The Efficacy of an Internet-based Behavioural Intervention for Physical Activity Promotion among University Students
Fung Lin Elean Leung, The Chinese University of Hong Kong , Hong Kong
The Chinese University of Hong Kong . Awarded
Despite the numerous health benefits associated with regular physical activity (PA), an obvious decline in PA during the transition from secondary school to university has been reported (Bray & Born, 2004). Most university students have easy access to the Internet and are technologically savvy about computer and Internet use. Using of the Internet to promote PA in university campus settings is promising but the efficacy is unknown. Two randomized controlled trials were conducted in this thesis to examine the efficacy of the Internet for PA promotion among university students in Hong Kong.
In study 1 (Chapter 3), the effectiveness of the Internet-based behavioural intervention for PA promotion among university students was examined. A total of 111 Hong Kong university students were randomly assigned to one of the three groups, namely, Internet-based group (IB), print-based group (PB), and control group (C). Both the IB and PB groups received the same program materials, i.e. the 14-week PA behaviour change program entitled “Active Living Every Day (ALED)” (Blair et al., 2001), but through different delivery media (online programme for the IB group and face-to-face class for the PB group). Group C did not receive any intervention program. The assessments of PA level (by International Physical Activity Questionnaire, IPAQ) and stage of change (by Stage of Exercise Change Questionnaire, SECQ) were conducted at baseline, third and sixth month of the intervention. Increased total PA scores (p < 0.05) were found in the PB and IB groups at the 3rd and 6th month assessments; there was no difference ( p > 0.05) in changes of total PA scores between the intervention groups.
An increase in number of participants meeting the ACSM/AHA criteria of sufficient PA was found in the IB group (Z = 2.646, p < 0.05) at the 3rd month assessment. Improvement in stage of change was only found in the IB group (Z = 3.288, p < 0.05) at the 3rd month assessment. Improvements in stage of change were found in both the PB group (Z = 3.026, p < 0.05) and the IB group (Z = 2.766, p < 0.05) at the 6th month assessment. The results suggested that the Internet-based intervention was as effective as the print-based intervention in PA promotion among university students in Hong Kong.
Whether standard Internet was as effective as the tailored-Internet for PA promotion was inconclusive. In order to test for the efficacy of the standard Internet in relation to the tailored-Internet for PA promotion, the medium of delivery was controlled in study 2 (Chapter 4). This study implemented mixed research methodology by using both quantitative (online questionnaire) and qualitative (face-to-face semi-structured interviews) data collection means. The use of this design allowed the qualitative results to connect and expand on the quantitative findings in order to have a better understanding of the mechanisms by which the intervention programmes worked.
A total of 161 Hong Kong university students were randomly assigned to one of the three groups, namely, public access Internet group (PAI), stage-targeted Internet group (STI), and control group (C). Participants of the PAI group received a Web page containing links to five publicly available websites relating to PA. Participants of the STI group received the ALED online programme (Blair et al., 2001). Group C did not receive any intervention program. The assessments of PA level (by IPAQ), stage of change (by SECQ) and exercise self-efficacy (by Self-efficacy Questionnaire, SEQ) were conducted at baseline, third and sixth month of the intervention.
Increased total PA scores were only found in the STI group ( F [1,48] = 9.965, p < 0.05) at the 3rd month assessment. There were no significant changes (p > 0.05) in the numbers of participants meeting the ACSM/AHA criteria of sufficient PA found in all groups at the 3rd and 6th month assessments. Improvements in stage of change were found in the STI group (Z = 2.379, p < 0.05) at the 3rd month assessment and in both the PAI group (Z= 2.351, p < 0.05) and the STI group (Z = 2.013, p < 0.05) at the 6th month assessment. Decreased mean self-efficacy scores were found in the PAI group at the 3rd (F [1,50] = 6.130, p < 0.05) and 6th month (F [1, 50] = 4.659, P < 0.05) assessments respectively.
Three focus group interviews were conducted, a total of 15 participants were interviewed, and qualitative data were collected. The contents of the public access web sites could not arouse the PAI group participants' interest to read through the details and hence did not help in increasing their PA levels and stages of exercise change. The ALED course contents facilitated the STI group participants to increase their PA levels by leading them to set their own exercise goals and by emphasizing the importance and health benefits of regular PA. Both the ALED course contents and assessment questionnaires had positive influences on stages of exercise changes of the STI group participants. The participants in the PAI and the STI groups did not perceive any positive influences from the intervention contents on their exercise self-efficacy. In addition, participants in all groups commented that the campus environment and sports facilities were useful in increasing chances of PA participation.
The results suggested that participants in the PAI group did not demonstrate improvement in PA to the same extent as their counterparts in the STI group. The public access websites were not effective for PA promotion among university students. The STI intervention was effective in elevating the PA level of the university students, however, the influence was rather short term, and the effect disappeared at the 6th month assessment.
The findings of current studies can provide evidence-based support for the efficacy of using stage-tailored Internet to promote PA among university students in Hong Kong. Future Internet-based PA research might focus on the long-term PA participation enhancement. Future design of PA promotion websites may not only focus on information dissemination but on experience-sharing and social interaction. This might be crucial for enhancing the rate of retention of participants.
Leung, F.L.E. The Efficacy of an Internet-based Behavioural Intervention for Physical Activity Promotion among University Students. Ph.D. thesis, The Chinese University of Hong Kong.
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