flex (and accompanying app), and online digital behaviour change resources and weekly challenges delivered via Facebook. RAW-PA was evaluated using a cluster-randomised controlled trial with 275 adolescents (50.2% female; 13.7 ± 0.4 years) from 18 Melbourne secondary schools (intervention n = 9; wait-list control group n = 9). The primary outcome was moderate- to vigorous-intensity physical activity (MVPA), measured using hip-worn ActiGraph accelerometers. The secondary outcome was self-reported physical activity. Data were collected at baseline, 12-weeks (immediately post-intervention), and 6-months post-intervention (follow-up). Multilevel models were used to determine the effects of the intervention on daily MVPA over time, adjusting for covariates. Results No significant differences were observed between intervention and wait-list control adolescents’ device-assessed MVPA immediately post-intervention. At 6-months post-intervention, adolescents in the intervention group engaged in 5 min (95% CI: − 9.1 to − 1.0) less MVPA per day than those in the wait-list control group. Males in the intervention group engaged in 11 min (95% CI: − 17.6 to − 4.5) less MVPA than males in the wait-list control group at 6-months post-intervention. No significant differences were observed for females at either time point. For self-reported physical activity, no significant effects were found at 12-weeks and 6-months post-intervention. Conclusions Combining a wearable activity tracker with digital behaviour change resources and weekly challenges did not increase inactive adolescents’ accelerometer-derived and self-reported physical activity levels immediately post-intervention. This contrasts previous research that has suggested wearable activity tracker may increase youth physical activity levels in the short-term. Lower engagement in MVPA 6-months post-intervention was observed for males but not for females, though it is unclear why this finding was observed. The results suggest wearable activity trackers, in combination with supporting materials, may not be effective for increasing physical activity levels in adolescents. Trial registration ACTRN12616000899448. Australian and New Zealand Clinical Trials Registry. Registered 7 July 2016.

Physical Activity Knowledge, Attitude, and Behaviours Among Adolescents in the Kingdom of Saudi Arabia Prior to and during COVID-19 Restrictions

“…This question has been validated previously [ 41 ]. Similar to other studies [ 42 , 43 ], binary variables were created to represent less and more active students: <5 days per week (less active) and ≥5 days per week (more active). Other questions included comparative questions on PA, ST, social media use, and sleep changes during COVID-19 restrictions.…”

Mediators of Effects on Physical Activity and Sedentary Time in an Activity Tracker and Behavior Change Intervention for Adolescents: Secondary Analysis of a Cluster Randomized Controlled Trial

“…The eligibility criteria for participants included the following: (1) being ≥13 years old; (2) having access to the internet outside of school; (3) not engaging in regular organized physical activity or sport outside of school; (4) not meeting physical activity guidelines of ≥60 minutes of moderate to vigorous physical activity (MVPA) every day; and (5) not a current or past owner of an activity tracker. All eligible students (n=280) who returned informed written parental consent and student assent were recruited into the study [ 8 ]. As 5 students withdrew before baseline data collection, a total of 275 students participated.…”

“…Such devices can measure physical activity, enable self-monitoring, and provide real-time feedback. Wearable activity trackers are increasingly being used in physical activity research as both a measurement and intervention tool, while some devices have the capability to provide feedback and alerts for periods of sedentary time [ 8 , 9 ]. Emerging evidence suggests that these trackers have the potential to be used as intervention tools as adolescents perceive them as easy to use and useful [ 10 ], and that they increase their motivation to be physically active [ 11 ].…”

“…Grounded in social cognitive theory [ 21 ] and behavioral choice theory [ 13 ], the intervention targeted multiple potential mediators of adolescent physical activity. While this intervention did not increase inactive adolescents’ accelerometer-derived and self-reported physical activity levels immediately after intervention [ 8 ], it provides a unique opportunity to explore potential cognitive, behavioral, and interpersonal mediators of physical activity and sedentary behavior. This is important as identifying which factors are on the mediating pathway between the intervention and the targeted outcomes can inform the development of future physical activity interventions.…”

Physical Activity Knowledge, Attitude and Behaviours among Adolescents in the Kingdom of Saudi Arabia prior to and during COVID-19 restrictions

“…This question has previously been validated in the Australian National Nutrition and Physical Activity Survey and provided examples of activities that are considered moderate to vigorous [41]. Similar to other studies [42,43], binary variables were created to represent less active and more active students: <5 days per week (less active) and ≤ 5 days per week (more active). Other questions included comparative questions of PA, ST, social media use and sleep changes after COVID-19 restrictions began.…”