Background
Methods
Study design
Intervention development
Ethics
Participants and recruitment
Inclusion criteria | Exclusion criteria |
---|---|
• Male | • Self-reported meeting national recommendations for fruit and vegetable intakes (Based on age/sex recommendations: men aged 18 = 5 vegetables and 2 fruit, men aged 19–25 = 6 vegetables and 2 fruit daily) [74] |
• Aged 18 to 25 years | • Self-reported meeting physical activity recommendations (moderate-intensity PA for 300 min or more per week or vigorous-intensity PA for 150 min or more per week or combined moderate and vigorous physical activity (MVPA) of 300 min or more per week) [38] |
• Available for assessment sessions | • Currently participating in an alternative healthy lifestyle program. |
• Access to a computer or tablet or smartphone with e-mail and Internet facilities | • History of major medical problems (such as heart disease or diabetes that requires insulin injections) that had not been granted GP approval to participate.a
|
• Reported psychological distress and no GP approval (or associated expert) to participateb
| |
• Diagnosed with an eating disorder | |
• Non-English speaking | |
• Disability (e.g. physical/mobility disability, sight or hearing impairment) that precluded participation |
The HEYMAN intervention group
The Waitlist control group
Data collection
Outcomes
Feasibility
Estimation of treatment effect
Sample size
Randomisation
Statistical analysis
Results
Participant flow at each stage
Baseline data
Variable | Intervention group (n = 26) | Waitlist control group (n = 24) | Total (n = 50) |
---|---|---|---|
Mean (SD) or % (n) | |||
Age | 22.4 (2.0) | 21.9 (2.1) | 22.1 (2.0) |
Country of birth: | |||
Australia | 76.9% (20) | 83.3% (20) | 80.0% (40) |
Other | 23.1% (6) | 16.7% (4) | 20.0% (10) |
Marital status | |||
Single/Divorced | 88.5% (23) | 79.2% (19) | 84.0% (42) |
Married/De facto | 11.5% (3) | 20.8% (5) | 16.0% (8) |
Employment status | |||
Student (University) | 65.4% (17) | 58.3% (14) | 62.0% (31) |
Student (Technical college) | 3.8% (1) | 0% (0) | 2.0% (1) |
Employed | 23.1% (6) | 37.5% (9) | 30.0% (15) |
Unemployed | 7.7% (2) | 4.2% (1) | 6.0% (3) |
Highest education level | |||
No formal qualification | 0% (0) | 4.2% (1) | 2.0% (1) |
Higher School Certificate | 53.8% (14) | 66.7% (16) | 60.0% (30) |
Trade/Apprenticeship | 3.8% (1) | 4.2% (1) | 4.0% (2) |
Certificate/Diploma | 3.8% (1) | 8.3% (2) | 6.0% (3) |
University degree or higher | 38.5% (10) | 16.7% (4) | 28.0% (14) |
Individual income ($AU) | |||
Lower ($0-$299 per week) | 50.0% (13) | 45.8% (11) | 48.0% (24) |
Middle ($300-$999 per week) | 38.5% (10) | 45.8% (11) | 42.0% (21) |
Higher ($1,000 or more per week) | 11.5% (3) | 4.2% (1) | 8.0% (4) |
Did not want to answer | 0% (0) | 4.2% (1) | 2.0% (1) |
Physical activity | |||
Pedometer (means steps/day) | 7722.7 (2514.7) | 6171.1 (2067.6)* | 6994.4 (2421.8) |
MVPA (minutes/week)a
| 137.2 (157.5) | 108.8 (124.9) | 123.3 (20.2) |
Diet | |||
Diet quality (ARFS total score) | 30.7 (8.6) | 27.9 (11.2) | 29.4 (9.9) |
Energy intake (kJ/day) | 11090.6 (3413.4) | 9982.6 (3168.9) | 10558.8 (3312.2) |
Fruit (serves/day) | 1.5 (1.2) | 1.3 (1.1) | 1.4 (1.2) |
Vegetables (serves/day) | 3.5 (1.8) | 3.5 (2.6) | 3.5 (2.2) |
Proportion of energy from ED-NP foods (%) | 40.2 (11.4) | 41.8 (11.9) | 41.0 (11.6) |
Proportion of energy from alcohol (%) | 1.7 (1.6) | 2.6 (3.0) | 2.1 (2.4) |
Psychological measures & well-being | |||
Satisfaction with life scale (total score) | 23.8 (6.6) | 22.5 (7.4) | 23.2 (6.9) |
Salivary cortisol (nmol/l) | 6.8 (4.8) | 8.3 (4.8) | 7.5 (4.8) |
Depression, Anxiety & Stress Scale (total score) | 11.4 (8.1) | 14.1 (11.1) | 12.7 (9.7) |
K10 Psychological distress scale (total score) | 18.5 (6.2) | 21.0 (7.2) | 19.7 (6.7) |
Mental Health continuum- short form (total score) | 44.5 (13.2) | 43.8 (10.2) | 44.1 (11.7) |
Quality of life, enjoyment & satisfaction (total score) | 49.2 (9.3) | 49.3 (6.3) | 49.2 (7.9) |
Alcohol (AUDIT -C) | |||
Hazardous drinking | 34.6% (9) | 54.2% (13) | 44.0% (22) |
Weight status and body composition | |||
Current weight (kg) | 83.6 (16.9) | 80.9 (15.3) | 82.3 (16.1) |
Current height (cm) | 179.0 (6.6) | 180.3 (6.5) | 179.6 (6.5) |
Waist circumference | 89.1 (12.0) | 85.9 (11.9) | 87.6 (12.0) |
BMI (kg/m2) | 26.1 (5.0) | 24.8 (4.1) | 25.5 (4.6) |
Skeletal muscle mass (kg) | 36.2 (5.8) | 36.5 (4.6) | 36.3 (5.2) |
Body fat mass (kg) | 19.9 (10.0) | 16.9 (9.6) | 18.5 (9.8) |
BMI category (kg/m2) | |||
Healthy weight | 46.2% (12) | 62.5% (15) | 54.0% (27) |
Overweight | 30.8% (8) | 29.2% (7) | 30.0% (15) |
Obese | 23.1% (6) | 8.3% (2) | 16.0% (8) |
Cholesterol (mmol/L) | |||
Total cholesterol | 3.9 (0.8) | 3.9 (0.7) | 3.9 (0.7) |
HDL-cholesterol | 1.2 (0.2) | 1.3 (0.3) | 1.3 (0.2) |
LDL- cholesterol | 2.2 (0.6) | 2.0 (0.6) | 2.1 (0.6) |
Triglyceride | 1.2 (0.6) | 1.2 (0.7) | 1.2 (0.6) |
Total cholesterol/HDL-C ratio | 3.3 (0.9) | 3.2 (1.1) | 3.2 (1.0) |
Blood pressure (mmHg) | |||
Systolic blood pressure | 120.1 (9.0) | 121.6 (8.3) | 120.8 (8.7) |
Diastolic blood pressure | 75.1 (4.7) | 77.2 (5.6) | 76.1 (5.2) |
Resting heart rate (bpm) | 69.7 (10.6) | 73.8 (8.9) | 71.6 (9.9) |
Augmentation index (%) | 40.3 (18.3) | 34.6 (12.6) | 37.6 (15.9) |
Feasibility of research procedures
Feasibility of implementing HEYMAN
Program usage
Acceptability of program components (attractiveness, comprehension, usability, supportiveness, satisfaction and ability to persuade)
Website (n = 24) | Jawbone™/UP app (n = 23) | F2F (group) (n = 19) | F2F (1-2-1) (n = 22) | Facebook group (n = 24) | Food & nutrient report (n = 24) | Gymstick™ (n = 23) | TEMPlate™ dinner disc (n = 16) | |
---|---|---|---|---|---|---|---|---|
Provided me with useful information about healthy eating | 4.0 ± 0.6 | 3.2 ± 1.0 | 4.1 ± 0.6 | 4.5 ± 0.7 | 3.8 ± 0.8 | 4.4 ± 0.9 | NA | 3.9 ± 0.9 |
Provided me with useful information about exercise | 4.2 ± 0.6 | 3.9 ± 0.9 | 4.2 ± 0.9 | 4.2 ± 0.8 | 3.7 ± 0.8 | NA | NA | NA |
Provided me with useful information about stress | 3.7 ± 0.7 | 3.0 ± 0.9 | 3.6 ± 0.8 | 4.0 ± 0.9 | 3.5 ± 0.8 | NA | NA | NA |
Helped me to attain my goals | 3.6 ± 0.8 | 3.8 ± 0.9 | 3.9 ± 1.0 | 4.0 ± 0.9 | 3.7 ± 0.9 | 4.1 ± 1.0 | 3.7 ± 1.0 | 3.3 ± 0.9 |
Motivated me | 3.5 ± 0.9 | 4.1 ± 0.7 | 4.3 ± 0.7 | 4.0 ± 0.8 | 3.6 ± 0.8 | 4.0 ± 0.9 | 3.5 ± 1.0 | 3.3 ± 1.1 |
Made me feel accountable | 3.3 ± 0.9 | 4.0 ± 1.0 | 3.8 ± 0.9 | 4.1 ± 0.8 | 3.5 ± 1.0 | 4.2 ± 0.9 | 3.6 ± 1.0 | 3.2 ± 0.9 |
Was easy to use/navigate | 4.3 ± 0.6 | 4.0 ± 0.9 | NA | NA | 4.2 ± 0.8 | NA | 3.8 ± 1.0 | 3.5 ± 1.2 |
Content was easy to understand | 4.3 ± 0.4 | 4.1 ± 0.7 | 4.4 ± 0.6 | 4.4 ± 0.6 | 4.2 ± 0.8 | 4.1 ± 0.9 | NA | NA |
Was visually appealing | 4.0 ± 0.7 | 4.0 ± 0.9 | NA | NA | 3.8 ± 0.8 | 3.9 ± 0.9 | NA | 3.4 ± 0.9 |
Was supportive in answering any queries/questions | NA | NA | 4.5 ± 0.7 | 4.5 ± 0.6 | 3.7 ± 0.8 | NA | NA | NA |
Satisfaction | 4.0 ± 0.6 | 4.2 ± 1.1 | 4.1 ± 0.8 | 4.3 ± 0.8 | Not asked | 4.2 ± 0.8 | 4.0 ± 0.9 | 3.0 ± 0.9 |
Estimation of treatment effect
Mean change from baseline (95%CI)a
| |||||
---|---|---|---|---|---|
Outcomesc
| Control group (n = 24) | Intervention group (n = 26) | Mean difference between groups (95%CI)b
|
p-Value | Effect size (Cohen’s d) |
Physical activity (pedometer steps/day) | 575.4 (−518.8, 1669.7) | 1588.2 (534.7, 2641.6) | 1012.7 (−506.2, 2531.6) | 0.191 | 0.36 |
Diet quality (ARFS total score) | 2.3 (−0.5, 5.2) | 5.9 (3.1, 8.7) | 3.6 (−0.4, 7.6) | 0.081 | 0.48 |
Satisfaction with life scale (total score) | 0.5 (−0.9, 2.0) | 0.9 (−0.5, 2.4) | 0.4 (−1.6, 2.5) | 0.683 | 0.11 |
Fruit (serves/day) | 0.3 (−0.1, 0.7) | 0.5 (0.1, 0.9) | 0.2 (−0.4, 0.8) | 0.496 | 0.20 |
Vegetables (serves/day) | −0.1 (−0.8, 0.6) | 1.0 (0.3, 1.6) | 1.1 (0.1, 2.0) |
<0.05
| 0.62 |
Energy intake (kJ/day) | −68.9 (−1090.7, 953.0) | −475.9 (−1470.6, 518.8) | −407.0 (−1833.1, 1019.0) | 0.576 | 0.16 |
Proportion of energy from ED-NP foods (%) | −2.6 (−6.2, 1.1) | −9.8 (−13.3, −6.2) | −7.2 (−12.3, −2.1) |
<0.01
| 0.73 |
Proportion of energy from alcohol (%) | −0.5 (−1.2, 0.3) | 0.2 (−0.5, 1.0) | 0.7 (−0.3, 1.8) | 0.181 | 0.36 |
AUDIT-C (total score) | −0.6 (−1.1, −0.1) | 0.1 (−0.4, 0.6) | 0.7 (−0.1, 1.4) | 0.074 | 0.53 |
Salivary Cortisol (nmol/l) | 2.7 (−0.4, 5.8) | 0.6 (−2.4, 3.6) | −2.1 (−6.4, 2.2) | 0.341 | 0.27 |
Depression, Anxiety & Stress Scale (total score) | −2.1 (−4.8, 0.5) | −1.7 (−4.3, 0.9) | 0.4 (−3.3, 4.1) | 0.835 | 0.06 |
K-10 Psychological distress scale | −1.7 (−3.0, −0.4) | −2.6 (−3.8, −1.3) | −0.9 (−2.6, 0.9) | 0.331 | 0.28 |
Mental Health Continuum (total score) | 4.0 (0.8, 7.1) | 5.5 (2.4, 8.6) | 1.5 (−2.9, 6.0) | 0.505 | 0.19 |
Quality of Life, Enjoyment and Satisfaction (total score) | 2.9 (0.1, 5.6) | 6.0 (3.3, 8.7) | 3.2 (−0.7, 7.0) | 0.110 | 0.45 |
Weight (kg) | 1.0 (0.1, 2.0) | −0.6 (−1.5, 0.3) | −1.6 (−3.0, −0.3) |
<0.05
| 0.63 |
Weight (%) | 1.3 (0.2, 2.5) | −0.6 (−1.7, 0.5) | −2.0 (−3.5, −0.4) |
<0.05
| 0.67 |
Waist circumference (cm) | 1.9 (0.7, 3.1) | −1.2 (−2.4, −0.0) | −3.1 (−4.8, −1.4) |
<0.001
| 0.89 |
BMI (Kg/m2) | 0.3 (0.0, 0.6) | −0.2 (−0.5, 0.0) | −0.6 (−0.9, −0.2) |
<0.01
| 0.81 |
Skeletal muscle mass (kg) | 0.1 (−0.5, 0.6) | −0.0 (−0.6, 0.5) | −0.1 (−0.9, 0.6) | 0.755 | 0.07 |
Body fat mass (kg) | 0.9 (0.1, 1.7) | −0.5 (−1.3, 0.3) | −1.4 (−2.5, −0.3) |
<0.05
| 0.67 |
MVPA (minutes/week) | 26.1 (−58.0, 110.2) | 154.1 (71.0, 237.1) | 128.0 (9.8, 246.2) |
<0.05
| 0.58 |
Total cholesterol (mmol/l) | 0.0 (−0.2, 0.3) | −0.4 (−0.6, −0.2) | −0.4 (−0.8, −0.1) |
<0.05
| 0.61 |
HDL-Cholesterol (mmol/l) | 0.0 (−0.0, 0.1) | 0.0 (−0.0, 0.1) | 0.0 (−0.1, 0.1) | 0.986 | 0.00 |
LDL- Cholesterol (mmol/l) | 0.1 (−0.1, 0.3) | −0.4 (−0.6, −0.1) | −0.5 (−0.8, −0.2) |
<0.01
| 0.83 |
Triglyceride (mmol/l) | −0.2 (−0.5, −0.0) | −0.0 (−0.3, 0.2) | 0.2 (−0.1, 0.6) | 0.200 | 0.31 |
Total cholesterol/HDL-C ratio | −0.0 (−0.2, 0.2) | −0.3 (−0.5, −0.2) | −0.3 (−0.6, −0.0) |
<0.05
| 0.60 |
Systolic blood pressure (mm Hg) | −2.6 (−5.5, 0.2) | −2.4 (−5.1, 0.4) | 0.3 (−3.7, 4.2) | 0.898 | 0.04 |
Diastolic blood pressure (mm Hg) | −1.1 (−2.9, 0.7) | −1.7 (−3.5, 0.0) | −0.6 (−3.1, 1.9) | 0.629 | 0.13 |
Resting Heart rate (BPM) | −2.1 (−6.1, 1.9) | −0.1 (−4.0, 3.8) | 2.0 (−3.6, 7.6) | 0.480 | 0.20 |
Augmentation Index (%) | −0.7 (−8.1, 6.6) | −4.8 (−11.9, 2.3) | −4.1 (−14.3, 6.2) | 0.438 | 0.22 |