R01HL153810

Influencing Basic Behavioral Mechanisms of Action while Targeting Daily Walking in Those at Risk for Cardiovascular Disease: Science of Behavior Change Factorial Experiment of Behavioral Change

We use the basic science of behavior change to experimentally test the effects of four distinct behavior change techniques (BCTs) in an efficient manner. These BCTs are selected to engage one of the key behavioral mechanisms of action (MOAs) - self-efficacy - for improving daily walking by at least 1000 steps in individuals who are very sedentary and at elevated cardiovascular disease risk. To do so, we propose a randomized 2x5 factorial experiment.

Whereas we have hundreds of behavior change interventions aimed at physical activity initiation, most of them test multi-BCT interventions, averaging six BCTs in each randomized controlled trial. Systematic reviews of these trials have concluded that self-efficacy was often the key proposed mechanism of action that improved initiation. They also found that self-efficacy was significantly improved by these multi-BCT interventions, as was physical activity. However, they cannot conclusively determine which BCT uniquely engaged or changed self-efficacy, and whether the change in self-efficacy in turn increased physical activity. This is because currently published physical activity interventions, with one single exception, always involve multiple BCTs. These interventions do not quantitatively assess whether the BCT was used by the participant, do not assess the key MOA and behavior repeatedly across time, and do not estimate statistical power for conducting a mediation model test. As a result, they are likely underpowered to detect mediation.

The science of behavior change experimental method proposes that researchers identify the putative MOA, engage this MOA through experimentation and/or intervention, and then assess the degree to which MOA engagement produces behavior change. We used this approach to design an experiment in which eligible sedentary adults will be randomized to one of 16 cells for five months of intervention. The innovations of this project include: 1) identifying the individual effects of each of four BCTs on the hypothesized MOA, with a full factorial design; 2) using sequential mediation analysis to address longitudinal mediators; 3) including sufficient participants (N=480) to have adequate statistical power; and 4) quantitatively assessing whether the BCT was used.

Sedentary behavior among participants at risk for cardiovascular disease is highly prevalent and is associated with increased risk for morbidity and mortality. Identifying which unique behavior change techniques engage self-efficacy and improve walking, and which ones don't, may allow future interventions to be more efficient and scientifically informed to precisely target this important public health problem.

The Feinstein Institutes For Medical Research

TO FOSTER HEART AND VASCULAR RESEARCH IN THE BASIC, TRANSLATIONAL, CLINICAL AND POPULATION SCIENCES, AND TO FOSTER TRAINING TO BUILD TALENTED YOUNG INVESTIGATORS IN THESE AREAS, FUNDED THROUGH COMPETITIVE RESEARCH TRAINING GRANTS. SMALL BUSINESS INNOVATION RESEARCH (SBIR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, USE SMALL BUSINESS TO MEET FEDERAL RESEARCH AND DEVELOPMENT NEEDS, FOSTER AND ENCOURAGE PARTICIPATION IN INNOVATION AND ENTREPRENEURSHIP BY SOCIALLY AND ECONOMICALLY DISADVANTAGED PERSONS, AND INCREASE PRIVATE-SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL RESEARCH AND DEVELOPMENT FUNDING. SMALL BUSINESS TECHNOLOGY TRANSFER (STTR) PROGRAM: TO STIMULATE TECHNOLOGICAL INNOVATION, FOSTER TECHNOLOGY TRANSFER THROUGH COOPERATIVE R&D BETWEEN SMALL BUSINESSES AND RESEARCH INSTITUTIONS, AND INCREASE PRIVATE SECTOR COMMERCIALIZATION OF INNOVATIONS DERIVED FROM FEDERAL R&D.

93.837 - Cardiovascular Diseases Research

National Heart Lung and Blood Institute (NHLBI) [HHS - NIH]

Manhasset, New York 110303816 United States

Single Zip Code

Research Project Grant (Parent R01 Clinical Trial Required) (PA-20-183)

Amendment Since initial award the total obligations have increased 380% from $768,138 to $3,687,122.