A feasibility randomized trial of an identity-based physical activity intervention among university students

Figures & data

Figure 1. Logic model of relationship between exercise identity and exercise behaviour.

Table 1. Behaviour change techniques (BCT) utilized in intervention content.

Group	BCT	Session component
Indirect Intervention
	1.1 Goal setting (behaviour)	Setting SMART goals
	1.2 Problem solving	Barrier identification
	1.4 Action planning	Creating a detailed PA plan
	1.5 Review behavioural goal(s)	Each week, goals were reviewed and revised
	2.3 Self-monitoring of behaviour	Self-monitoring explicitly discussed
	5.1 Information about health consequences	Physical health consequences explicitly discussed
	5.6 Information about emotional consequences	Emotional consequences explicitly discussed
	8.7 Graded tasks	SMART goals including reasonable goals for individual’s current fitness level
Direct Intervention
	1.6 Discrepancy between current behaviour and goal	Activity on ideal self vs actual self
	7.1 Prompts/cues	Environmental cuing explicitly discussed
	8.3 Habit formation	Habit formation explicitly discussed
	12.1 Restructuring the physical environment	Changing one’s environment explicitly discussed
	12.4 Distraction	Discussed when brainstorming ways to make physical activity fun
	12.5 Adding objects to the environment	Discussed during section on changing the environment
	13.2 Framing/reframing	Cognitive restructuring of physical activity beliefs
	13.3 Incompatible beliefs	Drawing attention to the fact that a participant exercises but does not consider themselves ‘an exerciser’
	13.5 Identity associated with changed behaviour	Discussion around creating a new identity surrounding exercise, including changing dress, social media presence, etc
	15.4 Self-talk	Positive self-talk regarding being an exerciser (ex ‘I am an exerciser therefore I will … ’)

Note: Direct intervention group received the indirect intervention BCTs as well as the direct intervention group BCTs; see Appendix 2 for full intervention materials

Figure 2. CONSORT flow diagram of sign-ups, allocation, participant progress, and analysis.

Table 2. Baseline characteristics of participants: mean (SD).

Characteristic	Overall (n = 18)	Indirect (n = 9)	Direct (n = 9)
Age	21.33 (2.30)	22.11 (2.42)	20.56 (2.01)
Leisure Score Index	26.14 (19.33)	27.00 (18.21)	25.28 (21.47)
Exercise Identity Score	3.12 (0.92)	2.86 (0.59)	3.38 (1.14)
Year in University	3.22 (1.73)	3.33 (1.94)	3.11 (1.62)

Table 3. Satisfaction and evaluation questionnaire results.

Satisfaction and Evaluation Questions	Overall (n = 18)	Indirect Intervention (n = 9)	Mean (SD)	Direct Intervention (n = 9)	Mean (SD)	Effect size d
Information provided in workbooks: Quite or extremely interesting	14/18 (77.8%)	6/9 (66.7%)	2.67 (0.87)	8/9 (88.9%)	3.00 (0.50)	0.48
Learned anything new from the workbooks: Learned quite a bit or a lot	8/18 (44.4%)	3/9 (33.3%)	2.22 (0.97)	5/9 (55.65)	2.67 (0.71)	0.54
Used the tools and strategies provided in the workbooks: Used quite a bit or a lot	11/18 (61.1%)	6/9 (66.7%)	2.89 (1.05)	5/9 (55.6%)	2.56 (0.53)	−0.42
Tools provided in workbooks helped increase physical activity: Helped quite a bit or a lot	11/18 (61.1%)	6/9 (66.7%)	3.00 (1.12)	5/9 (55.6%)	3.00 (0.87)	0.00
Learn any new information working with the researcher: Learned quite a bit or a lot	10/18 (55.6%)	4/9 (44.4%)	2.44 (0.53)	6/9 (66.7%)	2.89 (0.78)	0.68
Used the tools discussed during counselling sessions: Used quite a bit or a lot	13/18 (72%)	5/9 (55.6%)	3.00 (1.00)	8/9 (88.9%)	3.22 (0.67)	0.26
Counselling sessions helped to increase PA: Quite helpful or extremely helpful	16/18 (88.9%)	7/9 (77.8%)	3.22 (0.83)	9/9 (100.0%)	3.22 (0.44)	0.00
Amount of exposure to counselling sessions: Good amount	17/18 (94.4%)	9/9 (100%)	2.00 (0.00)	8/9 (88.9%)	1.89 (0.33)	−0.67
Effectiveness of material delivery: Quite effectively or extremely well delivered	16/18 (88.9%)	8/9 (88.9%)	3.33 (0.71)	8/9 (88.9%)	3.44 (0.73)	0.15

Note: ‘Amount of exposure to counselling sessions’ ranked from 1 (not enough) to 3 (too much), with 2 being good amount

Table 4. Results from satisfaction and evaluation exit interviews.

Satisfaction and evaluation questions	Indirect intervention	Sample quote	Direct intervention	Sample quote
How did you feel about the study?	1/5 neutral 4/5 positive	Oh my gosh I actually loved it. Like I, cause I actually like had an increase (in physical activity). And I liked that it wasn’t focused around like performance	6/6 positive	I really enjoyed like the identity – exercise identity piece of it, like that was kind of what hit home the most
What was your favourite part?	1/5 N/A 1/5 liked increasing PA 3/5 liked study features	Just getting back into it and knowing that I could. Cause I think it can be a very mental thing sometimes where you sort of psych yourself out before you’ve even tried it, so yeah I think that I came into this feeling very, like it was going to be a huge challenge, and obviously it was in some aspects but I think that I made it to be more of a challenge in my head than it was in reality.	1/6 liked study features 1/6 liked increasing PA 4/6 liked interaction with researcher and counseling sessions	Definitely just like the personal interaction and talking about, just having somebody to talk to about all the things that are going on. I don’t really get that anywhere else, so it’s good to take off a little bit of weight there … emotional weight
What was your least favourite part?	3/5 N/A 2/5 goal related guilt	During the weeks when I didn’t exercise I felt kind of like guilty or embarrassed to talk about it. Because this is an exercise study and I felt really lazy and like couch potato, not because of you but just because, it was embarrassing to report on it that I hadn’t been to the gym.	1/6 N/A 5/6 goal related guilt	Probably just in the beginning when things weren’t working before I had developed some strategies I guess? Cause like it’s nice to be able to check in with you and actually say ‘yes I did meet my goals’ it’s kind of disappointing to have to say no, it sucks, but it’s part of the learning curve I guess.
What would you change?	2/5 N/A 3/5 intervention logistics, intervention structure, materials	Something more structured time wise would probably be more wide reaching in its effects, rather than … and probably apply to more people rather than letting people just sort of forget about it.	1/6 N/A 5/6 intervention logistics, intervention structure, materials	Maybe the timing, like when it was. It would have been easier at the beginning of the semester, it would have been good to get into the rhythm when the semester started instead of doing it at the end when all hell was breaking loose.

Table 5. Secondary outcome measures at baseline and 6 week.

Characteristic	Indirect (n = 9)			Direct (n = 9)			Main effect		Interaction effect
	Baseline	6 weeks	Change score [95% CI]	Baseline	6 weeks	Change score [95% CI]	F-value	Partial Eta Squared	F-value	Partial Eta Squared
Mean Leisure Score Index (SD)	27.00 (18.21)	35.11 (14.76)	8.11 [−7.39–23.61]	25.28 (21.47)	37.89 (26.88)	12.61 [−1.39–26.61]	5.23	0.25	0.63	0.02
Mean Exercise Identity score (SD)	2.86 (0.59)	3.54 (0.69)	0.68 [0.23–1.13]	3.38 (1.14)	3.83 (0.80)	0.44 [−0.16–1.05]	11.90	0.43	0.52	0.03