title: Effectiveness of a web- and mobile phone-based intervention to promote physical activity and healthy eating in middle-aged males: randomized controlled trial of the ManUp study.
abstract: BACKGROUND
  The high number of adult males engaging in low levels of physical activity and poor dietary practices, and the health risks posed by these behaviors, necessitate broad-reaching intervention strategies. Information technology (IT)-based (Web and mobile phone) interventions can be accessed by large numbers of people, yet there are few reported IT-based interventions targeting males' physical activity and dietary practices.
  
  
  OBJECTIVE
  This study examines the effectiveness of a 9-month IT-based intervention (ManUp) to improve the physical activity, dietary behaviors, and health literacy in middle-aged males compared to a print-based intervention.
  
  
  METHODS
  Participants, recruited offline (eg, newspaper ads), were randomized into either an IT-based or print-based intervention arm on a 2:1 basis in favor of the fully automated IT-based arm. Participants were adult males aged 35-54 years living in 2 regional cities in Queensland, Australia, who could access the Internet, owned a mobile phone, and were able to increase their activity level. The intervention, ManUp, was based on social cognitive and self-regulation theories and specifically designed to target males. Educational materials were provided and self-monitoring of physical activity and nutrition behaviors was promoted. Intervention content was the same in both intervention arms; only the delivery mode differed. Content could be accessed throughout the 9-month study period. Participants' physical activity, dietary behaviors, and health literacy were measured using online surveys at baseline, 3 months, and 9 months.
  
  
  RESULTS
  A total of 301 participants completed baseline assessments, 205 in the IT-based arm and 96 in the print-based arm. A total of 124 participants completed all 3 assessments. There were no significant between-group differences in physical activity and dietary behaviors (P≥.05). Participants reported an increased number of minutes and sessions of physical activity at 3 months (exp(β)=1.45, 95% CI 1.09-1.95; exp(β)=1.61, 95% CI 1.17-2.22) and 9 months (exp(β)=1.55, 95% CI 1.14-2.10; exp(β)=1.51, 95% CI 1.15-2.00). Overall dietary behaviors improved at 3 months (exp(β)=1.07, 95% CI 1.03-1.11) and 9 months (exp(β)=1.10, 95% CI 1.05-1.13). The proportion of participants in both groups eating higher-fiber bread and low-fat milk increased at 3 months (exp(β)=2.25, 95% CI 1.29-3.92; exp(β)=1.65, 95% CI 1.07-2.55). Participants in the IT-based arm were less likely to report that 30 minutes of physical activity per day improves health (exp(β)=0.48, 95% CI 0.26-0.90) and more likely to report that vigorous intensity physical activity 3 times per week is essential (exp(β)=1.70, 95% CI 1.02-2.82). The average number of log-ins to the IT platform at 3 and 9 months was 6.99 (SE 0.86) and 9.22 (SE 1.47), respectively. The average number of self-monitoring entries at 3 and 9 months was 16.69 (SE 2.38) and 22.51 (SE 3.79), respectively.
  
  
  CONCLUSIONS
  The ManUp intervention was effective in improving physical activity and dietary behaviors in middle-aged males with no significant differences between IT- and print-based delivery modes.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry: ACTRN12611000081910; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12611000081910 (Archived by WebCite at http://www.webcitation.org/6QHIWad63).
authors.affiliation: School of Medicine & Public Health, Priority Research Centre in Physical Activity and Nutrition, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia. Mitch.Duncan@newcastle.edu.au.
authors.forename: Mitch
authors.initials: M
authors.lastname: Duncan
authors.forename: Corneel
authors.initials: C
authors.lastname: Vandelanotte
authors.forename: Gregory S
authors.initials: GS
authors.lastname: Kolt
authors.forename: Richard R
authors.initials: RR
authors.lastname: Rosenkranz
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Caperchione
authors.forename: Emma S
authors.initials: ES
authors.lastname: George
authors.forename: Hang
authors.initials: H
authors.lastname: Ding
authors.forename: Cindy
authors.initials: C
authors.lastname: Hooker
authors.forename: Mohan
authors.initials: M
authors.lastname: Karunanithi
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Maeder
authors.forename: Manny
authors.initials: M
authors.lastname: Noakes
authors.forename: Rhys
authors.initials: R
authors.lastname: Tague
authors.forename: Pennie
authors.initials: P
authors.lastname: Taylor
authors.forename: Pierre
authors.initials: P
authors.lastname: Viljoen
authors.forename: W Kerry
authors.initials: WK
authors.lastname: Mummery
mesh_terms: D000328:Adult; D001315:Australia; D040421:Cell Phone; D004032:Diet; D015444:Exercise; D057220:Health Literacy; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged
keywords: Web-based; diet; mobile phone; physical activity; randomized controlled trial