Jaclyn P. Maher

Behavior Change Techniques in Top-Ranked Mobile Apps for Physical Activity

BACKGROUND Mobile applications (apps) have potential for helping people increase their physical activity, but little is known about the behavior change techniques marketed in these apps. PURPOSE The aim of this study was to characterize the behavior change techniques represented in online descriptions of top-ranked apps for physical activity. METHODS Top-ranked apps (n=167) were identified on August 28, 2013, and coded using the Coventry, Aberdeen and London-Revised (CALO-RE) taxonomy of behavior change techniques during the following month. Analyses were conducted during 2013. RESULTS Most descriptions of apps incorporated fewer than four behavior change techniques. The most common techniques involved providing instruction on how to perform exercises, modeling how to perform exercises, providing feedback on performance, goal-setting for physical activity, and planning social support/change. A latent class analysis revealed the existence of two types of apps, educational and motivational, based on their configurations of behavior change techniques. CONCLUSIONS Behavior change techniques are not widely marketed in contemporary physical activity apps. Based on the available descriptions and functions of the observed techniques in contemporary health behavior theories, people may need multiple apps to initiate and maintain behavior change. This audit provides a starting point for scientists, developers, clinicians, and consumers to evaluate and enhance apps in this market.

A Daily Analysis of Physical Activity and Satisfaction With Life in Emerging Adults

OBJECTIVE Subjective well-being has well-established positive health consequences. During emerging adulthood, from ages 18 to 25 years, peoples global evaluations of their well-being (i.e., satisfaction with life [SWL]) appear to worsen more than any other time in the adult life span, indicating that this population would benefit from strategies to enhance SWL. In these studies, we investigated top-down (i.e., time-invariant, trait-like) and bottom-up (i.e., time-varying, state-like) influences of physical activity (PA) on daily SWL. METHODS Two daily diary studies lasting 8 days (N = 190) and 14 days (N = 63) were conducted with samples of emerging adults enrolled in college to evaluate relations between daily PA and SWL while controlling for established and plausible top-down and bottom-up influences on SWL. RESULTS In both studies, multilevel models indicated that people reported greater SWL on days when they were more active (a within-person, bottom-up effect). Top-down effects of PA were not significant in either study. These findings were robust when we controlled for competing top-down influences (e.g., sex, personality traits, self-esteem, body mass index, mental health symptoms, fatigue) and bottom-up influences (e.g., daily self-esteem, daily mental health symptoms, daily fatigue). CONCLUSIONS We concluded that SWL was impacted by peoples daily PA rather than their trait level of PA over time. These findings extend evidence that PA is a health behavior with important consequences for daily well-being and should be considered when developing national policies to enhance SWL.

Sedentary behavior as a daily process regulated by habits and intentions

OBJECTIVE Sedentary behavior is a health risk but little is known about the motivational processes that regulate daily sedentary behavior. This study was designed to test a dual-process model of daily sedentary behavior, with an emphasis on the role of intentions and habits in regulating daily sedentary behavior. METHOD College students (N = 128) self-reported on their habit strength for sitting and completed a 14-day ecological momentary assessment study that combined daily diaries for reporting motivation and behavior with ambulatory monitoring of sedentary behavior using accelerometers. RESULTS Less than half of the variance in daily sedentary behavior was attributable to between-person differences. People with stronger sedentary habits reported more sedentary behavior on average. People whose intentions for limiting sedentary behavior were stronger, on average, exhibited less self-reported sedentary behavior (and marginally less monitored sedentary behavior). Daily deviations in those intentions were negatively associated with changes in daily sedentary behavior (i.e., stronger than usual intentions to limit sedentary behavior were associated with reduced sedentary behavior). Sedentary behavior also varied within people as a function of concurrent physical activity, the day of week, and the day in the sequence of the monitoring period. CONCLUSIONS Sedentary behavior was regulated by both automatic and controlled motivational processes. Interventions should target both of these motivational processes to facilitate and maintain behavior change. Links between sedentary behavior and daily deviations in intentions also indicate the need for ongoing efforts to support controlled motivational processes on a daily basis.

Daily physical activity and life satisfaction across adulthood.

Physical activity is considered a valuable tool for enhancing life satisfaction. However, the processes linking these constructs likely differ across the adult life span. In older adults the association between physical activity and life satisfaction appears to involve usual levels of physical activity (i.e., a between-person association driven by differences between more and less active people). In younger adults the association has consistently been based on day-to-day physical activity (i.e., a within-person association driven by differences between more and less active days). To resolve this inconsistency, a daily diary study was conducted with a life span sample of community-dwelling adults (age 18-89 years; N = 150) over three 21-day measurement bursts. Usual physical activity was positively associated with life satisfaction in middle and older adulthood; however, this association was not present in young adulthood. When present, this between-person association was mediated by physical and mental health. A within-person association between physical activity and life satisfaction was also present (and did not differ across age). Generally, on days when people were more physically active then was typical for them, they experienced greater life satisfaction. Age differences in life satisfaction followed a cubic trajectory: lower during emerging adulthood, higher during midlife, and lower during older adulthood. This study adds to accumulating evidence that daily fluctuations in physical activity have important implications for well-being regardless of age, and clarifies developmental differences in life satisfaction dynamics that can inform strategies for enhancing life satisfaction.

Habits Predict Physical Activity on Days When Intentions Are Weak

Physical activity is regulated by controlled processes, such as intentions, and automatic processes, such as habits. Intentions relate to physical activity more strongly for people with weak habits than for people with strong habits, but peoples intentions vary day by day. Physical activity may be regulated by habits unless daily physical activity intentions are strong. University students (N = 128) self-reported their physical activity habit strength and subsequently self-reported daily physical activity intentions and wore an accelerometer for 14 days. On days when people had intentions that were weaker than typical for them, habit strength was positively related to physical activity, but on days when people had typical or stronger intentions than was typical for them, habit strength was unrelated to daily physical activity. Efforts to promote physical activity may need to account for habits and the dynamics of intentions.

Habit Strength Moderates the Effects of Daily Action Planning Prompts on Physical Activity but Not Sedentary Behavior

This study was designed to examine the moderating influence of habit strength on daily action planning effects on physical activity and sedentary behavior. A 2 by 2 design was used with experimental factors corresponding to action planning interventions for (a) engaging in physical activity and (b) limiting or interrupting sedentary behavior. At the end of each day for 1 week, university students (n = 195) completed (a) a questionnaire about their behavior during the day and behavioral intentions for the following day and (b) a planning intervention(s) corresponding to their randomly assigned experimental condition. Action planning increased physical activity in those with weak habits but decreased physical activity in those with strong habits compared with those who did not create action plans. Action planning did not impact sedentary behavior. Action planning was a useful behavior change technique for increasing physical activity in people with weak habits, but may be iatrogenic for those with strong habits.

Daily Satisfaction With Life Is Regulated by Both Physical Activity and Sedentary Behavior

Recent research revealed that on days when college students engage in more physical activity than is typical for them, they also experience greater satisfaction with life (SWL). That work relied on self-reported physical activity and did not differentiate between low levels of physical activity and sedentary behavior. This study was designed to (1) determine if the association between self-reported physical activity and SWL would exist when physical activity was monitored objectively and (2) examine the between- and within-person associations among physical activity, sedentary behavior, and SWL. During a 14-day ecological momentary assessment study, college students (N = 128) wore an accelerometer to objectively measure physical activity and sedentary behavior, and they self-reported their physical activity, sedentary behavior, and SWL at the end of each day. Physical activity and sedentary behavior had additive, within-person associations with SWL across self-reported and objective-measures of behavior. Strategies to promote daily well-being should encourage college students to incorporate greater amounts of physical activity as well as limit their sedentary behavior.

Associations of maternal stress with children's weight-related behaviours: a systematic literature review

Low adherence to guidelines for weight‐related behaviours (e.g. dietary intake and physical activity) among US children underscores the need to better understand how parental factors may influence childrens obesity risk. In addition to most often acting as primary caregiver to their children, women are also known to experience greater levels of stress than men. This study systematically reviewed associations between maternal stress and childrens weight‐related behaviours. Our search returned 14 eligible articles, representing 25 unique associations of maternal stress with a distinct child weight‐related behaviour (i.e. healthy diet [n = 3], unhealthy diet [n = 6], physical activity [n = 7] and sedentary behaviour [n = 9]). Overall, findings for the relationship between maternal stress and childrens weight‐related behaviours were mixed, with no evidence for an association with childrens healthy or unhealthy dietary intake, but fairly consistent evidence for the association of maternal stress with childrens lower physical activity and higher sedentary behaviour. Recommendations for future research include prioritizing prospective designs, identifying moderators, and use of high‐resolution, real‐time data collection techniques to elucidate potential mechanisms.

Acceptability of mobile health interventions to reduce inactivity-related health risk in central Pennsylvania adults.

Insufficient physical activity and excessive sedentary behavior elevate health risk. Mobile applications (apps) provide one mode for delivering interventions to modify these behaviors and reduce health risk. The purpose of this study was to characterize the need for and acceptability of health behavior interventions among rural adults and evaluate the interest in and the value of app-based interventions in this population. Central Pennsylvania adults with smartphones (N = 258) completed a brief web survey in October–November 2012. Most adults report one or both inactivity-related behavioral risk factors, would use a free app to modify those risk behaviors, and would pay a small amount for that app. Low-cost, efficacious apps to increase physical activity or reduce sedentary behavior should be promoted in public health practice. User experience should be at the forefront of this process to increase value and minimize burden in the service of long-term engagement, behavior change, and health risk reduction.

Daily Associations of Stress and Eating in Mother–Child Dyads

Background and Aims. This study used Ecological Momentary Assessment (EMA) in mother–child dyads to examine the day-level associations of stress and eating. Method. Mothers and their 8- to 12-year-old children (N = 167 dyads) completed between three (weekday) and eight (weekend) EMA survey prompts per day at random nonschool times across 8 days. EMA measured perceived stress, and past 2-hour healthy (i.e., fruit and vegetables) and unhealthy (e.g., pastries/sweets, soda/energy drinks) eating. Results. Children reported more healthy and unhealthy eating on days when their mothers also engaged in more healthy and unhealthy eating, respectively. On days when mothers’ perceived stress was greater than usual, they reported more healthy eating. Discussion and Conclusions. Eating behaviors were coupled between mothers and children at the day level. Mothers’ stress was related to their own eating but not to children’s eating.