Poor quality diet and physical inactivity are the most prevalent, preventable causes of death in the United States. In particular, high saturated fat diet (Fat), low fruit and vegetable intake (FV), low physical activity (PA), and high sedentary leisure screen time (Sed) co-occur and heighten the risks of cardiovascular disease and cancers. The first Make Better Choices (MBC1) experiment contrasted four strategies to promote healthful change across these four risk behaviors. Each intervention targeted two behaviors (one diet, one activity) simultaneously and either increased healthy or decreased unhealthy responding. The intervention targeting increased FV and decreased Sed was most efficacious, yielding unexpectedly sustained improvement in three out of the four risk behaviors (FV, Sed, Fat). The proposed MBC2 trial tests the efficacy of MBC intervention to promote sustained, healthful change in diet and activity at 6 and 12 months, as contrasted with an attention control treatment (stress management) . MBC2 also (a) tests competing hypotheses about the optimal way to add PA without undermining maintenance of FV, Sed, and Fat;and (b) examines mediators and biomarkers of healthy lifestyle change. Community dwelling adults (N=250) with suboptimal diet and inactive lifestyle will be randomized to: 1) Sequential MBC (FV+ Sed-, followed by PA+), 2) Simultaneous MBC (FV+Sed-PA+), or 3) Control (stress management). All will use a smart phone with behavioral decision support tools to self- monitor and transmit data and will be coached by telephone. The Mastery hypothesis, based upon theories of self-regulatory strength and habit, predicts superior healthy change for sequential intervention, mediated by greater habit strength for healthy eating and activity. The Synergy hypothesis, based upon goal systems theory, predicts best outcome from simultaneous intervention, mediated by the establishment of a superordinate healthy lifestyle goal. Results of the MBC2 trial will shed light on mechanisms that underlie healthy change in prevalent risk behaviors. If successful, the trial also will result in an innovative, highly disseminable technology-supported minimal counseling intervention to address the modal American unhealthy diet and sedentary lifestyle.
The average adult has a poor quality diet and sedentary lifestyle, but the best way to produce sustained healthy change remains unknown. Make Better Choices treatment uses handheld technology to help people monitor and transmit information about their eating and activity to a personal coach. The proposed trial tests whether Make Better Choices treatment improves diet and activity more than stress management does and whether it is better to add new lifestyle goals all at once or one after another.
|Spring, Bonnie; Pellegrini, Christine; McFadden, H G et al. (2018) Multicomponent mHealth Intervention for Large, Sustained Change in Multiple Diet and Activity Risk Behaviors: The Make Better Choices 2 Randomized Controlled Trial. J Med Internet Res 20:e10528|
|Welch, Whitney A; Spring, Bonnie; Phillips, Siobhan M et al. (2018) Moderating Effects of Weather-Related Factors on a Physical Activity Intervention. Am J Prev Med 54:e83-e89|
|Siddique, Juned; de Chavez, Peter John; Craft, Lynette L et al. (2017) The Effect of Changes in Physical Activity on Sedentary Behavior: Results From a Randomized Lifestyle Intervention Trial. Am J Health Promot 31:287-295|
|Manini, Todd M; Beavers, Daniel P; Pahor, Marco et al. (2017) Effect of Physical Activity on Self-Reported Disability in Older Adults: Results from the LIFE Study. J Am Geriatr Soc 65:980-988|
|Conroy, David E; Hedeker, Donald; McFadden, H G et al. (2017) Lifestyle intervention effects on the frequency and duration of daily moderate-vigorous physical activity and leisure screen time. Health Psychol 36:299-308|
|Schneider, Kristin L; Coons, Michael J; McFadden, H Gene et al. (2016) Mechanisms of Change in Diet and Activity in the Make Better Choices 1 Trial. Health Psychol :|
|Kheirkhahan, Matin; Tudor-Locke, Catrine; Axtell, Robert et al. (2016) Actigraphy features for predicting mobility disability in older adults. Physiol Meas 37:1813-1833|
|Wilson, Kristina; Senay, Ibrahim; Durantini, Marta et al. (2015) When it comes to lifestyle recommendations, more is sometimes less: a meta-analysis of theoretical assumptions underlying the effectiveness of interventions promoting multiple behavior domain change. Psychol Bull 141:474-509|
|Poncela-Casasnovas, Julia; Spring, Bonnie; McClary, Daniel et al. (2015) Social embeddedness in an online weight management programme is linked to greater weight loss. J R Soc Interface 12:20140686|
|Pellegrini, Christine A; Pfammatter, Angela F; Conroy, David E et al. (2015) Smartphone applications to support weight loss: current perspectives. Adv Health Care Technol 1:13-22|
Showing the most recent 10 out of 30 publications