Document Type
Article
Publication Date
12-5-2025
Identifier
DOI: 10.2196/59334; PMCID: PMC12680371
Abstract
BACKGROUND: An adaptive text messaging intervention to promote adolescent physical activity has demonstrated feasibility, acceptability, and preliminary efficacy in a recent proof-of-concept study. To inform future intervention development, a secondary analysis of the data examined how physical activity is influenced by mood, environment, and physical feelings of energy and fatigue.
OBJECTIVE: This study aims to understand how both macro- and microtemporal variables (eg, psychological and environmental variables at both levels) influence the efficacy of a brief mobile health intervention (ie, NUDGE) for physical activity.
METHODS: Using a matched control design, we evaluated the effect of daily positive and negative affect, perceptions of the weather, energy, and fatigue as moderators of the effect of the intervention on 21 intervention participants and 21 matched controls.
RESULTS: Consistent with study hypotheses, macrotemporal (levels of the variable on a 3-week timescale) moderators of intervention effectiveness were observed for positive affect (P< .001), negative affect (P=.03), energy (P< .001), fatigue (P< .001), and perceived weather barriers (P< .001) for moderate-to-vigorous physical activity. These effects were observed more consistently for moderate-to-vigorous physical activity than for sedentary behavior, which was only significant for energy (P< .001). No effects for microtemporal variables (at the day level) were observed.
CONCLUSIONS: There appears to be an optimization opportunity for mobile health physical activity interventions that can be achieved by personalizing intervention features and content based on approximately monthly assessments of affect, physical feeling states, and perceived weather barriers.
Journal Title
JMIR Pediatr Parent
Volume
8
First Page
59334
Last Page
59334
PubMed ID
41349008
Keywords
adolescent; acceptability; adaptive intervention; adolescent well-being; energy; exercise; fatigue; feasibility; mHealth; mobile health; mood; nudge; optimization; personalized; physical activity; teen; teenager; text message; text messaging; youth
Recommended Citation
Cushing CC, Ortega A, Fedele DA, et al. Moderators of a mHealth Intervention for Adolescent Physical Activity: Intervention Refinement Study. JMIR Pediatr Parent. 2025;8:e59334. Published 2025 Dec 5. doi:10.2196/59334


Comments
This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Pediatrics and Parenting, is properly cited. The complete bibliographic information, a link to the original publication on https://pediatrics.jmir.org, as well as this copyright and license information must be included.
Publisher's Link: https://pediatrics.jmir.org/2025/1/e59334