%0 Journal Article
%@ 2561-326X
%I JMIR Publications
%V 8
%N 
%P e55722
%T Applying Meaning and Self-Determination Theory to the Development of a Web-Based mHealth Physical Activity Intervention: Proof-of-Concept Pilot Study
%A Hooker,Stephanie A
%A Crain,A Lauren
%A Muegge,Jule
%A Rossom,Rebecca C
%A Pronk,Nicolaas P
%A Pasumarthi,Dhavan Prasad
%A Kunisetty,Gopikrishna
%A Masters,Kevin S
%+ Division of Research and Evaluation, HealthPartners Institute, 8170 33rd Ave S MS21112R, Minneapolis, MN, 55425, United States, 1 9529675056, stephanie.a.hooker@healthpartners.com
%K physical activity
%K midlife
%K digital health
%K SMS text messaging
%K theory-based
%K meaning in life
%K mobile phone
%D 2024
%7 25.6.2024
%9 Original Paper
%J JMIR Form Res
%G English
%X Background: Meaning in life is positively associated with health, well-being, and longevity, which may be partially explained by engagement in healthier behaviors, including physical activity (PA). However, promoting awareness of meaning is a behavior change strategy that has not been tested in previous PA interventions. Objective: This study aims to develop, refine, and pilot-test the Meaningful Activity Program (MAP; MAP to Health), a web-based mobile health PA intervention, theoretically grounded in meaning and self-determination theory, for insufficiently active middle-aged adults. Methods: Following an iterative user-testing and refinement phase, we used a single-arm double baseline proof-of-concept pilot trial design. Participants included 35 insufficiently active adults in midlife (aged 40-64 years) interested in increasing their PA. After a 4-week baseline period, participants engaged in MAP to Health for 8 weeks. MAP to Health used a web-based assessment and just-in-time SMS text messaging to individualize the intervention; promote meaning salience; support the basic psychological needs of autonomy, competence, and relatedness; and increase PA. Participants completed measures of the hypothesized mechanisms of behavior change, including meaning salience, needs satisfaction, and autonomous motivation at pretest (−4 weeks), baseline (0 weeks), midpoint (4 weeks), and posttest (8 weeks) time points, and wore accelerometers for the study duration. At the end of the intervention, participants completed a qualitative interview. Mixed models compared changes in behavioral mechanisms during the intervention to changes before the intervention. Framework matrix analyses were used to analyze qualitative data. Results: Participants were aged 50.8 (SD 8.2) years on average; predominantly female (27/35, 77%); and 20% (7/35) Asian, 9% (3/35) Black or African American, 66% (23/35) White, and 6% (2/35) other race. Most (32/35, 91%) used MAP to Health for ≥5 of 8 weeks. Participants rated the intervention as easy to use (mean 4.3, SD 0.8 [out of 5.0]) and useful (mean 4.3, SD 0.6). None of the hypothesized mechanisms changed significantly during the preintervention phase (Cohen d values <0.15). However, autonomy (P<.001; Cohen d=0.76), competence (P<.001; Cohen d=0.65), relatedness (P=.004; Cohen d=0.46), autonomous motivation (P<.001; Cohen d=0.37), and meaning salience (P<.001; Cohen d=0.40) increased significantly during the intervention. Comparison of slopes before the intervention versus during the intervention revealed that increases during the intervention were significantly greater for autonomy (P=.002), competence (P<.001), and meaning salience (P=.001); however, slopes were not significantly different for relatedness (P=.10) and autonomous motivation (P=.17). Qualitative themes offered suggestions for improvement. Conclusions: MAP to Health was acceptable to participants, feasible to deliver, and associated with increases in the target mechanisms of behavior change. This is the first intervention to use meaning as a behavior change strategy in a PA intervention. Future research will test the efficacy of the intervention in increasing PA compared to a control condition. 
%R 10.2196/55722
%U https://formative.jmir.org/2024/1/e55722
%U https://doi.org/10.2196/55722