Effects of a Web-Based, Evolutionary Mismatch-Framed Intervention Targeting Physical Activity and Diet: a Randomised Controlled Trial

Int J Behav Med. 2019 Dec;26(6):645-657. doi: 10.1007/s12529-019-09821-3.

Abstract

Background: This study sought to test the effectiveness of a 12-week, novel online intervention (Evolife) aiming to increase physical activity level (PAL) and reduce energy intake (EI) among overweight/obese adults. The intervention used an evolutionary mismatch message to frame health information in an engaging way, incorporating evidence-based behaviour change techniques to promote autonomous motivation, self-efficacy and self-regulatory skills.

Method: Men and women aged 35-74 years with a BMI of 25-40 kg/m2 were eligible. Participants were randomised to receive either the intervention (comprising a face-to-face introductory session, 12 weeks' access to the Evolife website and a pedometer) or a control condition (face-to-face introductory session and NHS online health resources). PAL was measured objectively and EI was self-reported using 3-day weighed food records. Secondary measures included BMI, waist circumference and blood pressure.

Results: Sixty people met inclusion criteria; 59 (30 intervention) completed the trial (mean age = 50; 56% male). Differences between groups' change scores for PAL and EI were of small effect size but did not reach significance (d = 0.32 and d = - 0.49, respectively). Improvements were found in both groups for PAL (int: d = 0.33; control: d = 0.04), EI (int: d = - 0.81; control: d = - 0.16), waist circumference (int: d = - 0.30; control: d = - 0.17) and systolic blood pressure (int: d = - 0.67; control: d = - 0.28).

Conclusion: The intervention did not lead to significantly greater improvement in PAL or reduction in EI than a minimal intervention control, although the changes in the intervention group were of meaningful effect size and comparable with positive outcomes in larger intervention trials.

Trial registration: This trail was registered on www.clinicaltrials.gov on 16 January 2017 (appeared online 26 January 2017), reference NCT03032731.

Keywords: Behaviour change; Diet; Physical activity; Randomised controlled trial; Web-based intervention.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Behavior Therapy / methods*
  • Blood Pressure
  • Diet, Reducing / psychology*
  • Energy Intake
  • Exercise / psychology*
  • Female
  • Humans
  • Internet-Based Intervention*
  • Male
  • Middle Aged
  • Motivation
  • Obesity / psychology
  • Obesity / therapy*
  • Overweight / psychology
  • Overweight / therapy*
  • Self Efficacy
  • Self Report
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT03032731