Factors That Help and Hinder the Implementation of Community-Wide Behavior Change Programs.

Novel community-wide approaches that gamify physical activity through challenges and competition have become increasingly popular in recent years. However, little is known about the factors that help or hinder their implementation. This qualitative study aimed to address this gap in the literature by systematically investigating the facilitators (organizational and experiential) and barriers to successful implementation of a community-wide intervention delivered in Gloucester, the United Kingdom. A two-phased process evaluation was conducted. Phase 1 involved the thematical analysis of open question feedback from n = 289 adults. Phase 2 included three focus groups conducted with n = 12 participants. This research showed that promoting the initiative through primary education settings was fundamental to enhancing awareness and participation. Social elements of the intervention were identified as a motivating factor for, and a consequential outcome of, participation. A lack of promotion to wider-reaching proportions of the community was perceived to be a significant barrier to implementation, potentially limiting inclusivity and participation in the activity. Game dynamics, timing, and fears regarding sustainability represented further difficulties to implementation.

Creating a social movement to engage communities in physical activity: A mixed methods study of motivations to engagement.

Throughout the world social isolation and loneliness are common and both have several adverse impacts on health and wellbeing. We are designed to live in close-knit communities and we thrive in close co-operation, however, modern life isolates us from others. To reduce the burden of loneliness and social isolation we need to find strategies to reconnect people to each other, their place and provide a common purpose. Social movements aim to create healthier communities by connecting people to each other and giving people a common purpose. Interventions which create a social movement appear to be effective at engaging substantial portions of a community, however, it remains unclear why individuals are attracted to these initiatives, and if such reasons differ by sociodemographic characteristics. This study combined qualitative and quantitative methods to understand what motivated (different) people to take part in a social movement based intervention. This study suggests that it is not one but a combination of reasons people engage in interventions of this nature. This diversity needs to be acknowledged when promoting and communicating these interventions to potential participants to maximise engagement. Promoting an end reward or health/fitness may not be the most effective way to promote interventions to a large proportion of people. Instead, communications should be centred around what people value (i.e., being with their friends, doing what they enjoy and are good at).

Motivations and barriers to engagement with a technology-enabled community wide physical activity intervention.

Previous physical activity interventions have failed to create population change and an alternative approach is needed to support a World Health Organization target of a 15% reduction in global levels of inactivity by 2030. There is growing evidence that gamification-based interventions can reach substantial portions of the community. However, to date, these studies have been predominantly quantitative and as such there is a paucity of research in the area on motivations and barriers to engagement with these programs. Four focus groups conducted with N = 26 players who participated in a gamification-based intervention 'Beat the Street' revealed several varied motives to engagement, including collective reward; social influence; game reinvention; exploration; accessibility and awareness. However, several barriers specific to the Beat the Street intervention and outdoor gamification interventions more generally were also identified. This study provides novel insight into the motives which engage individuals into physical activity interventions and the design principles which need to be considered when implementing interventions of this nature.

Intrasexual competition as a potential influence on anabolic-androgenic steroid use initiation.

An estimated 293,000 people living in the United Kingdom have used anabolic-androgenic steroids. However, there is currently no intervention to reduce usage available in practice or academic circulation throughout the United Kingdom. This study aimed to test a novel hypothesis that increased levels of intrasexual competition may play an important influential role in the use of anabolic-androgenic steroids. Significantly higher levels of intrasexual competition were evident in users compared to non-users but only in the novice group (0-2 years of experience). The research provides evidence for intrasexual competition potentially influencing anabolic-androgenic steroid use but only during the initial stages of usage.

Maintenance of behaviour change following a community-wide gamification based physical activity intervention.

Gamification refers to the use of game mechanics (e.g. competition, point scoring, progress visualisation and task setting) to engage and motivate people to achieve an end goal. Public health programs that incorporate gamification-based approaches which aim to improve the public's health have grown in popularity, however most commonplace are individualistic, smartphone-based applications and few studies have been conducted on community-wide interventions. Furthermore, the few studies which have been conducted have relied on small sample sizes with short-term follow-up. In view of this gap in current understanding, this study explored the impact of a community-wide gamified intervention, called 'Beat the Street' (in Reading UK) on levels of physical activity at 1 and 2-years post-intervention (between 2014 and 2016). Data were available for N = 1567 participants at one-year post-intervention and N = 723 participants at 2-years post-intervention. A Pretest-Posttest analysis revealed a 11% and 13% decrease in levels of inactivity at 1 and 2-years post-intervention respectively. Furthermore, participants who were inactive at baseline reported undertaking 3.4 and 3.8 days of activity at 1 and 2-years post-intervention, respectively. These findings provide promising preliminary evidence that gamification may be effective for decreasing physical inactivity and game-design mechanisms which may support behaviour change are discussed.

Beat the Street: A Pilot Evaluation of a Community-Wide Gamification-Based Physical Activity Intervention.

OBJECTIVE: There is a plethora of published research reporting the wealth and breadth of biopsychosocial benefits of physical activity; however, a recent Cochrane systematic review concluded insufficient evidence for current population level physical activity interventions, citing scalability as a major contributory factor, with many of the interventions failing to reach a substantial proportion of the community. The current study aimed to conduct a pilot evaluation of a technology-enabled, gamification-based intervention called Beat the Street and sought to examine the impact of the Beat the Street intervention on self-reported physical activity. METHODS: In total, n = 329 people completed the International Physical Activity Questionnaire Short Form (I-PAQ-SF) in full at baseline (before the intervention) and follow-up (immediately following the 7-week intervention). RESULTS: Overall, participants increased their weekly walking by +180 minutes per week (P < 0.001) and their weekly physical activity by +335 minutes per week (P < 0001). Vigorous activity increased by +48 minutes per week (P = 0.004) and moderate activity increased by +60 minutes per week (P < 0.001). CONCLUSION: The findings provide preliminary evidence that the Beat the Street intervention may be a promising approach to increasing physical activity at a community-wide level and warrants further investigation.

The relationship between physical inactivity and mental wellbeing: Findings from a gamification-based community-wide physical activity intervention.

Mental ill health accounts for 13 per cent of total global disease burden with predictions that depression alone will be the leading cause of disease burden globally by 2030. Poor mental health is consistently associated with deprivation, low income, unemployment, poor education, poorer physical health and increased health-risk behaviour. A plethora of research has examined the relationship between physical activity and mental wellbeing; however, the influence of community-wide gamification-based physical activity interventions on mental wellbeing, to the authors' knowledge, is yet to be explored. In view of this paucity of attention, the current study examined the relationship between physical activity and mental wellbeing pre/post a community-wide, gamification-based intervention. The findings revealed that increases in mental wellbeing were significantly greater for the least active prior to the intervention, and a strong, positive correlation between increase in physical activity and increase in mental wellbeing was observed.