The effects of an app-based health and fitness intervention for airline pilots

The intervention is an app-based 16-week lifestyle program that incorporates evidence-based strategies for improving physical activity, nutrition and sleep. The program is administered through an app platform. The program will be conducted once, with all participants engaging simultaneously. Being app-based, the participants can access the program from their place of residence and will not make face-to-face contact with the researchers. Each participant is granted access to the app, which contains all intervention supplied material including a calendar loaded with physical activity session plans, health educational materials, and weekly health behavior self-monitoring questionnaires. Prior to the commencement of the intervention, volunteers will be randomized to either an intervention group, or a wait-list control. The intervention commences with participants completing an online health survey (evaluating subjective health outcome measures, a physical activity pre-screen, and individual goals and preferences) and a range of self-administered physical assessments (physical fitness outcome measures). For physical assessments (such as push-ups and plank hold) educational materials are provided to participants that demonstrate correct technique to perform the activity. Subsequently, an experienced health coach (with over 20 years’ experience) remotely allocates a personalized programme to each participant according to their goals and preferences. Sleep hygiene represents a range of behavioural and environmental practices which support restorative sleep. An evidence-based sleep hygiene checklist was developed specifically for this intervention and the contents were derived from previous sleep hygiene and stimulus control studies. Educational materials pertaining to healthy sleep habits (such as regular sleep and wake times, perform and pre-bed relaxation routine, dim lights and avoid screen time within 30 minutes before bed etc.) are provided to participants via readings within the app during the intervention, and participants self-monitor hours of sleep per night weekly. Evidence-based healthy dietary behaviours which support a healthy bodyweight were delivered through individualized advice and educational materials. Healthy eating principles included limiting processed foods and enhancing whole food consumption, “adding colour” via consumption of fruit and vegetables and choosing nutrient dense foods, and reducing white carbohydrates, refined carbohydrates and added sugar (for example, energy dense food). Weekly educational materials, along with prompts to action are promoted to participants during the intervention (for example; adding colourful whole foods to meals; replace high glycaemic index (GI) foods with low GI options; replace processed breakfast cereal with egg and vegetable omelette). Prescribed dose of fruit was equal to or greater than 2 servings and vegetables was equal to or greater than 3 serves per day. Congruent with the participant’s preferences and goals towards exercise, personalized physical activity prescription was established with the application of the frequency, intensity, time, and type (FITT) principles, and progression to attainment of sufficient moderate-to-vigorous physical activity (MVPA) to meet guidelines appropriate to individual capabilities. A minimum dose of weekly MVPA at commencement of the intervention was 150 minutes per week, such as 3x50 minute activity sessions or 5x30 minute activity sessions. Frequency and time of PA sessions were tailored to participant weekly time availability. Intensity was tailored based on participant physical activity experience, physical fitness, and goal orientation. Type of PA was customized to the individual’s modality preferences for cardiovascular (such as walking, running, or cycling) and strengthening (for example, resistance equipment and/or bodyweight exercises) PA. Physical activity progression self-monitoring was indicated via weekly session completion tracking within the app, and participants were advised to implement small progressive changes in PA during the intervention (such as; increase session duration; perform more repetitions; perform greater intensity; or accomplish more weekly bouts). Throughout the intervention, weekly health education posts were delivered to participants via the app. The emails consisted of educational blog posts of varying topics related to sleep health, healthy nutrition, physical activity, and supporting a healthy immune system, congruent with evidence-based methods previously described. Educational content was derived from health authorities via publicly available information from the World Health Organization and the Centers for Disease Control and Prevention. Intervention adherence was monitored via weekly logging of daily fruit and vegetable intake, average hours of sleep per night and weekly moderate to vigorous exercise session frequency and duration recording. Participants are not expected to use the app for a minimum time duration each day, app engagement will be at the user’s discretion for reading exercise session outlines and educational materials. The anticipated time needed from participants to enter self-monitoring data per week is <5 minutes.