• Ronald C Plotnikoff, Anna K Jansson, Mitch J Duncan, Jordan J Smith, Adrian Bauman, John Attia, and David R Lubans.
• Centre for Active Living and Learning, School of Education, The University of Newcastle, Callaghan, Australia; Active Living Research Program, Hunter Medical Research Institute, New Lambton Heights, Australia. Electronic address: ron.plotnikoff@newcastle.edu.au.
• Am J Prev Med. 2023 Jun 1; 64 (6): 853864853-864.

IntroductionIn Australia, 45% of adults meet the aerobic recommendations, and only 9%-30% meet the resistance training guidelines. Given the lack of at-scale community-based interventions promoting resistance training, the aim of this study was to assess the impact of an innovative mHealth intervention on upper- and lower-body muscular fitness, cardiorespiratory fitness, physical activity, and social-cognitive mediators among a sample of community-dwelling adults.Study DesignResearchers evaluated the community-based ecofit intervention using a cluster RCT from September 2019 to March 2022 in 2 regional municipalities of New South Wales, Australia.Setting/ParticipantsResearchers recruited a sample of 245 participants (72% female, aged 53.4±13.9 years) who were randomized to the ecofit intervention group (n=122) or waitlist control (n=123) group.InterventionThe intervention group received access to a smartphone application with standardized workouts tailored to 12 outdoor gym locations and an introductory session. Participants were encouraged to perform at least 2 ecofit workouts per week.Main Outcome MeasuresPrimary and secondary outcomes were assessed at baseline, 3 months, and 9 months. The coprimary muscular fitness outcomes were evaluated using the 90-degree push-up and the 60-second sit-to-stand test. Intervention effects were estimated using linear mixed models accounting for group-level clustering (participants could enroll in groups of up to 4). Statistical analysis was conducted in April 2022.ResultsStatistically significant improvements were observed in upper (1.4 repetitions, 95% CI=0.3, 2.6, p=0.018) and lower (2.6 repetitions, 95% CI=0.4, 4.8, p=0.020) body muscular fitness at 9 months but not at 3 months. Increases in self-reported resistance training, resistance training self-efficacy, and implementation intention for resistance training were statistically significant at 3 and 9 months.ConclusionsThis study has shown that a mHealth intervention promoting resistance training using the built environment can improve muscular fitness, physical activity behavior, and related cognitions in a community sample of adults.Trial RegistrationThis trial was preregistered with the Australian and New Zealand Clinical Trial Registry (ACTRN12619000868189).Copyright © 2023 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

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