Aherence to Different Exercise Interventions
Phase: NA
Conditions: Exercise Adherence
Sponsor: California Polytechnic State University-San Luis Obispo

Date: June 29, 2023 
Title: Adherence to different exercise interventions  
 
Project Personnel: 
 
Todd Hagobian, Ph.D. 
Kinesiology and Public Health 
Cal Poly   
 
Adam Seal, Ph.D. 
Kinesiology and Public Health 
Cal Poly   
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

Objective of study: 
Regular exercise, in the form of walking 150 minutes per week, is widely regarded as having 
many health and fitness benefits (1-5). Despite these well-known benefits, adherence to exercise 
interventions is extremely low. When sedentary adults start an exercise training program only 
50% adhere to the program and meet the national recommendations of 150 minutes per week. A 
possible explanation of the low adherence is that most adults only walk for exercise, and that 
providing a variety of exercise may increase adherence. Preliminary observational data does 
show that a variety of exercise may increase weekly exercise expenditure compared to other 
interventions (2). The overall objective this study is to investigate the feasibility, adherence, and 
acceptability of different exercise interventions including 1) walk intervention, 2) variety 
intervention, and 3) progressive intervention (see below for description). 
 
Participant Characteristics: 
Inclusion criteria 
• 60 total adults (30 men and 30 women) will be recruited from Cal Poly and the San Luis 
Obispo area.   
• 18-40 years old  
• Sedentary (<1 hour per week of exercise)  
• BMI 18.5 to 40 kg/m2  
• All participants will be healthy, weight-stable for the previous 6 months, free of any 
metabolic or chronic disease, non-smoking, and sedentary, assessed by Health and 
Fitness History and Physical Activity Readiness (PAR-Q) questionnaires. 
• All race/ethnicities will be eligible for this study with a target enrollment of 20% 
Hispanic and 80% non-Hispanic. 
 
Exclusion criteria 
• Adults with diagnosed cardiovascular, diabetes, renal, or any other metabolic disease 
determined by Health and Fitness History questionnaire. 
• Any other disability, ailment, or physical characteristics that may hinder the ability to 
participate in regular exercise.  
• Participating in other studies that would interfere with their ability to safely complete the 
exercise protocols. 
• Pregnant or trying to become pregnant, and peri-menopausal or post-menopausal women.  
• History of smoking within the last 6 months  
• Any vulnerable population (children <18, pregnant women, prisoners, etc.) 
 
Recruitment 
Recruitment efforts will be focused on California Polytechnic State University San Luis Obispo 
and the surrounding area. Participants will be recruited via flyer across campus and in the 
surrounding area. These flyers will also be distributed electronically via campus listservs and 
appropriate social media outlets. The flyer will contain both an email address and QR code that 
will be linked contact information. Once contact information has been obtained, a member of the 

research staff will contact the participant. If the participant is deemed eligible for the study 
(based on script delivered on the phone, on Zoom or by phone), they will be asked to schedule a 
Zoom or in-person meeting with a member of the research staff to go over the study protocol in 
more detail and address any questions or concerns the participant may have. Visit 1: If the 
participant is interested in taking part in the study, they will be provided with an informed 
consent form (electronic via RedCap or paper copy). After consent has been obtained, 
participants will be asked to schedule their first visit. The consent visit will take approximately 1 
hour. The visit will occur in the William and Linda Frost Center for Research and Innovation. 
 
Methods 
Visit 2: Preliminary Tests.  After informed consent has been obtained, participants will body 
weight, height will be measured. In addition, participants will fill out a Health and Fitness 
History, demographics questionnaire, Physical Activity questionnaire (PAR-Q), Paffenbarger 
Physical Activity Questionnaire (PPAQ). Participants will also wear a GENE-Active watch on 
their non-dominant wrist for the entire 4-weeks of the study. The GENE-Active watch is a 
research grade, lightweight and waterproof watch that provides raw accelerometer data. 
Participants will be asked to wear the watch throughout the day but may take it off at night and 
to shower. The watch is designed for public health research and clinical trials, is lightweight and 
waterproof, and will record for 30 days raw data accelerometer. This visit will take 
approximately 1 hour and will occur in the William and Linda Frost Center for Research and 
Innovation in the Center for Health Research Laboratory. We will then collect 3-days of baseline 
accelerometer data. 
 
Visit 3: After 3 days of baseline, participants will be randomized (by sex, ethnicity, BMI) to one 
of three exercise interventions: 1) walk intervention, 2) variety intervention, 3) progressive 
intervention. For the variety intervention, each week participants will be prescribed a different 
exercise (variety) which will only include cycling, walking/jogging, yoga/Pilates, cross-training 
(kick boxing, karate, salsa dancing, circuit training), and strength training (e.g., Week 1: cycling, 
Week 2: walking, Week 3: Cross-training, Week 4: yoga). For the progressive intervention, the 
same exercises will be included but will be added to the list of options for participants (e.g., 
Week 1: yoga, Week 2: yoga and walking, Week 3: yoga, walking, and strength training, Week 
4: yoga, walking, strength training, cross-training). For the progressive intervention, participants 
may choose from the list of exercise.  They do not have to do them all, and they can do as much 
or little (none) of whatever they choose. The exercises will be randomized within variety and 
progressive interventions. If participants are Cal Poly students, the ASI recreation center has 
classes available for each activity. The exercise prescription of each intervention is to exercise 
for at least 150 minutes per week. The exercise will not be supervised, and participants will 
complete the exercise on their own. This visit will take approximately 30 minutes.  
Visits 4-6: After each week, the participant will be instructed to meet with a study researcher that 
will download the watch accelerometer data, measure weight, complete a physical activity diary 
for the week, and will be provided the next week exercise. Research staff will schedule the 

weekly meeting via email or text with the participant, and the participant will meet the research 
staff in the William and Linda Frost Center for Research and Innovation in the Center for Health 
Research laboratory. These visits will take approximately 15 minutes each.  
Visit 7. Final assessments of watch accelerometer, physical activity diary and questionnaire, and 
weight will be collected after the 4-weeks. Participants will complete some questions related to 
acceptability of the intervention. The questions This visit will take approximately 1 hour.   
Statistical Analyses: A repeated measures ANOVA (group x time interaction) adjusting for BMI, 
ethnicity/race, income, sex, and age.  
Primary Outcome Measure: Adherence to intervention determined by 150 minutes per week of 
moderate to vigorous physical activity via the GENE-Active watch. 
Secondary Outcomes Measures: Physical activity diary, Paffenbarger Physical Activity 
Questionnaire (PPAQ), body weight, acceptability of intervention via questionnaire. 
Moderators of intervention (Covariates): BMI category, ethnicity/race, income, sex, age.  
 
Potential Risks  
Despite the well-documented benefits, there are also a slight risk associated with regular 
engagement in exercise [1] including musculoskeletal injury. Though this risk increases amongst 
sedentary individuals, the rate of incidence is exponentially higher for those performing high-
impact sports (e.g., soccer, football, etc.). The participants in this study will not be asked to 
perform any contact sports that may increase the chance of a musculoskeletal injury.  
 
Participants may experience fatigue and muscle soreness due to an increase in physical activity 
from previous sedentary states. These health risks are small in people with no prior history of 
cardiovascular, respiratory, or musculoskeletal disease or injury. Any ordinary fatigue or muscle 
soreness is temporary and usually lasts 24-96 hours. Participants will not be performing any 
supervised exercise; however, the risks are included in the informed consent.  
 
Finally, there are slight psychological and social risks of completing the questionnaires, and 
participants may omit any question they do not feel comfortable answering. 
  
Confidentiality and Data Safety 
All data will be collected by trained student researchers under the authorization of the lead 
investigators (Drs. Hagobian and Seal). Data will be examined in a confidential fashion to 
preserve the privacy of each participant. All members of the research staff will have completed 
the required CITI training modules on responsible conduct of research. The data collected in this 
study will be accessible only to the researchers involved. All paper data will be stored in a locked 
file cabinet, and electronic data will stored on the Center for Health Research’s encrypted, 
password-protected cloud storage hosted by the Baily College of Science and Math using AWS. 

Additionally, the informed consent, questionnaires and other data will be administered and stored 
using RedCap. REDCap is a web application for building and managing online surveys and 
databases, and thus proper security practices are instituted on the network and server(s) hosting 
REDCap and within the REDCap software itself. All data will be de-identified using both a 
unique study and participant ID. The file linking the participant’s identifiable information to their 
ID number and confidential data will be kept in a separate password-protected location. Upon 
completion of the study, the accelerometer data and profile will be wiped from the device. Data 
specific to the aim of this study will be shared with scientific journals for publication purposes 
only, and will not include any names or participant ID.  
 
Data Sharing: All records will be retained in our database for 7 years after the date of the last 
participant completing the study, or the data may be destroyed if no longer in use before the 7 
years. We will follow NIH guidelines, and research data from participants may be shared with 
the broader scientific community or journals for publication upon request. We will make data 
and documentation available under a data-sharing agreement that provides for (1) a commitment 
to use the data for research purposes only; (2) a commitment to securing the data using 
appropriate computer technology (password protected and encrypted); (3) a commitment to 
destroying or returning the data after analyses are completed and (4) a commitment not to 
attempt to identify participants individually. Information shared with outside collaborators will 
link data to two unique study identifiers (De-Identified) to maintain participant anonymity, and 
outside researchers and the community will not be allowed to have access to participant names 
and confidential information. 
Compensation and Benefits 
There are no costs to participate in this study. There are no incentives for participating in this 
study. There are no direct benefits associated with the study. These data are collected for 
research purposes only and are not clinical or diagnostic. These data may further our 
understanding of methods to increase adherence to exercise interventions. 
 
 
 
References 
1. American College of Sports Medicine. (2018). ACSM's Guidelines for Exercise Testing 
and Prescription (10th ed.). Retrieved from https://www.acsm.org/docs/default-
source/publications-files/acsm-guidelines-download-10th-
edabf32a97415a400e9b3be594a6cd7fbf.pdf?sfvrsn=aaa6d2b2_0 
2. Bond, D. S., Raynor, H. A., Phelan, S., Steeves, J., Daniello, R., & Wing, R. R. (2011). 
The Relationship between Physical Activity Variety and Objectively Measured 
Moderate-to-Vigorous Physical Activity Levels in Weight Loss Maintainers and Normal-
Weight Individuals. Journal of Obesity, 2012. https://doi.org/10.1155/2012/812414 
3. Otten, J. J., Jones, K. E., Littenberg, B., & Harvey-Berino, J. (2009). Effects of television 
viewing reduction on energy intake and expenditure in overweight and obese adults: a 

randomized controlled trial. Archives of internal medicine, 169(22), 2109–2115. 
https://doi.org/10.1001/archinternmed.2009.430  
4. Troiano, R. P., Berrigan, D., Dodd, K. W., Mâsse, L. C., Tilert, T., & McDowell, M. 
(2008). Physical activity in the United States measured by accelerometer. Medicine and 
science in sports and exercise, 40(1), 181–188. 
https://doi.org/10.1249/mss.0b013e31815a51b3  
5. U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for 
Americans (2nd ed.). Retrieved from https://health.gov/sites/default/files/2019-
09/paguide.pdf