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Abstract Background Despite effectiveness of action and coping planning in digital health interventions to promote physical activity (PA), attrition rates remain high. Indeed, support to make plans is often abstract and similar for each individual. Nevertheless, people are different, and context varies. Tailored support at the content level, involving suggestions of specific plans that are personalized to the individual, may reduce attrition and improve outcomes in digital health interventions. The aim of this study was to investigate whether user information relates toward specific action and coping plans using a clustering method. In doing so, we demonstrate how knowledge can be acquired in order to develop a knowledge-base, which might provide personalized suggestions in a later phase. Methods To establish proof-of-concept for this approach, data of 65 healthy adults, including 222 action plans and 204 coping plans, were used and were collected as part of the digital health intervention MyPlan 2.0 to promote PA. As a first step, clusters of action plans, clusters of coping plans and clusters of combinations of action plans and barriers of coping plans were identified using hierarchical clustering. As a second step, relations with user information (i.e. gender, motivational stage, ...) were examined using anova’s and chi2–tests. Results First, three clusters of action plans, eight clusters of coping plans and eight clusters of the combination of action and coping plans were identified. Second, relating these clusters to user information was possible for action plans: 1) Users with a higher BMI related more to outdoor leisure activities (F = 13.40, P

Background: As smartphones become more widespread, software applications for occupational health, safety and well-being (OHS&W) at work are increasing. There is sparse knowledge about the available apps and the research evidence of their effects. This study aims to identify available smartphone applications designed to improve OHS&W at workplaces, and examine to what extent the apps are scientifically validated.Methods: We searched the Danish App Store and Google Play for free OHS&W apps. Apps were included if they targeted OHS&W and were designed for workplace use. After categorizing the apps, we searched bibliographic databases to identify scientific studies on the 'intervention apps'.Results: Altogether, 57 apps were included in the study; 19 apps were categorized as digital sources of information, 37 apps contained an intervention designed for workplace changes, and one app had too sparse information to be classified. Based on the publicly available information about the 37 intervention apps, only 13 had references to research. The bibliographic database search returned 531 publications, resulting in four relevant studies referring to four apps aimed at ergonomic measures, noise exposure, and well-being, which showed either limited effect or methodological limitations.Conclusion: There is no conceptual clarity about what can be categorized as an OHS&W app. Although some of the apps were developed based on scientific research, there is a need to evaluate the apps' effects in promoting OHS&W. The sparse documentation of evidence should be kept in mind when applying apps to improve OHS&W. [ABSTRACT FROM AUTHOR]

Abstract Background Employees dealing with job demands such as high workload and permeable work-life boundaries could benefit from bottom-up well-being strategies such as off-job crafting. We have developed a hybrid off-job crafting intervention to promote off-job crafting, a proactive pursuit to adjust one’s off-job time activities to satisfy one’s psychological needs. This hybrid intervention contains both on-site (two trainings) and online elements (smartphone app) to enhance employees’ well-being and performance within different life domains. Methods The study is designed as a randomized controlled trial with an intervention group and a waitlist control group. The study population will be Finnish knowledge workers. The intervention program focuses on six psychological needs (detachment, relaxation, autonomy, mastery, meaning, and affiliation) proposed by the DRAMMA model. The intervention will consist of the following components: 1) an on-site off-job crafting training, 2) an individual off-job crafting plan for the four-week intervention period, 3) Everydaily smartphone app usage, and 4) a training session for reflection. The study outcomes are assessed with online questionnaires once at baseline, weekly during the intervention period and twice after the intervention (two-week and six-week follow-up). Moreover, during the second training session, participants will participate in a process evaluation to shed light on the mechanisms that can affect the effectiveness of the intervention. Discussion We expect that the intervention will stimulate off-job crafting behaviors, which may in turn increase well-being and performance in both non-work and work domains during and after the intervention (compared to baseline and to the control group). The intervention may provide employees with additional resources to deal with various stressors in life. Furthermore, this off-job crafting intervention could also offer performance benefits for the employers such as increased organizational citizenship behaviors among employees. Trial registration The Netherlands Trial Register (NTR): NL8219, December 9, 2019. Registered retrospectively. https://www.trialregister.nl/trial/8219

Abstract Background At a population level, small reductions in energy intake have the potential to contribute to a reduction in the prevalence of childhood obesity. In many school systems, there is the potential to achieve a reduction in energy intake through modest improvements in foods packed in children’s school lunchboxes. This study will assess the effectiveness and cost-effectiveness of a multi-component intervention that uses an existing school-based communication application to reduce the kilojoule content from discretionary foods and drinks consumed by children from school lunchboxes whilst at school. Methods A Type I hybrid effectiveness-implementation cluster randomised controlled trial will be conducted in up to 36 primary schools in the Hunter New England, Central Coast and Mid North Coast regions of New South Wales, Australia. Designed using the Behaviour Change Wheel, schools will be randomly allocated to receive either a 5-month (1.5 school terms) multi-component intervention that includes: 1) school lunchbox nutrition guidelines; 2) curriculum lessons; 3) information pushed to parents via an existing school-based communication application and 4) additional parent resources to address common barriers to packing healthy lunchboxes or a control arm (standard school practices). The study will assess both child level dietary outcomes and school-level implementation outcomes. The primary trial outcome, mean energy (kJ) content of discretionary lunchbox foods packed in children’s lunchboxes, will be assessed at baseline and immediately post intervention (5 months or 1.5 school terms). Analyses will be performed using intention to treat principles, assessing differences between groups via hierarchical linear regression models. Discussion This study will be the first fully powered randomised controlled trial internationally to examine the impact of an m-health intervention to reduce the mean energy from discretionary food and drinks packed in the school lunchbox. The intervention has been designed with scalability in mind and will address an important evidence gap which, if shown to be effective, has the potential to be applied at a population level. Trial registration Australian Clinical Trials Registry ACTRN:12618001731280 registered on 17/10/2018. Protocol Version 1.

Abstract Background Fun For Wellness (FFW) is an online behavioral intervention developed to encourage growth in well-being by providing capability-enhancing learning opportunities to participants. Self-efficacy theory guides the conceptual model underlying the FFW intervention. Some initial evidence has been provided for the efficacy of FFW to promote: well-being self-efficacy; interpersonal, community, psychological and economic subjective well-being; and, interpersonal and physical well-being actions. The purpose of this paper is to describe the protocol for a new randomized controlled trial (RCT) designed to provide the first investigation of the effectiveness of FFW to increase well-being and physical activity in adults with obesity in the United States of America. Methods The study design is a large-scale, prospective, parallel group RCT. Approximately 9 hundred participants will be randomly assigned to the FFW or Usual Care (UC) group to achieve a 1:1 group (i.e., FFW:UC) assignment. Participants will be recruited through an online panel recruitment company. Data collection, including determination of eligibility, will be conducted online and enrollment is scheduled to begin on 8 August 2018. Data collection will occur at baseline, 30 days and 60 days after baseline. Instruments to measure demographic information, anthropometric characteristics, self-efficacy, physical activity and well-being will be included in the battery. Data will be modeled under an intent to treat approach and/or a complier average causal effect approach depending on the level of observed engagement with the intervention. Discussion The effectiveness trial described in this paper builds upon the 2015 FFW efficacy trial and has the potential to be important for at least three reasons. The first reason is based upon a general scientific approach that the potential utility of interventions should be evaluated under both ideal (e.g., more controlled) and real-world (e.g., less controlled) conditions. The second reason is based upon the global need for readily scalable online behavioral interventions that effectively promote physical activity in adults. The third reason is based upon the troubling global trend toward obesity along with evidence for obesity as a risk factor for several major non-communicable diseases. Trial registration ClinicalTrials.gov, identifier: NCT03194854 , registered 21 June 2017.

Background: Employees dealing with job demands such as high workload and permeable work-life boundaries could benefit from bottom-up well-being strategies such as off-job crafting. We have developed a hybrid off-job crafting intervention to promote off-job crafting, a proactive pursuit to adjust one's off-job time activities to satisfy one's psychological needs. This hybrid intervention contains both on-site (two trainings) and online elements (smartphone app) to enhance employees' well-being and performance within different life domains.Methods: The study is designed as a randomized controlled trial with an intervention group and a waitlist control group. The study population will be Finnish knowledge workers. The intervention program focuses on six psychological needs (detachment, relaxation, autonomy, mastery, meaning, and affiliation) proposed by the DRAMMA model. The intervention will consist of the following components: 1) an on-site off-job crafting training, 2) an individual off-job crafting plan for the four-week intervention period, 3) Everydaily smartphone app usage, and 4) a training session for reflection. The study outcomes are assessed with online questionnaires once at baseline, weekly during the intervention period and twice after the intervention (two-week and six-week follow-up). Moreover, during the second training session, participants will participate in a process evaluation to shed light on the mechanisms that can affect the effectiveness of the intervention.Discussion: We expect that the intervention will stimulate off-job crafting behaviors, which may in turn increase well-being and performance in both non-work and work domains during and after the intervention (compared to baseline and to the control group). The intervention may provide employees with additional resources to deal with various stressors in life. Furthermore, this off-job crafting intervention could also offer performance benefits for the employers such as increased organizational citizenship behaviors among employees.Trial Registration: The Netherlands Trial Register (NTR): NL8219, December 9, 2019. Registered retrospectively. https://www.trialregister.nl/trial/8219. [ABSTRACT FROM AUTHOR]

Background: At a population level, small reductions in energy intake have the potential to contribute to a reduction in the prevalence of childhood obesity. In many school systems, there is the potential to achieve a reduction in energy intake through modest improvements in foods packed in children's school lunchboxes. This study will assess the effectiveness and cost-effectiveness of a multi-component intervention that uses an existing school-based communication application to reduce the kilojoule content from discretionary foods and drinks consumed by children from school lunchboxes whilst at school.Methods: A Type I hybrid effectiveness-implementation cluster randomised controlled trial will be conducted in up to 36 primary schools in the Hunter New England, Central Coast and Mid North Coast regions of New South Wales, Australia. Designed using the Behaviour Change Wheel, schools will be randomly allocated to receive either a 5-month (1.5 school terms) multi-component intervention that includes: 1) school lunchbox nutrition guidelines; 2) curriculum lessons; 3) information pushed to parents via an existing school-based communication application and 4) additional parent resources to address common barriers to packing healthy lunchboxes or a control arm (standard school practices). The study will assess both child level dietary outcomes and school-level implementation outcomes. The primary trial outcome, mean energy (kJ) content of discretionary lunchbox foods packed in children's lunchboxes, will be assessed at baseline and immediately post intervention (5 months or 1.5 school terms). Analyses will be performed using intention to treat principles, assessing differences between groups via hierarchical linear regression models.Discussion: This study will be the first fully powered randomised controlled trial internationally to examine the impact of an m-health intervention to reduce the mean energy from discretionary food and drinks packed in the school lunchbox. The intervention has been designed with scalability in mind and will address an important evidence gap which, if shown to be effective, has the potential to be applied at a population level.Trial Registration: Australian Clinical Trials Registry ACTRN:12618001731280 registered on 17/10/2018. Protocol Version 1. [ABSTRACT FROM AUTHOR]

Abstract Background The Office of Public Health Preparedness and Response (OPHPR) in the Centers for Disease Control and Prevention conducts outreach for public preparedness for natural and manmade incidents. In 2011, OPHPR conducted a nationwide mobile public health (m-Health) campaign that pushed brief videos on preparing for severe winter weather onto cell phones, with the objective of evaluating the interoperability of multimedia m-Health outreach with diverse cell phones (including handsets without Internet capability), carriers, and user preferences. Methods Existing OPHPR outreach material on winter weather preparedness was converted into mobile-ready multimedia using mobile marketing best practices to improve audiovisual quality and relevance. Middleware complying with opt-in requirements was developed to push nine bi-weekly multimedia broadcasts onto subscribers’ cell phones, and OPHPR promoted the campaign on its web site and to subscribers on its govdelivery.com notification platform. Multimedia, text, and voice messaging activity to/from the middleware was logged and analyzed. Results Adapting existing media into mobile video was straightforward using open source and commercial software, including web pages, PDF documents, and public service announcements. The middleware successfully delivered all outreach videos to all participants (a total of 504 videos) regardless of the participant’s device. 54 % of videos were viewed on cell phones, 32 % on computers, and 14 % were retrieved by search engine web crawlers. 21 % of participating cell phones did not have Internet access, yet still received and displayed all videos. The time from media push to media viewing on cell phones was half that of push to viewing on computers. Conclusions Video delivered through multimedia messaging can be as interoperable as text messages, while providing much richer information. This may be the only multimedia mechanism available to outreach campaigns targeting vulnerable populations impacted by the digital divide. Anti-spam laws preserve the integrity of mobile messaging, but complicate campaign promotion. Person-to-person messages may boost enrollment.

Background: The Office of Public Health Preparedness and Response (OPHPR) in the Centers for Disease Control and Prevention conducts outreach for public preparedness for natural and manmade incidents. In 2011, OPHPR conducted a nationwide mobile public health (m-Health) campaign that pushed brief videos on preparing for severe winter weather onto cell phones, with the objective of evaluating the interoperability of multimedia m-Health outreach with diverse cell phones (including handsets without Internet capability), carriers, and user preferences.Methods: Existing OPHPR outreach material on winter weather preparedness was converted into mobile-ready multimedia using mobile marketing best practices to improve audiovisual quality and relevance. Middleware complying with opt-in requirements was developed to push nine bi-weekly multimedia broadcasts onto subscribers' cell phones, and OPHPR promoted the campaign on its web site and to subscribers on its govdelivery.com notification platform. Multimedia, text, and voice messaging activity to/from the middleware was logged and analyzed.Results: Adapting existing media into mobile video was straightforward using open source and commercial software, including web pages, PDF documents, and public service announcements. The middleware successfully delivered all outreach videos to all participants (a total of 504 videos) regardless of the participant's device. 54 % of videos were viewed on cell phones, 32 % on computers, and 14 % were retrieved by search engine web crawlers. 21 % of participating cell phones did not have Internet access, yet still received and displayed all videos. The time from media push to media viewing on cell phones was half that of push to viewing on computers.Conclusions: Video delivered through multimedia messaging can be as interoperable as text messages, while providing much richer information. This may be the only multimedia mechanism available to outreach campaigns targeting vulnerable populations impacted by the digital divide. Anti-spam laws preserve the integrity of mobile messaging, but complicate campaign promotion. Person-to-person messages may boost enrollment. [ABSTRACT FROM AUTHOR]

Background People with intellectual disabilities (ID) have lower levels of physical activity and quality of life and they have a lot of barriers to face when taking part in physical activity. Other problems are the poor adherence to physical activity such people have so this study is designed to improve adherence to physical activity for people with intellectual disabilities with the assistance of an application for smartphones. The aim of the study will be to improve physical activity and physical condition after multimodal intervention and to analyse the promotion of adherence to physical activity through a multimodal intervention and an app intervention (mHealth) in people with ID. Methods A two-stage study will be conducted. In stage 1 a multimodal intervention will take place will be done with physical activity and educational advice over eight weeks, two days a week. Data will be measured after and before the intervention. In stage 2 a randomized controlled trial will be conducted. In the intervention group we will install an application to a smartphone; this application will be a reminder to do a physical activity and they have to select whether they have or haven't done a physical activity every day. This application will be installed for 18 weeks. Data will be measured after and before the application is installed in two groups. We will measure results 10 weeks later when the two groups don't have the reminder. The principal outcome used to measure the adherence to physical activity will be the International Physical Activity Questionnaire; secondary outcomes will be a fun-fitness test and self-report survey about quality of life, self-efficacy and social support. Samples will be randomized by sealed envelope in two groups, with approximately 20 subjects in each group. It's important to know that the therapist will be blinded and won't know the subjects of each group. Discussion Offering people with ID a multimodal intervention and tool to increase the adherence to a physical activity may increase the levels of physical activity and quality of life. Such a scheme, if beneficial, could be implemented successfully within public health sense. [ABSTRACT FROM AUTHOR]