An App-Based Physical Activity Intervention in Community-Dwelling Chinese-, Tagalog-, and Vietnamese-Speaking Americans: Single-Arm Intervention Study

Abstract

Background: Physical inactivity is associated with adverse health outcomes among Asian Americans, who exhibit the least adherence to physical activity guidelines compared with other racial and ethnic groups. Mobile app-based interventions are a promising approach to promote healthy behaviors. However, there is a lack of app-based interventions focused on improving physical activity among Asian Americans whose primary language is not English.

Objective: This pilot study aimed to assess the feasibility and acceptability of a 5-week intervention using a culturally and linguistically adapted, evidence-based mobile phone app with an accelerometer program, to promote physical activity among Chinese-, Tagalog-, or Vietnamese-speaking Americans.

Methods: Participants were recruited through collaborations with community-based organizations. The intervention was adapted from a 12-month physical activity randomized controlled trial involving the app and accelerometer for English-speaking adults. Sociodemographic characteristics, lifestyle factors, and physical measurements were collected at the baseline visit. A 7-day run-in period was conducted to screen for the participants who could wear a Fitbit One (Fitbit LLC) accelerometer and complete the app's daily step diary. During the 4-week intervention period, participants wore the accelerometer and reported their daily steps in the app. Participants also received daily messages to reinforce key contents taught during an in-person educational session, remind them to input steps, and provide tailored feedback. Feasibility measures were the percentage of eligible participants completing the run-in period and the percentage of participants who used the app diary for at least 5 out of 7 days during the intervention period. We conducted poststudy participant interviews to explore overall intervention acceptability.

Results: A total of 19 participants were enrolled at the beginning of the study with a mean age of 47 (SD 13.3; range 29-70) years, and 58% (n=11) of them were female. Of the participants, 26% (n=5) were Chinese, 32% (n=6) were Vietnamese, and 42% (n=8) were Filipino. All participants met the run-in criteria to proceed with the intervention. Adherence to the app diary ranged from 74% (n=14) in week 2 to 95% (n=18) in week 4. The daily average steps per week from accelerometers increased each week from 8451 (SD 3378) steps during the run-in period to 10,930 (SD 4213) steps in week 4. Participants reported positive experiences including an increased motivation to walk and the enjoyment of being able to monitor their physical activity.

Conclusions: This is the first pilot study of a multicomponent intervention and evidence-based mobile phone app to promote physical activity among Asian Americans who use apps in traditional Chinese, Tagalog, or Vietnamese, which demonstrated high feasibility and acceptability. Future work focused on multilingual mobile apps to address disparities in physical inactivity among Asian Americans should be considered.

Keywords: Asian Americans; Chinese; Filipino; Vietnamese; acceptability; adult; adults; app; app-based; application; applications; apps; community-based; community-dwelling; cultural; culturally; evidence-based; feasibility; intervention; interventions; lifestyle; linguistic; linguistically; mHealth; mobile app; mobile health; mobile phone; multicomponent; multilingual; physical activity; physical activity tracker; pilot study; sociodemographic; tracker; trackers.

Figure 1

Screenshots of the study mobile app. (A) The Vietnamese version of the trial app. The app was also available in Tagalog and traditional Chinese. Translations: "Nhật ký hoạt động" = Activity diary; "Mục tiêu hàng tuần" = Weekly goals; "Nói Chuyện Với Chúng Tôi" = Talk to Us; "Quá trình số bước đã đi" = Steps History; "Trang chủ" = Home; "Tóm lược" = Summary; "Trợ giúp" = Help. (B) The mobile app daily diary step entry in traditional Chinese (translation: Weekly Steps). (C and D) Mobile app data visualization of steps by day as entered by the participants in English and Tagalog. Translation: "Mga nakaraang" = Prior. UCSF: University of California San Francisco.

Figure 2

Recorded daily average steps by Fitbit One accelerometer and percentage of app diary adherence* by week. *Adherence was defined as the percentage of participants who used the app diary on at least 5 days out of 7 days.