Riitta Pyky

Gamified physical activation of young men – a Multidisciplinary Population-Based Randomized Controlled Trial (MOPO study)

BackgroundInactive and unhealthy lifestyles are common among adolescent men. The planned intervention examines the effectiveness of an interactive, gamified activation method, based on tailored health information, peer networks and participation, on physical activity, health and wellbeing in young men. We hypothesize that following the intervention the physical activation group will have an improved physical activity, as well as self-determined and measured health compared with the controls.Methods/designConscription-aged men (18 years) attending compulsory annual call-ups for military service in the city of Oulu in Finland (nu2009=u20091500) will be randomized to a 6-months intervention (nu2009=u2009640) or a control group (nu2009=u2009640) during the fall 2013. A questionnaire on health, health behaviour, diet and wellbeing is administered in the beginning and end of the intervention. In addition, anthropometric measures (height, weight and waist circumference), body composition, grip strength, heart rate variability and aerobic fitness will be measured. The activation group utilizes an online gamified activation method in combination with communal youth services, objective physical activity measurement, social networking, tailored health information and exercise programs according to baseline activity level and the readiness of changes of each individual. Daily physical activity of the participants is monitored in both the activation and control groups. The activation service rewards improvements in physical activity or reductions in sedentary behaviour. The performance and completion of the military service of the participants will also be followed.DiscussionThe study will provide new information of physical activity, health and health behaviour of young men. Furthermore, a novel model including methods for increasing physical activity among young people is developed and its effects tested through an intervention. This unique gamified service for activating young men can provide a translational model for community use. It can also be utilized as such or tailored to other selected populations or age groups.Trial registrationClinicalTrials.gov Identifier: NCT01376986

Everyday health information literacy among young men compared with adults with high risk for metabolic syndrome - a cross-sectional population-based study

This cross-sectional population-based study aims at identifying differences in the aspects of everyday health information literacy among young healthy men and adults with an increased risk for metabolic syndrome. Data were collected with a self-assessment-based 10-item screening tool administered at the Finnish Defence Force’s call-ups (n=2507, response rate 59%) and at health intervention study (n=571, response rate 98%). Adults with increased risk for metabolic syndrome seemed to value health information but had more difficulty in knowing who to believe in health issues and understanding the terminology used. The difficulties applied especially to respondents 35 years old or over. Men, and especially young men, had lower motivation than women to seek health information. Although the results are indicative, the everyday health information literacy screening tool seems to be useful in revealing areas that health communication should be focused on among different populations.

Effect of wrist-worn activity monitor feedback on physical activity behavior: A randomized controlled trial in Finnish young men

The purpose of this study is to evaluate whether the use of an activity monitor providing feedback has an effect on physical activity (PA) in young men. A population-based sample of 276 conscription-aged (mean = 17.9, SD = 0.7 years) men participated in a 3-month randomized controlled trial in Oulu in 2012. Participants were randomized to an intervention group (INT, N = 137) and a control group (CON, N = 139). INT received a wrist-worn monitor (Polar Active) showing daily activity, and CON received identical monitors without feedback. Main outcome was the change from baseline in objectively measured weekly time spent in moderate-to-vigorous PA (MVPA) and sedentary activity (SED), as assessed by generalized estimation equations (GEE). Other lifestyle factors were assessed by a questionnaire at baseline and at 3 months. Weekly physical activity data (≥ 4 days with ≥ 8 h each) were obtained from 72 (53%) and 90 (65%) men in the INT and CON, respectively. Based on GEE, time spent in MVPA increased (p = 0.012) and SED decreased (p = 0.032) in the INT compared with the CON. During the first 7 weeks, the INT spent on average 1 h less sedentary than the CON (t-test, p < 0.05). During the first week, the INT showed 12 minutes more MVPA compared to the CON (t-test, p = 0.034). Based on questionnaire data, the proportion of the most sedentary men decreased in the INT (Wilcoxon test, 28% vs. 10%, p = 0.029), with no change in the CON (20% vs. 19%, p = 0.546). To conclude, a wrist-worn activity monitor providing feedback had a short-term positive effect on PA and SED in young men. Trial registration This is a pilot study for a larger randomized controlled trial registered to the clinical trials register NCT01376986.

Effect of tailored, gamified, mobile physical activity intervention on life satisfaction and self-rated health in young adolescent men

BackgroundOnline behavior-change programs may increase physical activity in adolescents, but their effects on subjective health and wellbeing are not well known. PurposeWe investigated the effects of a mobile physical activity intervention on life satisfaction and self-rated health among young adolescent men. MethodsIn this population-based study, 496 men (17.8y, SD 0.6y) participated in a 6-month trial. They were randomized into an intervention (n=250) and a control group (n=246). Only the intervention group had access to a tailored mobile service. Life satisfaction and self-rated health were inquired about at baseline and at the end of the trial. ResultsLife satisfaction improved in the intervention (p<0.001) and control group (p=0.01). Life satisfaction was most likely to improve among men with low baseline satisfaction (OR 13.8; 95% CI 3.751.8) and mood-related exercise motive (2.5 (1.15.6)). There were no statistically significant changes in self-rated health, but those who reported poor health at baseline (OR 9.6; 95% CI 3.724.9) and improved self-rated fitness during the trial (4.2 (1.511.9)) were more likely to gain improvements in self-rated health. ConclusionIn this mobile physical activity intervention, improvements in self-rated health and life satisfaction were associated with low life satisfaction and poor self-rated health at baseline within the intervention group. Trial registrationThis randomized controlled trial is registered to the clinical trials register NCT01376986. A population-based, large sample size and a randomized controlled design.Effectiveness of a novel intervention on subjective wellbeing among adolescent men.Life satisfaction increased similarly regardless of the group allocation.Low baseline subjective wellbeing was associated with positive changes.

Individual factors affecting preferences for feedback message tactics in the contexts of physical activity.

Tailored feedback on personal physical activity behavior has been used to inform individuals and promote physical activity among different populations. This study aimed to increase the understanding of factors associated with young mens preferences for feedback message tactics in the context of physical activity and exercise. How preferences vary was analyzed in terms of the self-reported physical activity, stage of exercise behavior change, exercise self-efficacy, objectively measured physical health status, and sociodemographic characteristics of young Finnish men. Population-based survey data, including physiological measurements (n = 525), were collected at the Finnish Defence Forces’ call-ups in the city of Oulu, Finland, in September 2011. The results indicate that the stage of exercise behavior change, exercise self-efficacy, physical health status, and educational level are associated with a preference for normative and ipsative comparison. Multivariate logistic regression models show that an advanced stage of exercise behavior change and education in the academic track of an upper secondary school are independent predictors of preferring ipsative and normative physical activity feedback among young men. The study provides new insights into how the stage of behavior change influences health information behavior and is in line with studies emphasizing social factors—including education—as being important in shaping health-related behavior. These factors could form the basis for tailoring information when designing health promotion.

Profiles of sedentary and non-sedentary young men - a population-based MOPO study.

BackgroundSedentary behavior is associated with poor well-being in youth with adverse trajectories spanning to adulthood. Still, its determinants are poorly known. Our aim was to profile sedentary and non-sedentary young men and to clarify their differences in a population-based setting.MethodsA total of 616 men (mean age 17.9, SD 0.6) attending compulsory conscription for military service completed a questionnaire on health, health behavior, socioeconomic situation and media use. They underwent a physical (body composition, muscle and aerobic fitness) and medical examination. Profiles were formed by principal component analysis (PCA).ResultsA total of 30.1xa0% men were sedentary (daily leisure-time sitting ≥5xa0h) and 28.9xa0% non-sedentary (sitting ≤2xa0h). The sedentary men had more body fat, more depressive symptoms, but lower fitness and life satisfaction than non-sedentary men. However, according to PCA, profiles of unhealthy eating, life-dissatisfaction, and gaming were detected both among sedentary and non-sedentary men, as well as high self-rated PA and motives to exercise.ConclusionDeterminants of sedentary and non-sedentary lifestyles were multiple and partially overlapping. Recognizing individual patterns and underlying factors of the sedentary lifestyle is essential for tailored health promotion and interventions.

Disordered eating behavior, health and motives to exercise in young men: cross-sectional population-based MOPO study

BackgroundBeing overweight is an increasing problem among young people, among whom disordered eating behavior is linked with weight problems as well as unhealthy weight control. The aim of the present study was to investigate whether health factors and motives to exercise differ in young men by the type of disordered eating behavior.MethodsThe population-based, cross-sectional MOPO study consisted of 2,096 young Finnish men (mean age 17.9, SD 0.7) attending compulsory call-ups for military service in the Oulu area in 2010, 2011, and 2013. They responded to a questionnaire that included two subscales of the Eating Disorder Inventory-3 indicating drive for thinness and bulimic behavior and questions on health, physical activity, and motives to exercise. The association between disordered eating behavior and related factors was analyzed by binary logistic regression.ResultsAltogether, 6.9xa0% (nu2009=u2009145) of the men had symptoms of disordered eating, i.e., 5.4xa0% had a drive for thinness (nu2009=u2009114) and 3.7xa0% had bulimic behavior (nu2009=u200977). Drive for thinness was associated with a perception of being overweight (OR 3.7; 95xa0% CI 2.2–6.1), poor self-rated health (2.3; 1.2–4.4), more leisure sitting time (1.1; 1.0–1.2), and body-related exercise motives (body acceptance: 3.0; 1.7–5.2; weight loss: 2.5; 1.4–4.4). Bulimic behavior was positively associated with poor self-rated health (2.6; 1.1–5.8) and several motives to exercise, i.e., due to another person’s suggestion (2.8; 1.6–4.8), competitive sports (2.1; 1.2–3.7), body acceptance (2.1; 1.1–3.9), and weight loss (1.9; 1.1–3.3), but inversely associated with health/fitness-related exercise motives (health promotion: 0.3; 0.1–0.5; muscular strength or physical performance: 0.5; 0.2–0.9).ConclusionsIn young men, disordered eating behavior was associated with being overweight, having poor self-rated health, and having a greater amount of leisure sitting time as well as non-health-related motives to exercise. In order to recognize those at risk for disordered eating behavior, evaluating these factors could be beneficial.

Health information literacy and stage of change in relation to physical activity information seeking and avoidance: a population-based study among young men

In this study we investigate young mens seeking and avoidance of physical activity and exercise information. Stage of exercise behavior change as identified in the Transtheoretical Model and everyday health information literacy are studied in relation to these actions. The data were collected with a questionnaire survey (n=1,040) administered at the Finnish Defence Forces’ call‐ups in September‐December 2013 in Oulu, Finland. Statistical analyses include analysis of variance and multivariate logistic regression analysis. The results indicate that stage of exercise behavior change is associated with information seeking on physical activity and exercise, but only vaguely with avoidance of information. By contrast, everyday health information literacy was associated with avoidance of information and not with information seeking. Future studies should look more carefully into the relationship between health information behavior and literacy. Moreover, information behavior in stages of behavior change should be studied in the context of other health behaviors and among other populations.

Detecting and profiling sedentary young men using machine learning algorithms

Many governments and institutions have guidelines for health-enhancing physical activity. Additionally, according to recent studies, the amount of time spent on sitting is a highly important determinant of health and wellbeing. In fact, sedentary lifestyle can lead to many diseases and, what is more, it is even found to be associated with increased mortality. In this study, a data set consisting of self-reported questionnaire, medical diagnoses and fitness tests was studied to detect sedentary young men from a large population and to create a profile of a sedentary person. The data set was collected from 595 young men and contained altogether 678 features. Most of these are answers to multi-choice close-ended questions. More precisely, features were mostly integers with a scale from 1 to 5 or from 1 to 2, and therefore, there was only a little variability in the values of features. In order to detect and profile a sedentary young man, machine learning algorithms were applied to the data set. The performance of five algorithms is compared (quadratic discriminant analysis (QDA), linear discriminant analysis (LDA), C4.5, random forests, and nearest neighbours (kNN)) to find the most accurate algorithm. The results of this study show that when the aim is to detect a sedentary person based on medical records and fitness tests, LDA performs better than the other algorithms, but still the accuracy is not high. In the second part of the study the differences between highly sedentary and non-sedentary young men are searched, recognition can be obtained with high accuracy with each algorithm.

Software Design Principles for Digital Behavior Change Interventions

Using the Internet as a delivery channel has become a popular approach to conducting health promotion interventions, n nand the evidence indicates that such interventions can be effective. In this paper we propose a set n nof design principles and a generic architectural model based on experiences accumulated while developing a n nWeb-based application for a physical activation intervention. The proposed principles address the development n nof an intervention application as an abstract entity, a platform for gathering data for the needs of three n nprincipal stakeholder groups. The principles are derived from the purposes for which the data is gathered and n nthe constraints that may limit the availability of desired data; by observing these principles, developers of intervention n napplications can identify the design trade-offs they need to make to ensure that all stakeholder needs n nare adequately fulfilled. An evolutionary development process is proposed as a way of gradually working n ntoward an application that induces the desired effect on the behavior of the users.