Currently submitted to: JMIR mHealth and uHealth
Date Submitted: May 29, 2019
Open Peer Review Period: Jun 3, 2019 - Jul 18, 2019
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Improving Pacific adolescents’ physical activity towards international recommendations: exploratory study of a digital education app coupled with activity trackers
The prevalence of overweight and obesity in children and adolescents has dramatically increased in the Pacific region over the last decade. Childhood overweight and obesity are likely to lead to noncommunicable diseases (NCDs) in adulthood. A major contributing factor to the rising prevalence is the insufficient amount of daily moderate to vigorous physical activity (MVPA). In the Pacific region, less than 50% of children and adolescents meet the recommendations of 11000 steps and 60 minutes of MVPA per day. Whilst studies have shown the potential of digital technologies to change behaviours, none has been proposed to guide adolescents towards achieving these international recommendations.
We propose a technology-supported educational program that includes objective measures of physical activity (PA) components and self-assessment of goal achievement, helps Pacific adolescents to meet the international PA recommendations. We also created data-mining techniques to provide a more detailed analysis of PA behaviour changes.
Twenty-four adolescents, 12-14 years old, participated in a 4-week program comprising eight 1-hour modules to develop health literacy and physical skills. This self-paced user-centred program was delivered via an app and provided learning content and goal-setting and self-assessment tasks. PA performed during the 4-week program was captured with an activity tracker to support learning and help the adolescents self-assess their achievements against personal goals. The data were analysed using a consistency rate and daily behaviour clustering to reveal any PA changes, particularly regarding adherence to international recommendations.
The consistency rate of daily steps revealed that the adolescents reached 11,000 steps per day 48.1% of the time in the first week of the program (~3.4 days per week) and this peaked at 59% (~4.1 days per week) toward program end. PA showed an overall increase during the program, particularly in the less active adolescents, who increased their daily steps by 15.6% and ultimately reached 11,000 steps more frequently. The consistency of daily behaviour clustering showed a 27% increase in adherence to international recommendations in the least active adolescents.
Technology-supported educational programs that include self-monitored PA via activity trackers can be successfully delivered to adolescents in schools in remote Pacific areas. New data-mining techniques enable innovative analyses of PA engagement based on the international recommendations.
The protocol was approved by the ethics committee of the University of New Caledonia and the consultative ethics committee for New Caledonia (CEC-NC03-2016).
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