The Impact of a Gamified Intervention on Daily Steps in Real-Life Conditions: Retrospective Analysis of 4800 Individuals.

BACKGROUND: Digital interventions integrating gamification features hold promise to promote daily steps. However, results regarding the effectiveness of this type of intervention are heterogeneous and not yet confirmed in real-life contexts. OBJECTIVE: This study aims to examine the effectiveness of a gamified intervention and its potential moderators in a large sample using real-world data. Specifically, we tested (1) whether a gamified intervention enhanced daily steps during the intervention and follow-up periods compared to baseline, (2) whether this enhancement was higher in participants in the intervention than in nonparticipants, and (3) what participant characteristics or intervention parameters moderated the effect of the program. METHODS: Data from 4819 individuals who registered for a mobile health Kiplin program between 2019 and 2022 were retrospectively analyzed. In this intervention, participants could take part in one or several games in which their daily step count was tracked, allowing individuals to play with their overall activity. Nonparticipants were people who registered for the program but did not take part in the intervention and were considered as a control group. Daily step counts were measured via accelerometers embedded in either commercial wearables or smartphones of the participants. Exposure to the intervention, the intervention content, and participants' characteristics were included in multilevel models to test the study objectives. RESULTS: Participants in the intervention group demonstrated a significantly greater increase in mean daily steps from baseline than nonparticipants (P<.001). However, intervention effectiveness depended on participants' initial physical activity. The daily steps of participants with <7500 baseline daily steps significantly improved from baseline both during the Kiplin intervention (+3291 daily steps) and the follow-up period (+945 daily steps), whereas participants with a higher baseline had no improvement or significant decreases in daily steps after the intervention. Age (P<.001) and exposure (P<.001) positively moderated the intervention effect. CONCLUSIONS: In real-world settings and among a large sample, the Kiplin intervention was significantly effective in increasing the daily steps of participants from baseline during intervention and follow-up periods compared to nonparticipants. Interestingly, responses to the intervention differed based on participants' initial steps, with the existence of a plateau effect. Drawing on the insights of self-determination theory, we can assume that the effect of gamification could depend of the initial motivation and activity of participants.

Relationships between changes in self-reported physical activity, sedentary behaviour and health during the coronavirus (COVID-19) pandemic in France and Switzerland.

To assess whether changes in physical activity and sedentary behaviour during the COVID-19 lockdown are associated with changes in mental and physical health. Observational longitudinal study. Participants living in France or Switzerland responded to online questionnaires measuring physical activity, physical and mental health, anxiety, and depressive symptoms. Paired sample t-tests were used to assess differences in physical activity and sedentary behaviour before and during lockdown. Multiple linear regressions were used to investigate associations between changes in physical activity and changes in mental and physical health during lockdown. 267 (wave1) and 110 participants (wave2; 2 weeks later) were recruited. Lockdown resulted in higher time spent in walking and moderate physical activity (~10min/day) and in sedentary behaviour (~75min/day), compared to pre COVID-19. Increased physical activity during leisure time from week 2 to week 4 of lockdown was associated with improved physical health (ß=.24, p=.002). Additionally, an increase in sedentary behaviour during leisure time was associated with poorer physical health (ß=-.35, p=.002), mental health (ß=-.25, p=.003), and subjective vitality (ß=-.30, p=.004). Ensuring sufficient levels of physical activity and reducing sedentary time can play a vital role in helping people to cope with a major stressful event, such as the COVID-19 pandemic.

Do compensatory health beliefs predict behavioural intention in a multiple health behaviour change context? Evidence in individuals with cardiovascular diseases?

Multiple health behaviour change (MHBC) represents one of the best ways to prevent reoccurrence of cardiovascular events. However, few individuals with cardiovascular diseases engage in this process. The present study examined the role of compensatory health beliefs (CHB; i.e., belief that a healthy behaviour compensates an unhealthy one) as a drag to engagement in this process. Some studies have shown that CHBs predict intention to engage in healthy behaviours, but no study has investigated CHBs in individuals who actually need to change multiple health behaviours. The goal was to better understand the role of CHBs in intentions formation process among individuals with cardiac diseases in an MHBC context. One hundred and four patients completed a questionnaire at the beginning of their cardiac rehabilitation program. Results showed that: (1) CHBs negatively predicted intentions (2) but only for participants with high self-efficacy or low risk perception; (3) CHBs predictions differed depending on the nature of the compensating behaviour, and were more predictive when medication intake was the compensating one. Findings only partially confirmed previous research conducted on healthy individuals who were not in an MHBC process, and emphasized the importance of considering CHBs for individuals in this process.

Are trait self-control and self-control resources mediators of relations between executive functions and health behaviors?

This study investigated associations between executive functions (i.e., inhibition, working memory, cognitive flexibility) and individual differences in self-control and health behaviors. We examined whether executive functions predict physical activity, sedentary activity, and healthy and unhealthy diets, and whether trait self-control and self-control resources mediate these associations. Three hundred and eighty-five participants completed a questionnaire assessing trait self-control and self-control resources, physical activity, sedentary activity, and healthy and unhealthy diets. They also performed three randomly ordered cognitive tasks, a stop-signal task (i.e., inhibition), a letter memory task (i.e., updating), and a number-letter task (i.e., switching). Structural equation modeling revealed that self-control resources predicted positively physical activity (R2 = 0.08), negatively sedentary activity (R2 = 0.03) and positively healthy diet (R2 = 10). Moreover, trait self-control predicted positively healthy diet (R2 = 0.10) and negatively unhealthy diet (R2 = 0.19). Moreover, analyses revealed that switching significantly predicted self-control resources, and highlighted three totally mediated relations between this executive function and physical activity, sedentary activity and healthy diet. However, no evidence was found supporting associations between inhibition and updating, and health behaviors, or relations mediated by self-control for these executive functions. The findings suggest the importance of trait self-control and self-control resources for health behavior adoption and pave the way for studies exploring the role of the executive functions in an affective context. Open materials [https://osf.io/hpsjw/].

Cognitive functions and physical activity in aging when energy is lacking.

Declines in subjective energy availability and cognitive functions could explain the decrease in physical activity observed across aging. However, how these factors interact remains unknown. Based on the theory of effort minimization in physical activity (TEMPA), we hypothesized that cognitive functions may help older adults to maintain physical activity even when energy availability is perceived as insufficient. This study used data of 104,590 adults from 21 European countries, from the Survey of Health, Ageing and Retirement in Europe (SHARE), including 7 measurement occasions between 2004 and 2017. Cognitive functions were assessed with verbal fluency and delayed recall, using the verbal fluency test and the 10-word delayed recall test. Physical activity and subjective energy availability were self-reported. Results of linear mixed-effects models revealed that cognitive functions moderated the associations between subjective energy availability and physical activity. Moreover, as adults get older, cognitive functions became critical to engage in physical activity regardless the availability of perceived energy. Sensitivity and robustness analyses were consistent with the main results. These results suggest that cognitive functions may help older adults to maintain regular physical activity even when energy for goal pursuit becomes insufficient, but that the protective role of cognitive functions becomes critical at older age, irrespective of the state of perceived energy. Supplementary Information: The online version contains supplementary material available at 10.1007/s10433-021-00654-2.

Individual, Sociodemographic, and Environmental Factors Related to Physical Activity During the Spring 2020 COVID-19 Lockdown.

Background: Research has shown important between-individual variations in physical activity (PA) during the COVID-19 lockdown. Objectives: The objectives of this is study are to examine the individual, sociodemographic, and environmental factors related to PA during the spring 2020 COVID-19 lockdown in France and to explore the mediating and moderating role of intention and self-efficacy toward PA in the relationships between sociodemographic/environmental variables and PA. Design: In this cross-sectional study, participants living in France (N = 386) completed an online survey between March 30 and April 10, 2020. Method: Minutes per week of moderate-to-vigorous PA during the lockdown; usual physical activity before the lockdown; and psychological (e.g., intention, self-efficacy, and autonomous and controlled motivation), sociodemographic (gender, age, and number of children), and environmental (habitat surface area and type of housing) factors were measured in the survey. Multiple linear regressions were used to investigate the role of these predictors on PA. Intention and self-efficacy were also examined as moderators and mediators of the association between sociodemographic/environmental factors and PA. Results: Usual physical activity before the COVID-19 lockdown, intention toward PA, habitat surface area, and controlled motivation significantly predicted PA during the lockdown. No mediating effects of intention or self-efficacy were found. Intention significantly moderated the association between gender and PA and the association between part-time work and PA. Conclusions: PA during the COVID-19 lockdown was mainly predicted by individual factors and notably usual PA. These results highlight the important role of habits in a highly changing context.

Corrigendum: Individual, Sociodemographic, and Environmental Factors Related to Physical Activity During the Spring 2020 COVID-19 Lockdown.

[This corrects the article DOI: 10.3389/fpsyg.2021.643109.].

Being Active during the Lockdown: The Recovery Potential of Physical Activity for Well-Being.

To examine the indirect relationships between physical activity, and well-being (i.e., need satisfaction, subjective vitality, and stress) of individuals, through recovery experiences (i.e., detachment from lockdown, relaxation, mastery, and control over leisure time) during the spring 2020 COVID-19 lockdown. METHODS: 405 participants answered an online survey including questions on physical activity, recovery experiences, subjective vitality, perceived stress, and basic psychological needs satisfaction. Structural equation modeling tested a full-mediated model in which physical activity predicted recovery experience, which in turn predicted well-being. RESULTS: Physical activity was positively related to a latent variable representing recovery experiences, which in turn was positively related to a latent variable representing well-being. CONCLUSIONS: Physical activity carried out regularly during the COVID-19 lockdown positively predicted well-being through recovery experiences. The study results highlight the importance of maintaining or increasing physical activity during periods when recovery experiences and well-being may be threatened.

Evolution of physical activity habits after a context change: The case of COVID-19 lockdown.

OBJECTIVE: Habits, defined as well-learned associations between cues and behaviours, are essential for health-related behaviours, including physical activity (PA). Despite the sensitivity of habits to context changes, little remains known about the influence of a context change on the interplay between PA habits and behaviours. We investigated the evolution of PA habits amidst the spring COVID-19 lockdown, a major context change. Moreover, we examined the association of PA behaviours and autonomous motivation with this evolution. DESIGN: Three-wave observational longitudinal design. METHODS: PA habits, behaviours, and autonomous motivation were collected through online surveys in 283 French and Swiss participants. Variables were self-reported with reference to three time-points: before-, mid-, and end-lockdown. RESULTS: Mixed effect modelling revealed a decrease in PA habits from before- to mid-lockdown, especially among individuals with strong before-lockdown habits. Path analysis showed that before-lockdown PA habits were not associated with mid-lockdown PA behaviours (ß = -.02, p = .837), while mid-lockdown PA habits were positively related to end-lockdown PA behaviours (ß = .23, p = .021). Autonomous motivation was directly associated with PA habits (ps < .001) and withto before- and mid-lockdown PA behaviours (ps < .001) (but not with end-lockdown PA behaviours) and did not moderate the relations between PA behaviours and habits (ps > .072). CONCLUSION: PA habits were altered, and their influence on PA behaviours was impeded during the COVID-19 lockdown. Engagement in PA behaviours and autonomous motivation helped in counteracting PA habits disruption.