MOVE@NUS digital intervention cohort: protocol of a pilot study to promote healthy movement in university students

Due to academic pressures and irregular schedules, university students often face challenges in maintaining healthy movement behaviours (including sleep, physical activity, and screen time), which are interrelated and influence both physical and mental health. Smartwatch- and smartphone-based ecological momentary assessments (EMAs) and ecological momentary interventions (EMIs) offer real-time, context-aware strategies to promote movement behaviours. This pilot study aims to assess the feasibility and preliminary effectiveness of a hybrid approach that combines continuous digital monitoring of movement behaviours with sequentially embedded randomised controlled trials (RCTs) evaluating EMIs.

MOVE@NUS pilot study employed a five-month hybrid design that combines continuous passive monitoring (primarily via Apple Watches, supplemented by iPhones) with three embedded RCTs targeting sleep (RCT-1), physical activity (RCT-2), and screen time (RCT-3). For each RCT, participants are randomised on a 1:1:1 schedule (control, intervention 1, intervention 2). Eligible participants are first-year undergraduates at the National University of Singapore, aged 18-25 years, who own or regularly use an iPhone and an Apple Watch. EMIs, delivered via the study app, comprise standard health messages or personalised reminders based on HealthKit data or participants' self-reported behaviours and preferences. Self-reported measures include eight EMA bursts (three-day periods every two weeks) and online questionnaires at baseline, midway (2.5 months), and endpoint (5 months). All EMIs and EMAs are text-based and can be completed in under two minutes. Feasibility outcomes include recruitment, engagement, and user experience assessed through quantitative surveys and semi-structured interviews. Preliminary effectiveness will be explored separately for each RCT, comparing movement behaviours between intervention and control groups.

Findings from this study will inform the development of scalable and longer-term digital intervention cohorts for promoting healthier lifestyles among university students. Furthermore, as university students soon transition to the workforce, insights gained will inform scalable digital health interventions for broader populations.

ClinicalTrials.gov ID NCT06597890 First Posted: 19 September 2024.