Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2022 Apr 27;19(1):49.
doi: 10.1186/s12966-022-01288-y.

Promoting an active choice among physically inactive adults: a randomised web-based four-arm experiment

Lorraine L Landais  1 , Olga C Damman  2 , Judith G M Jelsma  2 , Evert A L M Verhagen  2   3 , Danielle R M Timmermans  2
Affiliations
Randomized Controlled Trial

Promoting an active choice among physically inactive adults: a randomised web-based four-arm experiment

Lorraine L Landais et al. Int J Behav Nutr Phys Act. .

Abstract

Background: Promoting active (i.e., conscious, autonomous, informed, and value-congruent) choices may improve the effectiveness of physical activity interventions. This web-based four-arm experimental study investigated the effect of promoting an active versus passive choice regarding physical activity on behavioural and psychological outcomes (e.g., physical activity intentions and behaviours, autonomy, commitment) among physically inactive adults.

Methods: Dutch inactive adults were randomized into four groups: physical activity guideline only (control group G), guideline & information (GI), guideline & active choice (GA), or guideline & active choice & action planning (GA +). GA and GA + participants were stimulated to make an active choice by weighing advantages and disadvantages of physical activity, considering personal values, and identifying barriers. GA + participants additionally completed action/coping planning exercises. Passive choice groups G and GI did not receive exercises. Self-reported behavioural outcomes were assessed by a questionnaire pre-intervention (T0, n = 564) and at 2-4 weeks follow-up (T2, n = 493). Psychological outcomes were assessed post-intervention (T1, n = 564) and at follow-up. Regression analyses compared the outcomes of groups GI, GA and GA + with group G. We also conducted sensitivity analyses and a process evaluation.

Results: Although promoting an active choice process (i.e., interventions GA and GA +) did not improve intention (T1) or physical activity (T2 versus T0), GA + participants reported higher commitment at T1 (β = 0.44;95%CI:0.04;0.84) and more frequently perceived an increase in physical activity between T0 and T2 (β = 2.61;95%CI:1.44;7.72). GA participants also made a more active choice at T1 (β = 0.16;95%CI:0.04;0.27). The GA and GA + intervention did not significantly increase the remaining outcomes. GI participants reported higher intention strength (β = 0.64;95%CI:0.15;1.12), autonomy (β = 0.50;95%CI:0.05;0.95), and commitment (β = 0.39;95%CI:0.04;0.74), and made a more active choice at T1 (β = 0.13;95%CI:0.02;0.24). Interestingly, gender and health condition modified the effect on several outcomes. The GA + intervention was somewhat more effective in women. The process evaluation showed that participants varied in how they perceived the intervention.

Conclusions: There is no convincing evidence of a beneficial effect of an active versus passive choice intervention on physical activity intentions and behaviours among inactive adults. Further research should determine whether and how active choice interventions that are gender-sensitized and consider health conditions can effectively increase physical activity.

Trial registration: ClinicalTrials.gov: NCT04973813 . Retrospectively registered.

Keywords: Active choice; Decision making; Inactive Adults; Intention; Physical activity; Process evaluation; Web-based intervention.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study design
Fig. 2
Fig. 2
Participant flow diagram
See this image and copyright information in PMC

References

    1. Howlett N, Trivedi D, Troop NA, Chater AM. Are physical activity interventions for healthy inactive adults effective in promoting behavior change and maintenance, and which behavior change techniques are effective? A systematic review and meta-analysis. Transl Behav Med. 2019;9(1):147–157. doi: 10.1093/tbm/iby010. - DOI - PMC - PubMed
    1. Johnson EJ, Shu SB, Dellaert BG, Fox C, Goldstein DG, Häubl G, et al. Beyond nudges: Tools of a choice architecture. Market Lett. 2012;23(2):487–504. doi: 10.1007/s11002-012-9186-1. - DOI
    1. Thaler H, Sunstein CR. Nudge: improving decisions about health, wealth, and happiness. New Haven & London: Yale University Press; 2008.
    1. Carroll GD, Choi JJ, Laibson D, Madrian BC, Metrick A. Optimal defaults and active decisions. Q J Econ. 2009;124(4):1639–1674. doi: 10.1162/qjec.2009.124.4.1639. - DOI - PMC - PubMed
    1. Keller PA, Harlam B, Loewenstein G, Volpp KG. Enhanced active choice: A new method to motivate behavior change. J Consum Psychol. 2011;21(4):376–383. doi: 10.1016/j.jcps.2011.06.003. - DOI

Publication types

Associated data