April J. Stull

Participant engagement is critical to program success yet is under-measured because of reliance on retrospective self-report methods. This study examines the feasibility and utility of real-time physiological measures for assessing in-situ engagement during a six-week healthy eating program. Engagement was measured with wearable heart rate sensors using Immersion Neuroscience Software (INS) and self-reported surveys. Feasibility was assessed through data completeness and the implementation of INS data-collection procedures across sessions and sites, whereas analytic utility was examined through engagement patterns across sessions and program segments. INS data were collected in all sessions, yielding usable data for 94% of eligible observations. Cooking demonstrations elicited significantly higher INS engagement than lessons. Physiological engagement metrics captured variation over time, whereas self-reported engagement showed ceiling effects. These findings demonstrate the feasibility and added value of integrating real-time physiological measures into program evaluation, offering evaluators a granular approach to understanding participant experience and informing program refinement.

Background: African American men are at a higher risk for serious health conditions such as cardiovascular disease, diabetes, and stroke compared to non-Hispanic White men. Physical activity (PA) is a modifiable health behavior that has been shown to decrease chronic disease risk; yet, PA engagement is alarmingly low in African American men. Interventions to improve PA engagement are effective in a number of populations; however, very few have been tailored to the unique needs of African American men. Even fewer have leveraged mobile health apps, despite African American men’s interest in and willingness to use such technologies for health improvement. Objective: This comparative effectiveness trial aims to evaluate MobileMen, a PA promotion app tailored to the needs and preferences of African American men. This trial will compare the MobileMen app to a commercially available PA promotion app with similar features but lacks culturally tailored components. Methods: We will recruit a sample of “low active” (accumulating 30 years from Baton Rouge, Louisiana, and the surrounding communities. All participants are given a Fitbit Charge 6 wearable activity tracker to assess daily PA and steps and are randomized to either the MobileMen intervention app or the comparator app, which is a commercially available PA tracking app called Stridekick. The Stridekick app has features similar to those in the MobileMen app but was not intentionally designed for African American men. The intervention period is 6 months during which participants will interact with their assigned mobile app. MobileMen includes features such as digital badges earned for PA; tangible prizes like exercise equipment; challenges among participants; goal setting; nutrition; PA; and behavior change educational information in text, audio, and video formats. Participants will complete assessments at baseline and at 6 months post randomization. Assessments include objective measurements of daily steps and minutes of moderate to vigorous PA, quality of life, dietary measures, self-efficacy for fruit and vegetable consumption and PA, and autonomous motivation for PA. Results: This trial is in the start-up phase. The MobileMen app development and usability testing was completed in August 2024. Participant recruitment efforts began in October 2024. The trial and associated data analyses and interpretation are planned to be completed by fall 2025. Conclusions: Mobile apps are a widely accessible means to disseminate culturally tailored PA promotion interventions to various populations, including African American men. MobileMen has the potential to impact PA engagement in African American men, which would dramatically improve the overall health and chronic disease risk in this underrepresented group. Trial Registration: ClinicalTrials.gov NCT05621044; https://clinicaltrials.gov/study/NCT05621044 International Registered Report Identifier (IRRID): PRR1-10.2196/67809

BACKGROUND African American men are at a higher risk for serious health conditions such as cardiovascular disease, diabetes, and stroke compared to non-Hispanic White men. Physical activity (PA) is a modifiable health behavior that has been shown to decrease chronic disease risk; yet, PA engagement is alarmingly low in African American men. Interventions to improve PA engagement are effective in a number of populations; however, very few have been tailored to the unique needs of African American men. Even fewer have leveraged mobile health apps, despite African American men’s interest in and willingness to use such technologies for health improvement. OBJECTIVE This comparative effectiveness trial aims to evaluate MobileMen, a PA promotion app tailored to the needs and preferences of African American men. This trial will compare the MobileMen app to a commercially available PA promotion app with similar features but lacks culturally tailored components. METHODS We will recruit a sample of “low active” (accumulating 30 years from Baton Rouge, Louisiana, and the surrounding communities. All participants are given a Fitbit Charge 6 wearable activity tracker to assess daily PA and steps and are randomized to either the MobileMen intervention app or the comparator app, which is a commercially available PA tracking app called Stridekick. The Stridekick app has features similar to those in the MobileMen app but was not intentionally designed for African American men. The intervention period is 6 months during which participants will interact with their assigned mobile app. MobileMen includes features such as digital badges earned for PA; tangible prizes like exercise equipment; challenges among participants; goal setting; nutrition; PA; and behavior change educational information in text, audio, and video formats. Participants will complete assessments at baseline and at 6 months post randomization. Assessments include objective measurements of daily steps and minutes of moderate to vigorous PA, quality of life, dietary measures, self-efficacy for fruit and vegetable consumption and PA, and autonomous motivation for PA. RESULTS This trial is in the start-up phase. The MobileMen app development and usability testing was completed in August 2024. Participant recruitment efforts began in October 2024. The trial and associated data analyses and interpretation are planned to be completed by fall 2025. CONCLUSIONS Mobile apps are a widely accessible means to disseminate culturally tailored PA promotion interventions to various populations, including African American men. MobileMen has the potential to impact PA engagement in African American men, which would dramatically improve the overall health and chronic disease risk in this underrepresented group. CLINICALTRIAL ClinicalTrials.gov NCT05621044; https://clinicaltrials.gov/study/NCT05621044 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/67809