We did not observe relevant changes in the steps per day either throughout the intervention or compared with the control group. Results: Twelve participants, including five controls, finished the intervention. We compared the accelerometer-based steps per day before and after the intervention, as well as the slopes of the app-based steps per day between the first and second stages of the intervention. We considered responders as those with any positive slope in the linear relationship between weeks and steps per day at the end of the first stage of the intervention. Based on the 12-week intermediate outcome, responders continued the intervention and nonresponders were rerandomized to subsequent treatment, including a new group 3 (smartphone app + tailored messages + gamification) in which they were instructed to form groups to use several game elements available in the chosen app (Pacer). Participants were motivated to increase their step count by at least 2000 steps/day each week. Methods: We conducted a feasibility 24-week/two-stage SMART in which 18 insufficiently active participants (<10,000 steps/day) were first randomized to group 1 (smartphone app only), group 2 (smartphone app + tailored messages), and a control group (usual routine during the protocol). We also aimed to describe the participants’ perception regarding the protocol and the use of the app for physical activity qualitatively. Objective: We aimed to investigate the feasibility of the SMART design for assessing the effects of a smartphone app intervention to improve physical activity in adults. Despite its potential and feasibility for defining the best sequence of interventions, so far, it has not been utilized in a smartphone/gamified intervention for physical activity. Laboratory of Epidemiology and Human Movement (EPIMOV)Įmail: The sequential multiple assignment randomized trial (SMART) design allows for changes in the intervention during the trial period. Asian/Pacific Island Nursing Journal 10 articles.JMIR Bioinformatics and Biotechnology 32 articles.JMIR Biomedical Engineering 68 articles.Journal of Participatory Medicine 78 articles.JMIR Perioperative Medicine 89 articles.JMIR Rehabilitation and Assistive Technologies 201 articles.JMIR Pediatrics and Parenting 279 articles.Interactive Journal of Medical Research 306 articles.JMIR Public Health and Surveillance 1141 articles.Journal of Medical Internet Research 7471 articles.
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