Goal feedback from whom? A physical activity intervention using an N-of-1 RCT.

OBJECTIVE: Adolescents are not meeting the recommended guidelines for physical activity. Social support and self-regulatory skills are two factors known to impact physical activity and sedentary behaviour. The study sought to examine how targeting feedback as part of a self-regulatory process could increase physical activity, and the individual who should be providing the feedback. DESIGN: The study utilised an aggregated N-of-1 RCT which allows for an iterative process of intervention development, and examines variability within participants to answer the question for whom did the intervention work. Ten adolescents (ages 13-18) set a daily physical activity goal. Adolescents received a SMS text message providing feedback on goal attainment daily from a parent, peer, behavioural health specialist; or no text message (control). MAIN OUTCOME MEASURES: A bioharness heart rate monitor assessed heart rate as proxy for goal attainment. Adolescents also self-monitored their physical activity in the Calorie Counter and Diet Tracker by MyFitnessPalTM app (commercially available). RESULTS: Intervention demonstrated a significant effect for 30% of the sample in increasing MVPA (Mincrease = 52 min), with no significant effect on sedentary behaviour. CONCLUSION: A single occasion of text messaging from the right person can produce changes, however, careful consideration should be given to who provides the feedback.

Diabetes conflict outstrips the positive impact of self-efficacy on youth adherence and glycemic control in type 1 diabetes.

OBJECTIVE: To examine whether self-efficacy buffers the deleterious consequences of diabetes-specific family conflict on self-monitoring blood glucose (SMBG) and glycated hemoglobin (HbA1c) in youth with type 1 diabetes mellitus (T1DM). METHODS: A total of 129 youth with T1DM (aged 10-16 years) completed measures of diabetes-specific family conflict and self-efficacy for diabetes management, and their blood glucose meter data and HbA1c were extracted from the electronic medical record. We preformed moderation analyses to examine whether self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. We used simple slopes analyses to probe significant interactions. RESULTS: Our results indicated that self-efficacy moderated the association that diabetes-specific family conflict had with SMBG and HbA1c. The pattern of these findings showed that high self-efficacy buffered the negative impact of diabetes conflict on HbA1c. However, benefits of high self-efficacy for more frequent SMBG was only apparent in the context of low diabetes-specific family conflict. CONCLUSIONS: Study findings highlight the interactive relationship between diabetes-specific family conflict and self-efficacy in relation to SMBG and glycemic control. These findings suggest that family functioning and youth's self-efficacy are promising intervention targets for families having trouble with SMBG and HbA1c.