JMIR Publications

ABSTRACT

Background:

Mobile health (mHealth) exercise programs could be a cost-effective approach to broadening accessibility and providing support for physical activity (PA) behavior change, yet the optimal method of delivery of such interventions is still unclear.

Objective:

This study aimed to determine the feasibility and acceptability of an mHealth exercise intervention delivered in 3 ways: health education emails, asynchronous exercise videos or synchronous videoconference exercise classes.

Methods:

Physically inactive (< 30 min/week of exercise) adults (females 31.5 ± 11.3 yr, males 34.1 ± 28.9 yr, mean ± SD) were recruited online and randomized (1:1:1) to 8 weeks of increasing PA behavioral support: Level 1 (health education + objective monitoring, n=26), Level 2 (Level 1 + pre-recorded exercise videos, n=30), or Level 3 (Level 1 + videoconference group exercise with a live instructor, n=28). Participants used a heart rate monitor during exercise and a mobile application for interaction. Primary outcomes were feasibility (accrual, retention and adherence) and acceptability (user experience survey). Secondary outcomes were self-assessed at baseline and 8 weeks and included resting heart rate, PA and quality of life questionnaires, while exercise dose was evaluated throughout the intervention.

Results:

Between August 2020 and August 2021, 204 adults were screened for eligibility. Out of 135 eligible participants, 84 (62%) enrolled in the study. Retention was 50% (13/26) in Level 1, 60% (18/30) in Level 2 and 82% (23/28) in Level 3, while adherence was 31% (8/26) in Level 1, 40% (12/30) in Level 2 and 75% (21/28) in Level 3. Program satisfaction was highest in participants receiving exercise videos (90%, Level 2) or exercise classes (80%, Level 3), while only 63% of Level 1 reported the program as enjoyable. A total of 87% (13/15) of Level 3 would recommend the program, compared to 80% (8/10) in Level 2 and 46% (5/8) in Level 1. Both Level 3 and Level 2 significantly increased self-reported PA from baseline to intervention (p<.05), while Level 3 exercised at significantly higher doses throughout the intervention compared to Level 1 (p<.01). No other significant differences were observed between groups.

Conclusions:

Only the videoconference exercise classes met feasibility criteria, although both videoconference and pre-recorded videos had good acceptability. Future studies are needed to examine the effectiveness of videoconference exercise interventions on health-related outcomes and how asynchronous interventions might maximize adherence. Clinical Trial: ClinicalTrials.gov NCT05192421