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Testing self-regulation interventions to increase walking using factorial randomized N-of-1 trials

Lookup NU author(s): Professor Falko Sniehotta, Dr Justin Presseau, Dr Nicola O'Brien, Professor Vera Araujo-SoaresORCiD


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Objective: To investigate the suitability of N-of-1 randomized controlled trials (RCTs) as a means of testing the effectiveness of behavior change techniques based on self-regulation theory (goal setting and self-monitoring) for promoting walking in healthy adult volunteers. Method: A series of N-of-1 RCTs in 10 normal and overweight adults aged 19-67 (mean=36.9 years). We randomly allocated 60 days within each individual to text message-prompted daily goal-setting and/or self-monitoring interventions in accordance to a 2(step-count goal prompt vs. alternative goal prompt)*2(self-monitoring: open vs. blinded Omron-HJ-113-E pedometer) factorial design. Aggregated data were analyzed using random intercept multilevel models. Single cases were individually analyzed. The primary outcome was daily pedometer step counts over 60 days. Results: Single case analyses showed that 4 participants significantly increased walking: 2 on self-monitoring days and 2 on goal setting days, compared to control days. Six participants did not benefit from the interventions. In aggregated analyses, mean step counts were higher on goal-setting days (8499.9 vs. 7956.3) and on self-monitoring days (8630.3 vs. 7825.9). Multilevel analyses showed a significant effect of the self-monitoring condition (p= 0.025), the goal setting condition approached significance (p=.08) and there was a small linear increase in walking over time (p=.03). Conclusion: N-of-1 randomized trials are a suitable means to test behavioral interventions in individual participants.

Publication metadata

Author(s): Sniehotta FF, Presseau J, Hobbs N, Araújo-Soares V

Publication type: Article

Publication status: Published

Journal: Health Psychology

Year: 2012

Volume: 31

Issue: 6

Pages: 733-737

Print publication date: 20/02/2012

ISSN (print): 0278-6133

ISSN (electronic): 1930-7810

Publisher: American Psychological Association


DOI: 10.1037/a0027337


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Funder referenceFunder name
G0900686Medical Research Council