A theory-based online health behaviour intervention for new university students (U@Uni): results from a randomised controlled trial

BMC Public Health

Iltaf Shah³  Jen Kruger¹  Andrea Petroczi³  Declan Naughton³  Petra S Meier¹  Alan Brennan¹  Fabio Ciravegna⁴  Steven A Julious¹  Paschal Sheeran⁵  Thomas L Webb⁷  Peter R Harris⁶  Aba-Sah Dadzie⁴  Paul Norman⁷  Tracy Epton² 

[1] School of Health and Related Research, University of Sheffield, Regent Court, Sheffield S1 4DA, UK;School of Psychological Sciences, University of Manchester, Oxford Road, Manchester M13 9PL, UK;School of Life Science, Kingston University, Penrhyn Road, Kingston upon Thames KT1 2EE, UK;Department of Computer Science, University of Sheffield, Regent Court, Sheffield S1 4DA, UK;Psychology Department, University of North Carolina, 323 Davie Hall, Chapel Hill NC 27599-3270, USA;School of Psychology, University of Sussex, Falmer BN1 9QH, UK;Department of Psychology, University of Sheffield, Western Bank, Sheffield S10 2TP, UK

关键词: Smoking;    Exercise;    Fruit and vegetables;    Alcohol;    Implementation intentions;    Theory of planned behaviour;    Self-affirmation;    Internet;    Young adults;   

Others  :  1129755
DOI  :  10.1186/1471-2458-14-563

 received in 2014-01-31, accepted in 2014-05-23,  发布年份 2014

【 摘 要 】

Background

Too few young people engage in behaviours that reduce the risk of morbidity and premature mortality, such as eating healthily, being physically active, drinking sensibly and not smoking. This study sought to assess the efficacy and cost-effectiveness of a theory-based online health behaviour intervention (based on self-affirmation theory, the Theory of Planned Behaviour and implementation intentions) targeting these behaviours in new university students, in comparison to a measurement-only control.

Methods

Two-weeks before starting university all incoming undergraduates at the University of Sheffield were invited to take part in a study of new students’ health behaviour. A randomised controlled design, with a baseline questionnaire, and two follow-ups (1 and 6 months after starting university), was used to evaluate the intervention. Primary outcomes were measures of the four health behaviours targeted by the intervention at 6-month follow-up, i.e., portions of fruit and vegetables, metabolic equivalent of tasks (physical activity), units of alcohol, and smoking status.

Results

The study recruited 1,445 students (intervention n = 736, control n = 709, 58% female, Mean age = 18.9 years), of whom 1,107 completed at least one follow-up (23% attrition). The intervention had a statistically significant effect on one primary outcome, smoking status at 6-month follow-up, with fewer smokers in the intervention arm (8.7%) than in the control arm (13.0%; Odds ratio = 1.92, p = .010). There were no significant intervention effects on the other primary outcomes (physical activity, alcohol or fruit and vegetable consumption) at 6-month follow-up.

Conclusions

The results of the RCT indicate that the online health behaviour intervention reduced smoking rates, but it had little effect on fruit and vegetable intake, physical activity or alcohol consumption, during the first six months at university. However, engagement with the intervention was low. Further research is needed before strong conclusions can be made regarding the likely effectiveness of the intervention to promote health lifestyle habits in new university students.

Trial registration

Current Controlled Trials, ISRCTN67684181.

【 授权许可】

   
2014 Epton et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Parliamentary Office of Science and Technology: Health Behaviour. http://www.parliament.uk/documents/post/postpn283.pdf webcite
• [2]National Centre for Social Research: Health survey for England. 2008. http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles-related-surveys/health-survey-for-england webcite
• [3]Webb TL, Joseph J, Yardley L, Michie S: Using the internet to promote health behavior change. J Med Internet Res 2010, 12:e4.
• [4]Jemmott JB III, Jemmott LS, O'Leary A, Ngwane A, Icard L, Bellamy S, Jones S, Landis JR, Heeren A, Tyler JC, Makwane MB: Cognitive-behavioural health-promotion intervention increases fruit and vegetable consumption and physical activity among South African Adolescents: a cluster-randomised controlled trial. Psych Health 2011, 26:167.
• [5]Zhang Y, Cooke R: Using a combined motivational and volitional intervention to promote exercise and healthy dietary behaviour among undergraduates. Diab Res Clin Pract 2012, 95:115.
• [6]Epton T, Norman P, Sheeran P, Harris PR, Webb TL, Ciravegna F, Meier P, Brennan A, Julious SA, Naughton D, Petroczi A, Dadzie AS, Kruger J: A theory based online health behaviour intervention for new university students: study protocol. BMC Publ Health 2013, 13:107. BioMed Central Full Text
• [7]UCAS: Final end of cycle figures for. 2012. http://www.ucas.com/data-analysis/scheduled-releases#endcycle webcite
• [8]Gill JS: Reported levels of alcohol consumption and binge drinking within the UK undergraduate student population over the last 25 years. Alcohol 2002, 37:109-120.
• [9]Wood W, Tam L, Witt MG: Changing circumstances, disrupting habits. J Pers Soc Psychol 2005, 88:918-933.
• [10]Heatherton TF, Nichols PA: Personal accounts of successful versus failed attempts at life change. Pers Soc Psychol Bull 1994, 20:664-675.
• [11]Harris PR, Epton T: The impact of self-affirmation on health cognition, health behavior and other health-related responses: a narrative review. Soc Pers Psychol Comp 2009, 3:962-978.
• [12]Conner M, Norman P: Predicting Health Behavior: Research and Practice with Social Cognition Models. 2nd edition. Buckingham: Open University Press; 2005.
• [13]Gollwitzer PM, Sheeran P: Implementation intentions and goal achievement: a meta-analysis of effects and processes. Adv Exp Soc Psychol 2006, 38:69-119.
• [14]Office for National Statistics: Internet access. http://www.ons.gov.uk/ons/rel/rdit2/internet-access---households-and-individuals/2012/stb-internet-access--households-and-individuals--2012.html webcite
• [15]Ipsos Media CT: Technology tracker. http://www.ipsos-mori.com/researchspecialisms/ipsosmediact/customresearch/technology/techtracker.aspx webcite
• [16]SurveyGizmo http://www.surveygizmo.com webcite
• [17]Sherman DK, Bunyan DP, Creswell JD, Jaremka LM: Psychological vulnerability and stress: the effects of self-affirmation on sympathetic nervous system responses to naturalistic stressors. Health Psychol 2009, 28:554-562.
• [18]Ajzen I: Attitudes, Personality and Behaviour. Milton Keynes, UK: Open University Press; 1988.
• [19]Epton T, Norman P, Harris PR, Webb TL, Snowsill FA, Sheeran P: Development of theory-based messages: a three-phase programme of formative research. Health Promot IntIn press
• [20]Booth ML: Assessment of physical activity: an international perspective. Res Q Exerc Sport 2000, 71:s114-s120.
• [21]Office for National Statistics: General Lifestyle Survey. 2010. http://www.ons.gov.uk/ons/rel/ghs/general-lifestyle-survey/2010/index.html webcite
• [22]Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG: The alcohol use disorders identification test. whqlibdoc.who.int/hq/2001/who_msd_msb_01.6a.pdf
• [23]Rabin R, de Charro F: EQ-5D: a measure of health status from the EuroQol Arm. Ann Med 2001, 23:337-343.
• [24]National Institute of Health and Clinical Excellence: Guide to the methods of technology appraisal. http://www.nice.org.uk/aboutnice/howwework/devnicetech/guidetothemethodsoftechnologyappraisal.jsp webcite
• [25]Petroczi A, Nepusz T, Cross P, Taft H, Shah S, Deshmukh N, Schaffer J, Shane M, Adesanwo C, Barker J, Naughton DP: New non-randomised model to assess the prevalence of discriminating behaviour: a pilot study on mephedrone. Subst Abuse Treat Pr 2011, 3:6-20.
• [26]Nepusz T, Petróczi A, Naughton DP, Epton T, Norman P: Estimating the prevalence of socially sensitive behaviours: attributing guilty and innocent noncompliance with the single sample count method. Psychol Methods 2013. doi: 10.1037/a0034961
• [27]Julious SJ, Mullen MA: Issues with using baseline in last observation carried forward analysis. Pharm Stat 2008, 7:146-146. doi:10.1002/pst.311
• [28]International Conference on Harmonisation E9 Expert Working Group: ICH Harmonised tripartite guideline. Statistical principles for clinical trials. Stat Med 1999, 18:1905-1942.
• [29]Rabia M, Knauper B, Miquelon P: The eternal quest for optimal balance between maximizing pleasure and minimizing harm: the compensatory health beliefs model. Brit J Health Psych 2006, 11:139-153.