EFFECTIVENESS OF STEPWISE BEHAVIOURAL INTERVENTIONS ON HEART RATE–BASED PHYSICAL ACTIVITY AMONG EMPLOYED WOMEN
Keywords:
aerobic exercises, cardiovascular health, Keywords: physical activity; heart rate zones; wearable devices; adaptive interventions; SMART trial; employed women; behavioral support.Abstract
Background: Physical inactivity is a major contributor to cardiometabolic risk among employed women. Adaptive behavioural interventions provide an effective approach to increasing heart rate–based physical activity in this population. Objective was to evaluate the effectiveness of a 12-week stepwise behavioural intervention incorporating wearable devices, motivational messages, individualized calls, and online group sessions on moderate-to-vigorous physical activity (MVPA) and heart rate–based outcomes. Methods: A Sequential Multiple Assignment Randomized Trial (SMART) was conducted among 280 low-active employed women. Participants were initially randomized to wearable monitoring alone or monitoring plus motivational text messaging for 4 weeks. Non-responders (<10% increase in MVPA) at week 4 were re-randomized to receive either coaching calls or online group sessions during weeks 5–8. All participants continued with monitoring alone during weeks 9–12. Primary outcomes included MVPA (min/day), duration of elevated heart rate, and estimated energy expenditure, measured objectively via wearable devices. Results: Both initial groups demonstrated increased MVPA at week 4, with significantly greater improvement in the text messaging group compared with monitoring alone (+12.7±10.8 vs. +6.8±9.3 min/day; p<0.001). Among 108 non-responders, participants receiving online group sessions showed greater gains than those receiving coaching (+9.1±8.5 vs. +4.2±7.7 min/day; p=0.002). Conclusion: Stepwise adaptive behavioural interventions using wearable monitoring combined with digital and social support effectively improve physical activity in employed women.
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