Changes in the Use Intention of Digital Wellness Technologies and Its Antecedents Over Time: The Use of Physical Activity Logger Applications Among Young Elderly in Finland

There is consensus in health studies that regular physical activities of sufficient intensity and duration contribute to better health both in the short and long term. We have worked on getting young elderly, the 60–75 years age group, to adopt and include physical activities as part of their daily routines. One reason for addressing young elderly is large numbers – they are now 18–22% of the population in most EU countries (80–100 million citizens). A second reason is that regular health-enhancing physical activities (HEPA) can serve as preventive health care, which will improve and sustain quality of life and save health-care costs for the ageing population. We have learned that the adoption of digital services, which are modern implementations of DSS technology, can be instrumental for building sustainable HEPA programs. We also found out – a bit surprisingly – that digital applications on mobile phones are readily accepted and adopted by the young elderly (“no problems with understanding and learning to use the application”) when they are tailored to meaningful purposes and a context that is relevant for the young elderly.

P69 Intent to Change Surveys: A Promising and Practical Approach for Evaluating Adult Single-Session Education

A Daily Process Analysis of Intentions and Physical Activity in College Students

PurposePrevious research has not examined the utility of the Health Action Process Approach (HAPA) to predict physical activity (PA) change in cancer survivors. The aim of the study was to investigate the efficacy of a HAPA-based model in predicting temporal change in moderate-to-vigorous physical activity (MVPA) in cancer survivors.MethodsParticipants enrolled in the Wearable Activity Technology and Action Planning (WATAAP) trial completed validated questionnaires (n = 64) to assess HAPA constructs (action and maintenance self-efficacy, outcome expectancies, action planning, risk perceptions, and intention) and wore an ActiGraph to measure PA at baseline, 12 weeks, and 24 weeks later. Data were analyzed using variance-based structural equation modeling with residualized change scores for model variables.ResultsConsistent with predictions, changes in action self-efficacy (β = 0.490, p < 0.001, ES = 0.258) and risk perceptions (β = 0.312, p = 0.003, ES = 0.099) were statistically significant predictors of intention change over time. Changes in intention (β = 0.217, p = 0.029, ES = 0.040) and action planning (β = 0.234, p = 0.068, ES = 0.068) predicted changes in MVPA. Overall, the model accounted for significant variance in intention (R2 = 0.380) and MVPA (R2 = 0.228) change.ConclusionsChanges in intention and action planning were important correlates of MVPA change over 24 weeks. Further, changes in action self-efficacy and risk perceptions predicted changes in intention. Implications for cancer survivors: interventions that foster risk perceptions and self-efficacy, strengthen intentions, and promote action planning may be effective in promoting sustained PA change in cancer survivors.

There is no known research examining the use of strategic messages to motivate youth with physical disabilities (YWPD), or how to create effective messages for them. Guided by the Social Issue Advertising Believability Model (SIABM), the study aimed to: (i) examine the effectiveness of physical activity (PA) messages on YWPD’s attitudes and intentions to participate in PA, and (ii) consider factors related to message effectiveness. YWPD (N = 60) were randomized to view one of three PA messages: (a) no youth, (b) non-inclusive, and (c) targeted. Attitudes and intentions to participate in PA were assessed at baseline and immediately following viewing one of the three messages. Participants also evaluated the messages in terms of relevance, believability, attention, and attitudes. Repeated measures ANOVA and median split analyses indicated that attitudes toward PA increased after message viewing for participants with low baseline attitudes, but decreased for participants with high baseline attitudes. No significant changes in intentions emerged. The targeted message was most preferred and evaluated as most believable. Attention paid to the message was the only significant predictor of intention to participate in PA post-viewing (p = .001). PA campaigns should consider being inclusive of YWPD with low attitudes and intentions to engage in PA when developing messages.

To address a desire for timely, medically-accurate cancer education in rural Alaska, ten culturally-relevant online learning modules were developed, implemented, and evaluated with, and for, Alaska's Community Health Aides/Practitioners (CHA/Ps). The project was guided by the framework of Community-Based Participatory Action Research, honored Indigenous Ways of Knowing, and was informed by Empowerment Theory. Each learner was invited to complete an end-of-module evaluation survey. The survey asked about changes in intent to share cancer information with patients as a result of the module. In 1year, August 1, 2016-July 31, 2017, 459 surveys were completed by 79 CHA/Ps. CHA/Ps reported that, because of the modules, they felt more knowledgeable about cancer, and more comfortable, confident, and prepared to talk about cancer with their patients, families, and communities. All learners shared that because of the modules, they intended to talk with their patients more often about cancer screenings, tobacco cessation, physical activity, or nutrition. These findings suggest that the application of this collaboratively developed, culturally-relevant, health promotion intervention has supported increased CHA/P capacity and intent to interact with patients about cancer. In the words of a learner: "Doing all these courses makes me a ton times more comfortable in talking about cancer with anyone. I didn't know too much about it at first but now I know a whole lot. Thank you".

BackgroundCardiovascular imaging interventions are widely used to convey messages regarding cardiovascular disease risk, individual capability to adopt lifestyle changes, and the potential benefits of adhering to therapy or behaviour change....

Limited research has identified theoretical correlates of physical activity (PA) change in patients not receiving cardiac rehabilitation. The purpose of the present study was to determine whether changes in self-efficacy, PA intention, perceived severity and susceptibility, and PA benefits/barriers were associated with changes in PA over a 12-month period in these patients. Patients (N = 555) not attending cardiac rehabilitation completed a psychosocial questionnaire in hospital and 6 and 12 months after hospitalization for a cardiac event. Hierarchical regression analyses showed that the increase in PA from baseline to 6 months was significantly related to an increase in self-efficacy and PA intentions and a decrease in the impact of health-related barriers. Furthermore, the decrease in PA from 6 to 12 months was significantly related to a decrease in health-related benefits and PA intentions and an increase in time and health-related barriers. Finally, the increase in PA from baseline to 12 months was significantly related to an increase in health-related benefits and intentions and a decrease in health-related barriers. Changes in PA levels over a 12-month period were associated with changes in various theoretical variables. Interestingly, the associations among these variables with PA varied as a function of time after hospitalization.

Genetic testing for chronic disease susceptibility may motivate young adults for preventive behavior change. This nationally representative survey gave 521 young adults hypothetical scenarios of receiving genetic susceptibility results for heart disease, type 2 diabetes, and stroke and asked their (1) interest in such testing, (2) anticipated likelihood of improving diet and physical activity with high- and low-risk test results, and (3) readiness to make behavior change. Responses were analyzed by presence of established disease-risk factors. Respondents with high phenotypic diabetes risk reported increased likelihood of improving their diet and physical activity in response to high-risk results compared with those with low diabetes risk (odds ratio (OR), 1.82 (1.03, 3.21) for diet and OR, 2.64 (1.24, 5.64) for physical activity). In contrast, poor baseline diet (OR, 0.51 (0.27, 0.99)) and poor physical activity (OR, 0.53 (0.29, 0.99)) were associated with decreased likelihood of improving diet. Knowledge of genetic susceptibility may motivate young adults with higher personal diabetes risk for improvement in diet and exercise, but poor baseline behaviors are associated with decreased intention to make these changes. To be effective, genetic risk testing in young adults may need to be coupled with other strategies to enable behavior change.

ABSTRACTMotivation is a proximal determinant of behaviour, and increasing motivation is central to most health behaviour change interventions. This systematic review and meta-analysis sought to identify features of physical activity interventions associated with favourable changes in three prominent motivational constructs: intention, stage of change and autonomous motivation. A systematic literature search identified 89 intervention studies (k = 200; N = 19,212) which assessed changes in these motivational constructs for physical activity. Intervention descriptions were coded for potential moderators, including behaviour change techniques (BCTs), modes of delivery and theory use. Random effects comparative subgroup analyses identified 18 BCTs and 10 modes of delivery independently associated with changes in at least one motivational outcome (effect sizes ranged from d = 0.12 to d = 0.74). Interventions delivered face-to-face or in gym settings, or which included the BCTs ‘behavioural goal setting’, ‘self-monitoring (behaviour)’ or ‘behavioural practice/rehearsal’, or which combined self-monitoring (behaviour) with any other BCT derived from control theory, were all associated with beneficial changes in multiple motivational constructs (effect sizes ranged from d = 0.12 to d = 0.46). Meta-regression analyses indicated that increases in intention and stage of change, but not autonomous motivation, were significantly related to increases in physical activity. The intervention characteristics associated with changes in motivation seemed to form clusters related to behavioural experience and self-regulation, which have previously been linked to changes in physical activity behaviour. These BCTs and modes of delivery merit further systematic study, and can be used as a foundation for improving interventions targeting increases in motivation for physical activity.

Childhood obesity remains a critical public health concern among Hispanic families in Mexico and the United States. Healthy Change, a brief peer-led programme delivered in childcare centres, was designed to increase mothers' awareness of child weight status and support healthier feeding practices. Embedded within a cluster randomized trial, this qualitative study examined experiences of Mexican and Mexican American mothers in the intervention arm. Four post-intervention focus groups were conducted at intervention sites (n= 25), and transcripts were analysed using inductive content analysis. Mothers reported favourable impressions, emphasizing practical advice, relatable peer facilitators, and a supportive group atmosphere. Many described initial shock or discomfort on learning that their child was overweight, followed by greater recognition of risk and intentional changes in family diet, routines, and opportunities for physical activity. Participants also identified needs for broader content, clearer communication, and some professional involvement to complement peer support. Family encouragement and involvement facilitated change, whereas competing schedules and communication gaps hindered participation. Findings suggest that peer-led programmes in childcare settings are feasible, acceptable, and capable of supporting healthier family lifestyles. Such interventions may offer a resource-efficient approach to strengthening maternal awareness and advancing early childhood obesity prevention in diverse communities.

Mass media campaigns are conducted to influence community norms around health behaviours, including physical activity. Campaigns can reach large populations at relatively low cost, to influence awareness, knowledge and beliefs through to intention and behaviour change. We reviewed 15 campaigns with an explicit focus on physical activity, and explored impacts upon a range of proximal and distal variables. Campaigns achieved high recall, with a median of 70% of the target group aware of the campaign. Increases in knowledge or attitudes to physical activity were found among half the campaigns that reported this measure. Few campaigns reported other proximal variables, such as saliency, beliefs, self-efficacy or behavioural intention. Increases in physical activity were reported among motivated sub-groups of volunteers, but few campaigns reported population increases in activity. Campaigns increase awareness of the issue of physical activity but may not have a population-level effect on behaviour. Campaigns should focus more on influencing proximal variables, such as social norms, to bring about long-term behaviour change. This should be seen as part of a broader strategy, including policy and environmental change. Evaluation designs that measure the full range of variables are preferred to an over-concentration on behaviour alone.

`I'm doing a physics that is pulling me towards it.' `I like the course being more up to date.' `You learn the physics but you also think ``well I actually see a point in knowing this physics''.' `This course presents physics in a more interesting way as it focuses on practical activity and applications of physics.' `The industrial visit gives students the opportunity to look for science in action.' These are just some of the comments from students and teachers piloting the new Salters Horners Advanced Physics course (SHAP). Contexts and applications drive the course, providing interest and motivation for students and alerting them to some of the many career areas that involve physics. For example, the operation of a CD player leads to a study of waves and superposition; archaeological surveying and analysis brings in d.c. circuitry and x-ray diffraction; consideration of safety in rail transport involves learning about mechanics and electromagnetism. The course is produced by a team directed from the University of York and funded by a consortium of industrial and charitable sponsors. It is examined by Edexcel and support materials are published by Heinemann. The pilot, involving some 50 centres, began in September 1998 with the new subject core and the AS qualification intermediate between GCSE and the full A-level standard. The course has been fully approved by QCA, and from September 2000 it will be open to all. For comprehensive information about SHAP, visit the project's website: www.york.ac.uk/org/seg/salters/physics. Pilot materials for students, teachers and technicians are available from Heinemann. They will be re-edited and published in full colour for September 2000. Members of the team will attend the annual ASE meeting in Leeds this month; there will be a talk and a hands-on workshop where student activities can be sampled. Materials will be on view at the University of York stand. In addition, Edexcel and the York team are running a series of meetings in the spring term, including `taster' days in London on Friday 4 February and in Birmingham on Tuesday 8 February (for details contact Sue Howarth at Edexcel). To discuss any questions you may have about the course, or to be put in touch with a pilot centre near you, contact the Project Director (Elizabeth Swinbank) or the Project Officer (Chris Butlin) at: Salters Horners Advanced Physics Project, Science Education Group, University of York, Heslington, York YO10 5DD, tel: 01904 434537, e-mail: es14@york.ac.uk, cab5@york.ac.uk Elizabeth Swinbank Director of SHAP, University of York

Despite sedentary behavior being ubiquitous in students and detrimental to health, interventions specifically targeting it are mostly restricted to leisure time screen time reduction. With six weekly sessions alongside a poster campaign and an additional teacher intervention, the Let’s Move It trial delivered environmental and psychological strategies to increase physical activity (PA) and reduce sedentary behavior (SB) in vocational schools, an understudied environment for behavioral interventions. Participants in the intervention arm considerably reduced sedentary time post-intervention. To investigate how social cognitions about restricting SB, as defined by the Reasoned Action Approach, change in intervention and control arms, self-reported data on social cognitions was collected as part of a cluster-randomized controlled trial from 1166 students (59% female, mage = 18.7 years, range: 16–49) in six vocational schools before, post-intervention, and 14 months post-baseline. Data were analyzed using mixed between-within repeated measures ANOVA. We found greater improvements in intention (F(1, 833) = 9.69; η2 p = 0.01; p = .018) and descriptive norms (F(1, 831) = 13.25; η2 p = 0.016; p < .001) in the intervention than control arm, but these effects depended on the included control variables. Generally, intervention effects leveled off from post-intervention to follow-up. The Let’s Move It intervention for SB reduction showed modest, short-lived effects on social cognitions, indicating that changes in behavior are likely due to other factors like changes to the classroom environment. Optimally, SB reduction interventions should not only change behavior but produce robust changes in conscious intentions to restrict one’s sitting, so that positive effects generalize to other contexts.

12070 Background: Post-diagnosis weight gain is common among women with early-stage breast cancer and is associated with increased risk of recurrence, breast cancer death, and all-cause mortality. Intentional weight loss following diagnosis is difficult to maintain. Targeted lifestyle interventions focusing on behavioral changes and education that can be implemented long-term are needed. Methods: This was a prospective single-arm pilot study in patients with history of early-stage breast cancer (NCT04753268). Key eligibility criteria included body mass index (BMI) ≥27.5 kg/m2, stage I-III breast cancer, and completion of active cancer treatment ≥6 months prior to study enrollment. Patients were recruited at the Dempsey Center in Lewiston, ME and via social media. Participants were given access to the Noom mobile application, which utilizes cognitive behavioral therapy, motivational interviewing, and self-determination theory to induce behavior change using an educational curriculum of daily articles, virtual health coaching, social networking, food records, and physical activity logs. The primary endpoint was change in self-reported weight from baseline to 26 weeks. Secondary endpoints included change in physical activity measured using step count and the Global Physical Activity Questionnaire (GPAQ), change in diet patterns analyzed using the Nutrition Data System for Research, patient-reported outcome (PRO) measures, and metrics for engagement with the mobile application. Results: 31 patients were enrolled; 24 at the Dempsey Center and 7 via social media. Mean age was 56.8 and mean baseline BMI was 33.5 kg/m2. Mean weight change was -4.8 kg (range +0.6 to -19.9 kg, p &lt; 0.001) and mean percent weight change was -5.6%; 11/31 patients (35.5%) lost ≥5% of their initial weight. Average daily step count increased by 54.7% (p = 0.004). Mean GPAQ score for physical activity increased from 990 to 1773 (p = 0.01), and the proportion of patients who met physical activity guidelines increased from 45.1% to 74.2%. Mean energy intake did not change significantly over 26 weeks (p = 0.779). Improvements were observed in PROMIS-Physical Functioning T-scores and Body Image Scale scores (p = 0.04, p &lt; 0.001 respectively). Metrics of engagement with Noom that were predictive of weight loss ≥5% included total articles read (p = 0.012), total weights logged (p = 0.006), total food records logged (p = 0.001), messages sent to coach (p = 0.001), and number of times the application was opened (p = 0.014). Conclusions: In this pilot study, breast cancer survivors lost weight and became more physically active using a commercially-available mobile application. This digital weight loss program is a scalable intervention, and these findings support future studies investigating impact on breast cancer outcomes. Clinical trial information: NCT04753268 .