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      Harnessing Different Motivational Frames via Mobile Phones to Promote Daily Physical Activity and Reduce Sedentary Behavior in Aging Adults

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          Abstract

          Mobile devices are a promising channel for delivering just-in-time guidance and support for improving key daily health behaviors. Despite an explosion of mobile phone applications aimed at physical activity and other health behaviors, few have been based on theoretically derived constructs and empirical evidence. Eighty adults ages 45 years and older who were insufficiently physically active, engaged in prolonged daily sitting, and were new to smartphone technology, participated in iterative design development and feasibility testing of three daily activity smartphone applications based on motivational frames drawn from behavioral science theory and evidence. An “analytically” framed custom application focused on personalized goal setting, self-monitoring, and active problem solving around barriers to behavior change. A “socially” framed custom application focused on social comparisons, norms, and support. An “affectively” framed custom application focused on operant conditioning principles of reinforcement scheduling and emotional transference to an avatar, whose movements and behaviors reflected the physical activity and sedentary levels of the user. To explore the applications' initial efficacy in changing regular physical activity and leisure-time sitting, behavioral changes were assessed across eight weeks in 68 participants using the CHAMPS physical activity questionnaire and the Australian sedentary behavior questionnaire. User acceptability of and satisfaction with the applications was explored via a post-intervention user survey. The results indicated that the three applications were sufficiently robust to significantly improve regular moderate-to-vigorous intensity physical activity and decrease leisure-time sitting during the 8-week behavioral adoption period. Acceptability of the applications was confirmed in the post-intervention surveys for this sample of midlife and older adults new to smartphone technology. Preliminary data exploring sustained use of the applications across a longer time period yielded promising results. The results support further systematic investigation of the efficacy of the applications for changing these key health-promoting behaviors.

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          An experimental study of homophily in the adoption of health behavior.

          How does the composition of a population affect the adoption of health behaviors and innovations? Homophily--similarity of social contacts--can increase dyadic-level influence, but it can also force less healthy individuals to interact primarily with one another, thereby excluding them from interactions with healthier, more influential, early adopters. As a result, an important network-level effect of homophily is that the people who are most in need of a health innovation may be among the least likely to adopt it. Despite the importance of this thesis, confounding factors in observational data have made it difficult to test empirically. We report results from a controlled experimental study on the spread of a health innovation through fixed social networks in which the level of homophily was independently varied. We found that homophily significantly increased overall adoption of a new health behavior, especially among those most in need of it.
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            A review of eHealth interventions for physical activity and dietary behavior change.

            To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Systematic literature searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Articles published in scientific journals were included if they evaluated an intervention for physical activity and/or dietary behaviors, or focused on weight loss, used randomized or quasi-experimental designs, measured outcomes at baseline and a follow-up period, and included an intervention where participants interacted with some type of electronic technology either as the main intervention or an adjunct component. All studies were published between 2000 and 2005. Eighty-six publications were initially identified, of which 49 met the inclusion criteria (13 physical activity publications, 16 dietary behaviors publications, and 20 weight loss or both physical activity and diet publications), and represented 47 different studies. Studies were described on multiple dimensions, including sample characteristics, design, intervention, measures, and results. eHealth interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.
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              Too much sitting: a novel and important predictor of chronic disease risk?

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                25 April 2013
                : 8
                : 4
                : e62613
                Affiliations
                [1 ]Department of Health Research and Policy, and Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
                [2 ]School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona, United States of America
                [3 ]Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
                [4 ]School of Engineering, Stanford University, Stanford, California, United States of America
                [5 ]Department of Pediatrics, and Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, California, United States of America
                Universidad Europea de Madrid, Spain
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Provided edits/additions to the manuscript: LAG SJW JLS MPB BB TNR JC. Data cleaning/verification: LAG SJW JLS JC. Conceived and designed the experiments: ACK EBH MPB BB TNR. Performed the experiments: EBH MPB LAG SJW JLS JC. Analyzed the data: EBH LAG. Wrote the paper: ACK EBH.

                Article
                PONE-D-13-04762
                10.1371/journal.pone.0062613
                3636222
                23638127
                16ce0e14-d06d-4ff9-a2d8-33dd4bf01538
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 23 January 2013
                : 22 March 2013
                Page count
                Pages: 8
                Funding
                The reported research was funded by Public Health Service grant #RC1 HL099340 from the National Heart, Lung, & Blood Institute of the National Institutes of Health, awarded to ACK. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Computer Science
                Information Technology
                Software Engineering
                Software Design
                Engineering
                Software Engineering
                Software Design
                Medicine
                Mental Health
                Psychology
                Behavior
                Non-Clinical Medicine
                Health Informatics
                Socioeconomic Aspects of Health
                Public Health
                Behavioral and Social Aspects of Health
                Socioeconomic Aspects of Health
                Science Policy
                Technology Development
                Social and Behavioral Sciences
                Communications
                Psychology
                Applied Psychology
                Behavior

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