JMIR Publications

ABSTRACT

Background:

Regular exercise may counteract obesity-related health risks, but adherence is low among individuals with obesity. Personal trainers may positively influence exercise behavior by providing motivational support. Individuals who receive regular exercise coaching are more likely to adhere to their exercise routine, compared with those who exercise individually. However, investing in personalized exercise guidance, such as a personal trainer, can be expensive and rigid . Thus, integrating online coaching could be a more economically sustainable option, offering both flexibility and reduced costs compared with in-person coaching.

Objective:

Our 20-week pragmatic randomized controlled trial aimed to investigate the effect of weekly in-person coaching compared with two combinations of in-person and online coaching on five psychosocial factors in obese (BMI ≥30) women.

Methods:

Participants were invited through Facebook and Instagram advertisements posted by various fitness clubs across rural and urban locations in Norway (seven different counties and 12 different municipalities). Low-active women (n = 188, <150 minutes of moderate-intensity physical activity/week) were allocated into three groups of in-person coaching: weekly (n=47), twice weekly (n=47), once monthly (n=47), and as controls (n=47). Those with in-person coaching twice and once monthly received online coaching of 15 minutes during weeks without in-person coaching. Data included background variables, motivation (BREQ-2), barriers, self-efficacy (The Self-Efficacy Survey), social support (Social Support Questionnaire), and health-related quality of life (SF-36).

Results:

A total of 120 (64.0%) completed baseline and post-intervention assessments. A minor difference was observed in one item of the SF-36, where all intervention groups reported a greater "change in health last year" than the control group (mean diff: 14.2-17.1, P = ≤.01). No other effects were found on selected psychosocial factors. It should be noted that controls reported higher intrinsic motivational regulation at baseline than intervention groups (mean diff: 0.43-0.93, P = ≤.05). All intervention arms exercised more frequently than controls (P = ≤.001), with no differences in weekly exercise frequency between the three intervention arms (P = .30).

Conclusions:

We found no effects on motivation, barriers, self-efficacy, perceived social support, or other health domains compared with controls. All intervention groups reported a slight improvement in self-perceived health in one of the eight subscales of SF-36. Combined in-person and online coaching may give a minor improvement in self-perceived health in obese women. However, the lack of impact on motivation, barriers, and self-efficacy warrants further research. Clinical Trial: ClinicalTrials.gov NCT05792657.