PDF(Pubmed)
Abstract：
A healthy lifestyle may improve mental health. It is yet not known whether and how a mobile intervention can be of help in achieving this in adolescents. This study investigated the effectiveness and perceived underlying mechanisms of the mobile health (mHealth) intervention #LIFEGOALS to promote healthy lifestyles and mental health. #LIFEGOALS is an evidence-based app with activity tracker, including self-regulation techniques, gamification elements, a support chatbot, and health narrative videos.
A quasi-randomized controlled trial (N = 279) with 12-week intervention period and process evaluation interviews (n = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention (n = 184) or to a no-intervention group (n = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis.
Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity (χ21 = 4.36, P = .04), sedentary behavior (χ21 = 6.44, P = .01), sleep quality (χ21 = 6.11, P = .01), and mood (χ21 = 2.30, P = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL (χ22 = 14.72, P < .001), mood (χ21 = 6.03, P = .01), and peer support (χ21 = 13.69, P < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness.
#LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes.
ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.
A quasi-randomized controlled trial (N = 279) with 12-week intervention period and process evaluation interviews (n = 13) took place during the COVID-19 pandemic. Adolescents (12-15y) from the general population were allocated at school-level to the intervention (n = 184) or to a no-intervention group (n = 95). Health-related quality of life (HRQoL), psychological well-being, mood, self-perception, peer support, resilience, depressed feelings, sleep quality and breakfast frequency were assessed via a web-based survey; physical activity, sedentary time, and sleep routine via Axivity accelerometers. Multilevel generalized linear models were fitted to investigate intervention effects and moderation by pandemic-related measures. Interviews were coded using thematic analysis.
Non-usage attrition was high: 18% of the participants in the intervention group never used the app. An additional 30% stopped usage by the second week. Beneficial intervention effects were found for physical activity (χ21 = 4.36, P = .04), sedentary behavior (χ21 = 6.44, P = .01), sleep quality (χ21 = 6.11, P = .01), and mood (χ21 = 2.30, P = .02). However, effects on activity-related behavior were only present for adolescents having normal sports access, and effects on mood only for adolescents with full in-school education. HRQoL (χ22 = 14.72, P < .001), mood (χ21 = 6.03, P = .01), and peer support (χ21 = 13.69, P < .001) worsened in adolescents with pandemic-induced remote-education. Interviewees reported that the reward system, self-regulation guidance, and increased health awareness had contributed to their behavior change. They also pointed to the importance of social factors, quality of technology and autonomy for mHealth effectiveness.
#LIFEGOALS showed mixed results on health behaviors and mental health. The findings highlight the role of contextual factors for mHealth promotion in adolescence, and provide suggestions to optimize support by a chatbot and narrative episodes.
ClinicalTrials.gov [NCT04719858], registered on 22/01/2021.
摘要：
背景：健康的生活方式可以改善心理健康。目前尚不清楚移动干预是否以及如何帮助青少年实现这一目标。这项研究调查了移动健康（mHealth）干预#LIFEGOALS促进健康生活方式和心理健康的有效性和感知的潜在机制。#LIFEGOALS是一个基于证据的应用程序，带有活动跟踪器，包括自我调节技术，游戏化元素，一个支持聊天机器人，和健康叙事视频。
方法：在COVID-19大流行期间进行了一项准随机对照试验（N=279），包括12周的干预期和过程评估访谈（n=13）。来自普通人群的青少年（12-15岁）在学校一级被分配到干预组（n=184）或无干预组（n=95）。健康相关生活质量（HRQoL），心理健康，心情,自我感知，同行支持，弹性，抑郁的感觉,睡眠质量和早餐频率是通过一项基于网络的调查进行评估的；身体活动，久坐的时间，和睡眠程序通过加速度传感器。拟合了多级广义线性模型，以通过与大流行相关的措施来研究干预效果和适度。访谈使用主题分析进行编码。
结果：非使用减员率很高：干预组中有18％的参与者从未使用过该应用程序。另外30％的人在第二周停止使用。发现对身体活动有益的干预效果（χ21=4.36，P=.04），久坐行为（χ21=6.44，P=0.01），睡眠质量(χ21=6.11，P=0.01)，和情绪（χ21=2.30，P=.02）。然而,对活动相关行为的影响仅存在于具有正常运动机会的青少年，以及对情绪的影响仅适用于接受全面学校教育的青少年。HRQoL（χ22=14.72，P<.001），情绪(χ21=6.03，P=0.01)，大流行引起的远程教育青少年的同伴支持（χ21=13.69，P<.001）恶化。受访者报告说，奖励制度，自我调节指导，健康意识的提高有助于他们的行为改变。他们还指出了社会因素的重要性，技术质量和自主性，提高mHealth有效性。
结论：#LIFEGOALS在健康行为和心理健康方面表现出不同的结果。研究结果强调了环境因素在青春期mHealth促进中的作用，并提供建议以优化聊天机器人和叙事情节的支持。
背景：ClinicalTrials.gov[NCT04719858]，于2021年1月22日注册。
方法：在COVID-19大流行期间进行了一项准随机对照试验（N=279），包括12周的干预期和过程评估访谈（n=13）。来自普通人群的青少年（12-15岁）在学校一级被分配到干预组（n=184）或无干预组（n=95）。健康相关生活质量（HRQoL），心理健康，心情,自我感知，同行支持，弹性，抑郁的感觉,睡眠质量和早餐频率是通过一项基于网络的调查进行评估的；身体活动，久坐的时间，和睡眠程序通过加速度传感器。拟合了多级广义线性模型，以通过与大流行相关的措施来研究干预效果和适度。访谈使用主题分析进行编码。
结果：非使用减员率很高：干预组中有18％的参与者从未使用过该应用程序。另外30％的人在第二周停止使用。发现对身体活动有益的干预效果（χ21=4.36，P=.04），久坐行为（χ21=6.44，P=0.01），睡眠质量(χ21=6.11，P=0.01)，和情绪（χ21=2.30，P=.02）。然而,对活动相关行为的影响仅存在于具有正常运动机会的青少年，以及对情绪的影响仅适用于接受全面学校教育的青少年。HRQoL（χ22=14.72，P<.001），情绪(χ21=6.03，P=0.01)，大流行引起的远程教育青少年的同伴支持（χ21=13.69，P<.001）恶化。受访者报告说，奖励制度，自我调节指导，健康意识的提高有助于他们的行为改变。他们还指出了社会因素的重要性，技术质量和自主性，提高mHealth有效性。
结论：#LIFEGOALS在健康行为和心理健康方面表现出不同的结果。研究结果强调了环境因素在青春期mHealth促进中的作用，并提供建议以优化聊天机器人和叙事情节的支持。
背景：ClinicalTrials.gov[NCT04719858]，于2021年1月22日注册。
