Abstract
Obesity and insufficient physical activity represent ongoing pandemics. These cases describe the design process of two different electronic and mobile health interventions in the areas of behavioral weight loss and physical activity promotion. An interdisciplinary team of experts followed several guidelines of an established intervention framework to ensure the interventions were addressing significant research gaps and grounded in theory and empirical evidence. Intervention strategies were guided by the intervention mapping taxonomy of behavior change methods and integrated both custom-built and commercially available technologies. These cases detail how the chosen theories, methods, and intervention strategies were connected. Challenges and opportunities in relation to both the interventions and the fields of technology-based behavioral weight loss and physical activity more broadly are also discussed.
TopAccording to the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System 2020 data, 65% of adults in Columbia, SC – the location of the NETworks and Columbia Moves interventions – report being overweight or obese (i.e., body mass index greater than or equal to 25 kg/m2) and 48% report being insufficiently physically active (i.e., less than 150 minutes of moderate-intensity equivalent aerobic physical activity per week). These prevalence rates for overweight/obesity and insufficient physical activity are similar to those reported by adults in South Carolina (68% and 53%) and the United States (U.S.; 67% and 50%) (Centers for Disease Control and Prevention, 2020). Likewise, the most recent World Health Organization data show that just over half of the world’s adult population is overweight and obese and 28% are insufficiently physically active (World Health Organization, 2021a, 2021b).
The high prevalence of overweight and obesity, as well as insufficient physical activity leads to numerous adverse health and economic consequences in the population. Both issues negatively affect quality of life. They are also linked to premature mortality and an increased risk for cardiovascular disease, type 2 diabetes mellitus, and some cancers (U.S. Department of Health and Human Services, 2018; Williams et al., 2015). Their consequences extend beyond those related to non-communicable diseases. For example, individuals with obesity are at an elevated risk for hospitalization and mortality in relation to acquiring a COVID-19 infection (Popkin et al., 2020). While research on how physical activity might interact with the immune system to affect COVID-19 infectivity and disease progression is needed, scientific evidence from other viral infections suggests that leading a physically active lifestyle can mitigate symptom severity and shorten recovery time (Simpson & Katsanis, 2020). In the U.S., obesity accounts for $92 billion per year or 5% of total adult health expenditures (Aljunid, 2021). Inadequate physical activity is estimated to account for $117 billion per year or about 9% of total healthcare costs (Carlson et al., 2015). Both issues pose a similar, significant economic burden globally (Ding et al., 2016; Okunogbe et al., 2021).
Key Terms in this Chapter
Engagement: Level of interaction with intervention features.
Gamification: The influence affordances (i.e., components and mechanics that structure games) have on psychological outcomes and experiences, and in turn, motivation and behavioral outcomes.
API (Application Programming Interface): Collection of functions allowing two pieces of software to communicate with each other.
Behavioral Economics: Application of psychological principles to economic decision-making processes (can be adapted for application to health behavior decisions).
Social Cognitive Theory: An interpersonal-oriented theory that describes the collective influence of cognitive, socioenvironmental, and behavioral factors on health behavior.
Social Network Theory: The role of social relationships in spreading information, channeling influence, and enabling health behavior change.
Social Support: Perception of the provision of aid or comfort one receives from their social network to help them cope with stressors.