title: Web-Based Intervention for Physical Activity and Fruit and Vegetable Intake Among Chinese University Students: A Randomized Controlled Trial.
abstract: Ample evidence demonstrates that university students are at high risk for sedentary behaviors and inadequate fruit and vegetable intake (FVI). Internet-based interventions for multiple health behavior appear to be promising in changing such unhealthy habits. Limited randomized controlled trials have tested this assumption among Chinese university students.
  
  
  
  Our objective was to test the efficacy of an 8-week Web-based intervention compared with a control group condition to improve physical activity (PA) and FVI in Chinese university students. The intervention content was based on the health action process approach, and developed on the basis of previous evidence from the Western hemisphere. We evaluated self-reported data including PA and FVI, stages of change for PA and FVI, and motivational (risk perception, outcome expectancies, self-efficacy), volitional (action planning, coping planning, social support), and distal (intention, habit) indicators for PA and FVI, as well as perceived mental health outcomes (quality of life, depression).
  
  
  
  In a randomized controlled trial, we recruited 566 university students from one university in the central region of China during their general physical education class. After random allocation and exclusion of unsuitable participants, we assigned 493 students to 1 of 2 groups: (1) intervention group: first 4 weeks on PA and subsequent 4 weeks on FVI, (2) control group. We conducted 3 Web-based assessments: at the beginning of the intervention (T1, n=493), at the end of the 8-week intervention (T2, n=337), and at a 1-month follow-up after the intervention (T3, n=142). The entire study was conducted throughout the fall semester of 2015.
  
  
  
  Significant time ⨯ group interactions revealed superior intervention effects on FVI; motivational, volitional, and distal indicators of FVI; and PA behavior changes, with an effect size (η2) ranging from .08 to .20. In addition, the overall intervention effects were significant for stage progression to the action group from T1 to T2 in PA (χ21=11.75, P=.001) and FVI (χ21=15.64, P=.03). Furthermore, the intervention effect was seen in the improvement of quality of life (F3,492=1.23, η2=.03, P=.02).
  
  
  
  This study provides evidence for the efficacy of a Web-based multiple health behavior intervention among Chinese university students tested with different outcome variables. Future research should address the high dropout rate and optimize the most effective components of this intervention.
  
  
  
  Clinicaltrials.gov NCT01909349; https://clinicaltrials.gov/ct2/show/NCT01909349 (Archived by WebCite at http://www.webcitation.org/6pHV1A0G1).
authors.affiliation: Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).
authors.forename: Yan Ping
authors.identifier: 0000-0002-6432-7542
authors.initials: YP
authors.lastname: Duan
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Julian
authors.identifier: 0000-0003-1246-7591
authors.initials: J
authors.lastname: Wienert
authors.affiliation: Department of Physical Education, Faculty of Social Sciences, Hong Kong Baptist University, Hong Kong, China (Hong Kong).
authors.forename: Chun
authors.identifier: 0000-0002-7849-8449
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Health & Physical Education, The Education University of Hong Kong, Hong Kong, China (Hong Kong).
authors.forename: Gang Yan
authors.identifier: 0000-0002-7253-5456
authors.initials: GY
authors.lastname: Si
authors.affiliation: Bremen International Graduate School of Social Sciences, Jacobs University Bremen, Bremen, Germany.|Department of Psychology & Methods, Jacobs University Bremen, Bremen, Germany.
authors.forename: Sonia
authors.identifier: 0000-0002-8272-0399
authors.initials: S
authors.lastname: Lippke
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China; D015444:Exercise; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D020407:Internet; D008297:Male; D011788:Quality of Life; D013334:Students / Q000523:psychology*; D014495:Universities; D014675:Vegetables; D055815:Young Adult
keywords: Web-based intervention; fruit and vegetable intake; motivational indicators; physical activity; university students; volitional indicators