Accepted for/Published in: JMIR Formative Research
Date Submitted: May 5, 2024
Date Accepted: Feb 16, 2025
StepAdd, a Personalized mHealth Intervention to Increase Physical Activity in Japanese Patients with Type 2 Diabetes: A Secondary Analysis of Social Cognitive Theory Measurements of a Single-Arm Pilot Study
ABSTRACT
Background:
A 12-week pilot of the StepAdd mHealth behavior change intervention based on Social Cognitive Theory (SCT) saw an 86.7% increase in mean daily step counts among patients with type 2 diabetes. There is a need to understand the mechanism underlying the behavioral change to inform the future design of digital therapeutics.
Objective:
This study aimed to examine the SCT drivers underlying StepAdd’s mean increase in exercise.
Methods:
This is a post hoc analysis of data collected in the StepAdd pilot for the 32 patients who completed the intervention. StepAdd uses self-mastery and coping strategies to increase self-efficacy and thus increase walking. Self-mastery was measured by goal completion (GC) rate, which is the percentage of days in which patients met these adapting goals. The use of coping strategies were measured by strategy implementation (SI) rate, which is the percentage of days in which patients applied their selected coping strategies. We assessed correlation between GC, SI and self-efficacy to increase walking.
Results:
We found statistically significant support for the SCT approach, including 0.649 correlation between step increase and goal completion rate, 0.497 correlation between the coping strategy implementation rate and self-efficacy increase, and a 0.355 correlation between self regulation increase and step increase, giving us insight into why the behavior intervention succeeded.
Conclusions:
Self-mastery and coping strategies contributed to the walking behavior change in StepAdd, and support the SCT model of behavior change.
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