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  • Users’ experiences with the nohow web-based toolkit with weight and activity tracking in weight loss maintenance: Long-term randomized controlled trial
    Publication . Mattila, Elina; Hansen, Susanne; Bundgaard, Lise; Ramsey, Lauren; Dunning, Alice; Silva, Marlene N.; Harjumaa, Marja; Ermes, Miikka; Marques, Marta M.; Matos, Marcela; Larsen, Sofus C.; Encantado, Jorge; Santos, Inês; Horgan, Graham; O'Driscoll, Ruairi; Turicchi, Jake; Duarte, Cristiana; Palmeira, AL; Stubbs, R James; Heitmann, Berit Lilienthal; Lähteenmäki, Liisa
    Background: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. Objective: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. Methods: An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. Results: The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. Conclusions: The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content.
  • Keep on running – a randomized controlled trial to test a digital evidence-based intervention for sustained adoption of recreational running: rationale, design and pilot feasibility study
    Publication . Pereira, Hugo V.; Teixeira, Pedro J.; Marques, Marta M.; Carraça, Eliana V.; Silva, Marlene N.; Encantado, Jorge; Santos, Inês; Palmeira, António L.
    Background: This paper describes the rationale, intervention development, study design and results from the pilot feasibility study of the Keep On Running (KOR) trial. KOR aims to test a web-based brief theory-based intervention, targeting maintenance of recreational running behavior over time (i.e. relapse preventing). Methods: Intervention development was based both on Self- Determination Theory and on Self-Regulation Theory. As part of it, a pilot study was implemented (n=18) to measure intervention adherence and participant satisfaction in order to establish the feasibility and acceptability of the intervention toolkit. Furthermore, this pilot study was also used to test the feasibility and acceptability of the questionnaires selected to be part of the later RCT. Results: Pilot intervention acceptability was good, but overall adherence was low. Features such as feedback and social sharing should be added to the toolkit. The main trial should lessen questionnaire length and include data from usual monitoring gadgets and apps (APIs). The protocol of the RCT was adjusted to test the efficacy of the refined final version of the intervention, and the RCT that will test it, contributing to the understanding of recreational running sustainability, allowing the optimization of future interventions aimed at physical activity promotion.