Digital interventions to promote physical activity among inactive adults: A study protocol for a hybrid type I effectiveness-implementation randomized controlled trial.

Introduction: Physical inactivity is the fourth leading risk factor for global mortality, and inactive adults have a higher risk to develop lifestyle diseases. To date, there is preliminary evidence of the efficacy of fitness technologies and other digital interventions for physical activity (PA) promotion. Intervention studies are needed to test the effectiveness and implementation of innovative PA promotion strategies. Methods and analysis: The ONWARDS study is a hybrid type I effectiveness-implementation randomized control trial aiming at an inactive and presumably high-risk population living in Northern Norway. One hundred and eighty participants will be assigned to 3 groups in a 1:1:1 ratio and participate for 18 months. Participants in group A will be provided an activity tracker with the personalized metric Personal Activity Intelligence (PAI). Participants in group B will be provided with both an activity tracker with the personalized metric PAI and access to online training videos (Les Mills+) to perform home-based training. Participants in group C will be provided an activity tracker with the personalized metric PAI, home-based online training and additional peer support via social media. The primary objective is to test which combination of interventions is more effective in increasing PA levels and sustaining long-term exercise adherence. Secondary objectives include: proportion of participants reaching PA recommendations; exercise adherence; physical fitness; cardiovascular risk; quality of life; perceived competence for exercise; self-efficacy; social support; usability; users' perspectives on implementation outcomes (adoption, acceptability, adherence, sustainability). The study design will allow testing the effectiveness of the interventions while gathering information on implementation in a real-world situation. Discussion: This study can contribute to reduce disparities in PA levels among inactive adults by promoting PA and long-term adherence. Increased PA might, in turn, result in better prevention of lifestyle diseases. Digital interventions delivered at home can become an alternative to training facilities, making PA accessible and feasible for inactive populations and overcoming known barriers to PA. If effective, such interventions could potentially be offered through national health portals to citizens who do not meet the minimum recommendations on PA or prescribed by general practitioners or specialists. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04526444, Registered 23 April 2021, identifier: NCT04526444.

Ski Skating Race Technique-Effect of Long Distance Cross-Country Ski Racing on Choice of Skating Technique in Moderate Uphill Terrain.

The aim of this study was to investigate the effect of prolonged ski racing using skating style on technique choice in a transition section among female and male high-level skiers. Fifty three national-to-elite level skiers (20 females: 26.7 ± 4.8 years, 167.0 ± 6.5 m, 61.0 ± 5.1 kg, and 75.5 ± 68.8 FIS points; 33 males: 25.2 ± 3.5 years, 179.0 ± 5.2 cm, 73.1 ± 5.7 kg, and 73.7 ± 63.2 FIS points) were video recorded along a flat-to-uphill transition section of a course during the 30-km (females) and 50-km (males) races at the 2018 Norwegian National Championships. Across laps, section speeds decreased (P < 0.001) in all skiers, with the best-ranked skiers faster than the lowest-ranked (P < 0.001), and males faster than females in the first and middle laps. Section speed within each lap was associated with race performance (r = 0.76-0.86, P < 0.001 in females and r = 0.87-0.89, P < 0.001 in males). The prevalence of Gear 2 (G2) increased, while Gear 3 (G3) use decreased (both P < 0.001) across the subsequent laps, with females preferring G2 more than males in lap one (P = 0.027). In long-distance skate-style skiing, transition performance is representative of race performance and skiers decrease the use of the often-faster G3 technique while increasing the use of the slower G2 technique due to prolonged exercise. Especially female skiers should consider adding some flat-to-uphill G3 practice into established training, specifically early in the session before fatigue may occur.