Effects of a web-based, evolutionary mismatch-framed intervention targeting physical activity and diet: a randomised controlled trial

Background: This study sought to test the effectiveness of a 12-week, novel online intervention (Evolife) aiming to increase physical activity level (PAL) and reduce energy intake (EI) among overweight/obese adults. The intervention used an evolutionary mismatch message to frame health information in an engaging way, incorporating evidence-based behaviour change techniques to promote autonomous motivation, self-efficacy and self-regulatory skills. Method: Men and women aged 35–74 years with a BMI of 25–40 kg/m ² were eligible. Participants were randomised to receive either the intervention (comprising a face-to-face introductory session, 12 weeks’ access to the Evolife website and a pedometer) or a control condition (face-to-face introductory session and NHS online health resources). PAL was measured objectively and EI was self-reported using 3-day weighed food records. Secondary measures included BMI, waist circumference and blood pressure. Results: Sixty people met inclusion criteria; 59 (30 intervention) completed the trial (mean age = 50; 56% male). Differences between groups’ change scores for PAL and EI were of small effect size but did not reach significance (d = 0.32 and d = − 0.49, respectively). Improvements were found in both groups for PAL (int: d = 0.33; control: d = 0.04), EI (int: d = − 0.81; control: d = − 0.16), waist circumference (int: d = − 0.30; control: d = − 0.17) and systolic blood pressure (int: d = − 0.67; control: d = − 0.28). Conclusion: The intervention did not lead to significantly greater improvement in PAL or reduction in EI than a minimal intervention control, although the changes in the intervention group were of meaningful effect size and comparable with positive outcomes in larger intervention trials. Trial Registration: This trail was registered on www.clinicaltrials.gov on 16 January 2017 (appeared online 26 January 2017), reference NCT03032731.