Background

Health behavior change interventions delivered by social media allow for real-time, dynamic interaction, peer social support, and experimenter-provided content.

Aims

We tested the feasibility, acceptability, and preliminary efficacy of a novel Twitter-based walking break intervention with daily behavior change strategies and prompts for social support, combined with a Fitbit, vs. Fitbit alone.

Methods

In a 2-group pilot, 45 sedentary women from a heart clinic were randomized to Twitter + Fitbit activity tracker (Tweet4Wellness, n = 23) or Fitbit-only (control, n = 22). All received a Fitbit and 13 weeks of tailored weekly step goals. Tweet4Wellness consisted of a private Twitter support group, with daily automated behavior change “tweets” informed by behavior change theory, and encouragement to communicate within the group. Feasibility outcomes included recruitment and enrollment numbers, implementation challenges, and number and type of help requests from participants throughout the study period. Preliminary efficacy outcomes provided by Fitbit data were sedentary minutes, number of hours with >250 steps, maximum sitting bout, weighted sedentary median bout length, total steps, intensity minutes (>3.0 METS), and ratio of time spent sitting-to-moving. Acceptability outcomes included level of Twitter participation within Tweet4Wellness, and Likert scale plus open-ended survey questions on enjoyment and perceived effectiveness of intervention components. Survey data on acceptability of the features of the intervention were collected at 13 weeks (end-of-treatment [EOT]) and 22 weeks (follow-up).

Results

The study was feasible, with addressable implementation challenges. Tweet4Wellness participants changed significantly from baseline to EOT relative to control participants on number of active hours p = .018, total steps p = .028, and ratio of sitting-to-moving, p = .014. Only sitting-to-moving was significant at follow-up (p = .047). Among Tweet4Wellness participants, each tweet sent during treatment was associated with a 0.11 increase in active hours per day (p = .04) and a 292-step increase per day (p < .001). Tweet4Wellness participants averaged 54.8 (SD = 35.4) tweets, totaling 1304 tweets, and reported liking the accountability and peer support provided by the intervention.

Conclusion

A Twitter-delivered intervention for promoting physical activity among inactive women from a heart clinic was feasible, acceptable, and demonstrated preliminary efficacy in increasing daily active hours, daily total steps, and the ratio of sitting-to-moving from pre to post for the intervention compared with the control. Lessons learned from this pilot suggest that the next study should expand the recruitment pool, refine the intervention to increase group engagement, and select active hours, total steps, and ratio of sitting-to-movement as primary sedentary behavior measures.

中文翻译：

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基于 twitter 的社会支持小组与 Fitbit 的可行性、初步功效和可访问性仅用于减少女性的久坐行为

背景

社交媒体提供的健康行为改变干预允许实时、动态互动、同伴社会支持和实验者提供的内容。

目标

我们测试了基于 Twitter 的新型步行休息干预与日常行为改变策略和社会支持提示的可行性、可接受性和初步功效，并结合 Fitbit 与单独的 Fitbit。

方法

在 2 组试验中，来自心脏诊所的 45 名久坐不动的女性被随机分配到 Twitter + Fitbit 活动跟踪器（Tweet4Wellness，n = 23）或仅 Fitbit（对照，n = 22）。所有人都收到了 Fitbit 和 13 周的量身定制的每周步数目标。Tweet4Wellness 由一个私人 Twitter 支持小组组成，每天自动发布行为改变“推文”，并根据行为改变理论进行通知，并鼓励在小组内进行交流。可行性结果包括招募和入学人数、实施挑战以及整个研究期间参与者提出的帮助请求的数量和类型。Fitbit 数据提供的初步疗效结果是久坐时间、步数 > 250 的小时数、最大坐姿、加权久坐时间中位数、总步数、强度分钟 (>3.0 METS)、以及坐着与移动的时间比率。可接受性结果包括 Twitter 在 Tweet4Wellness 中的参与程度、李克特量表以及关于干预组件的享受和感知有效性的开放式调查问题。在 13 周（治疗结束 [EOT]）和 22 周（随访）收集有关干预特征可接受性的调查数据。

结果

该研究是可行的，具有可解决的实施挑战。相对于对照组参与者，Tweet4Wellness 参与者在活动小时数 p = .018、总步数 p = .028 和坐动比 p = .014 方面从基线到 EOT 发生了显着变化。在随访中，只有坐着移动是显着的（p = .047）。在 Tweet4Wellness 参与者中，治疗期间发送的每条推文都与每天活动时间增加 0.11 小时（p = .04）和每天增加 292 步（p < .001）相关。Tweet4Wellness 参与者平均发布 54.8 (SD = 35.4) 条推文，总计 1304 条推文，并表示喜欢干预提供的问责制和同伴支持。

结论

Twitter 提供的一项干预措施可促进心脏诊所不活跃女性的身体活动，这是可行的、可接受的，并且在增加每日活动时间、每日总步数以及从前到后的坐姿与移动的比例方面显示出初步效果。干预与控制相比。从该试点中汲取的经验表明，下一项研究应扩大招募池，改进干预措施以提高群体参与度，并选择活动时间、总步数和坐姿与活动的比率作为主要的久坐行为衡量标准。