College Campus-Based Physical Activity Support: Retrospective Longitudinal Analysis of Intra- Versus Inter-Personal Components for Uptake and Outcome Prediction (Preprint)
Authors: Ash Garrett I. , Mak Selene S , Haughton Adrian D , Augustine Madilyn , Bodurtha Philip , Axtell Robert S. , Borsari Beatrice , Liu Jason , Lou Shaoke , Xin Xin , Fucito Lisa M. , Jeon Sangchoon , Stults-Kolehmainen Matthew , Gerstein Mark B. 
Published: August 2023

BACKGROUND

Evidence suggests low physical activity (PA) levels among college students could be addressable by both intrapersonal fitness tracking (e.g., step-counting) and interpersonal support tailored to the campus environment. However, no studies have examined the appeal and influence of intra- and interpersonal components in campus-based PA interventions.

OBJECTIVE

Retrospectively observe a campus-based PA promotion program to compare usage of intervention components between students and faculty/staff, then test whether such usage was associated with successful retention and goal-achievement in the program.

METHODS

A public university used a commercial platform for a 30-day PA promotion program with intrapersonal (step-tracker syncing, education, self-monitoring, motivational messaging) and interpersonal (friend interactions, team games) components. All students and faculty were invited to participate. App usage was operationalized as intrapersonal (frequency of opening app, use of educational and self-monitoring features) and interpersonal components (friends made in-app, team affiliation and size). These metrics were compared between students and faculty using bivariate tests. They were tested as predictors of retention (i.e., duration of usage before abandonment) and step-goal achievement by a Cox frailty proportional hazard model and a generalized estimating equation respectively.

RESULTS

Campuswide email elicited signup by 156 undergraduate students, 57 graduate students, and 126 faculty/staff members. Most participants (92%) were retained for the first 7 days but by 30 days there was lower retention which differed by academic status: undergraduates 53%, graduates 68%, faculty/staff 74% (H=13.3, P<.001). Undergraduates used the app less frequently (median [IQR] 0.8 [0.4,1.7] per day) than other groups (grad 1.4 [0.7,2.7], faculty 1.3 [0.7,2.7]) (H=14.5, p=.001)). However, there were no differences in number of friends (undergrad 2 [0,3], grad 1 [0,4], faculty 2 [0,3]) (H=0.5, P =.77) or teammates made (undergrad 9 [6,10], grad 9 [5,10], faculty 8 [6,10]) (H=0.1, P =.93). Retention was predicted by app engagement frequency (frailty model hazard 0.56 (95% CI=[0.43, 0.72], P<.001)) and affiliation with a team having high median app engagement frequency and/or large size (intra-cluster correlation coefficient 0.064). Meeting daily step goal was predicted by app engagement frequency (β=0.36–0.72), number of friends (β=0.33-0.40), and initial motive of maintaining or increasing (rather than starting) PA (β =0.63-0.99). The latter was also predictive of adherence with wearing or carrying a step-tracker (β=1.69-1.70).

CONCLUSIONS

College students, compared with faculty/staff, 1) used the app less frequently; 2) used the app for shorter duration before abandonment; and 3) met step goal on fewer days. Engagement with the program suggests longer retention and better PA outcomes, that were critically modified by the interpersonal aspects of this engagement. These findings suggest college students could benefit from more tailored implementation strategies such as timed prompts and team reassignments.