Cited by 241Mobile Health and mHealth ApplicationsPhysical Activity and HealthDigital Mental Health Interventions

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Efficacy of Contextually Tailored Suggestions for Physical Activity: A Micro-randomized Optimization Trial of HeartSteps

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Klasnja, Predrag, Smith, Shawna, Seewald, Nicholas J, Lee, Andy, Hall, Kelly, Luers, Brook, Hekler, Eric B, Murphy, Susan A·2019·Annals of Behavioral Medicine

DOI 10.1093/abm/kay067PMC PMC6401341

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Abstract

BACKGROUND: HeartSteps is an mHealth intervention that encourages regular walking via activity suggestions tailored to the individuals' current context. PURPOSE: We conducted a micro-randomized trial (MRT) to evaluate the efficacy of HeartSteps' activity suggestions to optimize the intervention. METHODS: We conducted a 6-week MRT with 44 adults. Contextually tailored suggestions could be delivered up to five times per day at user-selected times. At each of these five times, for each participant on each day of the study, HeartSteps randomized whether to provide an activity suggestion, and, if so, whether to provide a walking or an antisedentary suggestion. We used a centered and weighted least squares method to analyze the effect of suggestions on the 30-min step count following suggestion randomization. RESULTS: Averaging over study days and types of activity suggestions, delivering a suggestion versus no suggestion increased the 30-min step count by 14% (p = .06), 35 additional steps over the 253-step average. The effect was not evenly distributed in time. Providing any type of suggestion versus no suggestion initially increased the step count by 66% (167 steps; p < .01), but this effect diminished over time. Averaging over study days, delivering a walking suggestion versus no suggestion increased the average step count by 24% (59 steps; p = .02). This increase was greater at the start of study (107% or 271 additional steps; p < .01), but decreased over time. Antisedentary suggestions had no detectable effect on the 30-min step count. CONCLUSION: Contextually tailored walking suggestions are a promising way of initiating bouts of walking throughout the day. CLINICAL TRIAL INFORMATION: This study was registered on ClinicalTrials.gov number NCT03225521.

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Authors: Klasnja, P., Smith, S., Seewald, N. J., Lee, A., Hall, K., Luers, B., Hekler, E. B., & Murphy, S. A.
Affiliations: Kaiser Permanente Washington Health Research Institute (US)
University of Michigan (US)
School of Information, University of Michigan, Ann Arbor, MI, USA
Department of Statistics, University of Michigan, Ann Arbor, MI, USA
University of California San Diego (US)
Harvard University (US)
Corresponding author: Klasnja, Predrag
ORCID: Klasnja, Predrag
Smith, Shawna
Seewald, Nicholas J
Luers, Brook
Hekler, Eric B
Murphy, Susan A
Venue: Annals of Behavioral Medicine
Publisher: Oxford University Press (OUP)
Published: 2018-09-05
Volume: 53
Issue: 6
Pages: 573-582
ISSN: 0742-5554 (ISSN-L)
0883-6612
1532-4796
DOI: 10.1093/abm/kay067
PMC: PMC6401341
OpenAlex: W2890071448
Cited by: 241
References: 32
Citations by year: 2026: 40 · 2025: 25 · 2024: 39 · 2023: 33 · 2022: 31 · 2021: 24 · 2020: 30 · 2019: 16 · 2018: 2
FWCI: 27.49
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Annals of Behavioral Medicine (publishedVersion)
Europe PMC (PubMed Central) (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (R01AA023187, P50DA039838, U54EB020404)
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords: mobile health intervention, walking, physical activity, step count, sedentary behavior, micro-randomized trial, intervention optimization
MeSH terms: Adult, Female, Health Promotion, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Walking, Telemedicine

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Efficacy of Contextually Tailored Suggestions for Physical Activity: A Micro-randomized Optimization Trial of HeartSteps

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