title: It's LiFe! Mobile and Web-Based Monitoring and Feedback Tool Embedded in Primary Care Increases Physical Activity: A Cluster Randomized Controlled Trial.
abstract: BACKGROUND
  Physical inactivity is a major public health problem. The It's LiFe! monitoring and feedback tool embedded in the Self-Management Support Program (SSP) is an attempt to stimulate physical activity in people with chronic obstructive pulmonary disease or type 2 diabetes treated in primary care.
  
  
  OBJECTIVE
  Our aim was to evaluate whether the SSP combined with the use of the monitoring and feedback tool leads to more physical activity compared to usual care and to evaluate the additional effect of using this tool on top of the SSP.
  
  
  METHODS
  This was a three-armed cluster randomised controlled trial. Twenty four family practices were randomly assigned to one of three groups in which participants received the tool + SSP (group 1), the SSP (group 2), or care as usual (group 3). The primary outcome measure was minutes of physical activity per day. The secondary outcomes were general and exercise self-efficacy and quality of life. Outcomes were measured at baseline after the intervention (4-6 months), and 3 months thereafter.
  
  
  RESULTS
  The group that received the entire intervention (tool + SSP) showed more physical activity directly after the intervention than Group 3 (mean difference 11.73, 95% CI 6.21-17.25; P<.001), and Group 2 (mean difference 7.86, 95% CI 2.18-13.54; P=.003). Three months after the intervention, this effect was still present and significant (compared to Group 3: mean difference 10.59, 95% CI 4.94-16.25; P<.001; compared to Group 2: mean difference 9.41, 95% CI 3.70-15.11; P<.001). There was no significant difference in effect between Groups 2 and 3 on both time points. There was no interaction effect for disease type.
  
  
  CONCLUSIONS
  The combination of counseling with the tool proved an effective way to stimulate physical activity. Counseling without the tool was not effective. Future research about the cost-effectiveness and application under more tailored conditions and in other target groups is recommended.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01867970, https://clinicaltrials.gov/ct2/show/NCT01867970 (archived by WebCite at http://www.webcitation.org/6a2qR5BSr).
authors.affiliation: CAPHRI School for Public Health and Primary Care, Department Health Services Research, Maastricht University, Maastricht, Netherlands. s.vanderweegen@vilans.nl.
authors.forename: Sanne
authors.identifier: http://orcid.org/0000-0003-3110-3873
authors.initials: S
authors.lastname: van der Weegen
authors.forename: Renée
authors.identifier: http://orcid.org/0000-0003-3623-6771
authors.initials: R
authors.lastname: Verwey
authors.forename: Marieke
authors.identifier: http://orcid.org/0000-0002-5798-0041
authors.initials: M
authors.lastname: Spreeuwenberg
authors.forename: Huibert
authors.identifier: http://orcid.org/0000-0002-8445-7432
authors.initials: H
authors.lastname: Tange
authors.forename: Trudy
authors.identifier: http://orcid.org/0000-0002-7469-3781
authors.initials: T
authors.lastname: van der Weijden
authors.forename: Luc
authors.identifier: http://orcid.org/0000-0002-3013-2640
authors.initials: L
authors.lastname: de Witte
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control*; D005260:Female; D000068156:Formative Feedback; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009043:Motor Activity; D011320:Primary Health Care / Q000379:methods*; D011788:Quality of Life; D020377:Self Efficacy; D017216:Telemedicine / Q000379:methods*
keywords: COPD; behavior change; motor activity; primary care nursing; remote sensing technology; self-management support; type 2 diabetes