Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial

Background Digital interventions have the potential to increase physical activity in adults with the use of few resources, but evidence of long-term effectiveness is limited. This study aimed to evaluate the effects of three digital interventions on physical activity.Methods 183 self-reported inacti...

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Main Authors: Paolo Zanaboni, Marie-Pierre Gagnon, Bente Morseth, Edvard H Sagelv, Bjarne Martens Nes, Unn Sollid Manskow, Konstantions Antypas, Inger-Lise Aamot Aksetøy
Format: Article
Language:English
Published: BMJ Publishing Group 2025-06-01
Series:BMJ Open Sport & Exercise Medicine
Online Access:https://bmjopensem.bmj.com/content/11/2/e001816.full
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author Paolo Zanaboni
Marie-Pierre Gagnon
Bente Morseth
Edvard H Sagelv
Bjarne Martens Nes
Unn Sollid Manskow
Konstantions Antypas
Inger-Lise Aamot Aksetøy
author_facet Paolo Zanaboni
Marie-Pierre Gagnon
Bente Morseth
Edvard H Sagelv
Bjarne Martens Nes
Unn Sollid Manskow
Konstantions Antypas
Inger-Lise Aamot Aksetøy
author_sort Paolo Zanaboni
collection DOAJ
description Background Digital interventions have the potential to increase physical activity in adults with the use of few resources, but evidence of long-term effectiveness is limited. This study aimed to evaluate the effects of three digital interventions on physical activity.Methods 183 self-reported inactive adults (<150 min per week of moderate to vigorous physical activity (MVPA)) aged 22–55 years were included in a hybrid type 1 effectiveness-implementation trial over 18 months and were randomised to three fully web-based interventions: (A) activity tracker with the personalised metric Personal Activity Intelligence on a mobile app, (B) group A+home-based online training and (C) group B+online peer support through social media. Physical activity was measured with hip-worn accelerometers (ActiGraph GT3X-BT) at baseline, 6, 12 and 18 months. Outcome measures included MVPA, light and total physical activity, steps, adherence to physical activity recommendations, waist circumference (WC), quality of life, perceived competence for exercise, self-efficacy for exercise, social support and reasons for performing physical activity. Longitudinal changes in outcomes were evaluated using linear mixed models adjusted for baseline values.Results Mean MVPA in all groups at baseline was over two times higher than the criteria for inactive and decreased from 69.7 min per day (95% CI: 67.3 to 72.1) to 60.2 min (95% CI: 56.8 to 63.7) through 18 months (p<0.001). No time by group interaction was observed (p=0.97). Similar patterns were observed for light and total physical activity (main effect of time: both p<0.02, time by group interaction: both p>0.59). WC increased from baseline through follow-up (all p<0.001), but with no time by group interaction (all p>0.15).Conclusion Self-reported physically inactive adults receiving an activity tracker with a mobile app accumulated high physical activity levels at baseline but decreased their activity levels over 18 months. Adding home-based online training and peer support did not provide additional effects.Trial registration number Prospectively registered, 23 of April 2021, identifier: NCT04526, https://clinicaltrials.gov/ct2/show/NCT04526444.
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spelling doaj-art-795a4e659fb2437baf6b8e2b2f3d90972025-08-20T02:39:29ZengBMJ Publishing GroupBMJ Open Sport & Exercise Medicine2055-76472025-06-0111210.1136/bmjsem-2023-001816Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trialPaolo Zanaboni0Marie-Pierre Gagnon1Bente Morseth2Edvard H Sagelv3Bjarne Martens Nes4Unn Sollid Manskow5Konstantions Antypas6Inger-Lise Aamot Aksetøy7UiT The Arctic University of Norway, Tromso, NorwayFaculty of Nursing, Université Laval, Quebec City, Quebec, CanadaSchool of Sport Sciences, UiT The Arctic University of Norway, Tromsø, NorwayFaculty of Health Sciences, School of Sport Sciences, UiT Arctic University of Norway, Tromsø, NorwayDepartment of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayNational Centre for E-health Research, University Hospital of North Norway, Tromso, NorwayNational Centre for E-health Research, University Hospital of North Norway, Tromsø, NorwayNorwegian National Advisory Unit on Exercise Training as Medicine for Cardiopulmonary Condition, St Olavs Hospital Trondheim University Hospital, Trondheim, NorwayBackground Digital interventions have the potential to increase physical activity in adults with the use of few resources, but evidence of long-term effectiveness is limited. This study aimed to evaluate the effects of three digital interventions on physical activity.Methods 183 self-reported inactive adults (<150 min per week of moderate to vigorous physical activity (MVPA)) aged 22–55 years were included in a hybrid type 1 effectiveness-implementation trial over 18 months and were randomised to three fully web-based interventions: (A) activity tracker with the personalised metric Personal Activity Intelligence on a mobile app, (B) group A+home-based online training and (C) group B+online peer support through social media. Physical activity was measured with hip-worn accelerometers (ActiGraph GT3X-BT) at baseline, 6, 12 and 18 months. Outcome measures included MVPA, light and total physical activity, steps, adherence to physical activity recommendations, waist circumference (WC), quality of life, perceived competence for exercise, self-efficacy for exercise, social support and reasons for performing physical activity. Longitudinal changes in outcomes were evaluated using linear mixed models adjusted for baseline values.Results Mean MVPA in all groups at baseline was over two times higher than the criteria for inactive and decreased from 69.7 min per day (95% CI: 67.3 to 72.1) to 60.2 min (95% CI: 56.8 to 63.7) through 18 months (p<0.001). No time by group interaction was observed (p=0.97). Similar patterns were observed for light and total physical activity (main effect of time: both p<0.02, time by group interaction: both p>0.59). WC increased from baseline through follow-up (all p<0.001), but with no time by group interaction (all p>0.15).Conclusion Self-reported physically inactive adults receiving an activity tracker with a mobile app accumulated high physical activity levels at baseline but decreased their activity levels over 18 months. Adding home-based online training and peer support did not provide additional effects.Trial registration number Prospectively registered, 23 of April 2021, identifier: NCT04526, https://clinicaltrials.gov/ct2/show/NCT04526444.https://bmjopensem.bmj.com/content/11/2/e001816.full
spellingShingle Paolo Zanaboni
Marie-Pierre Gagnon
Bente Morseth
Edvard H Sagelv
Bjarne Martens Nes
Unn Sollid Manskow
Konstantions Antypas
Inger-Lise Aamot Aksetøy
Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
BMJ Open Sport & Exercise Medicine
title Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
title_full Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
title_fullStr Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
title_full_unstemmed Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
title_short Online interventions to increase physical activity levels in self-reported inactive adults: the ONWARDS randomised controlled trial
title_sort online interventions to increase physical activity levels in self reported inactive adults the onwards randomised controlled trial
url https://bmjopensem.bmj.com/content/11/2/e001816.full
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