| Author: | Chau, Ching Sum |
| Title: | The mixed-methods process evaluation of zero-time exercise to improve sleep in physically inactive adults with insomnia |
| Advisors: | Yeung, Wing Fai (SN) Chan, Engle Angela (SN) |
| Degree: | DHSc |
| Year: | 2024 |
| Department: | Faculty of Health and Social Sciences |
| Pages: | 455 pages : color illustrations |
| Language: | English |
| Abstract: | Background This study employs process evaluation, specifically utilizing the COM-B model, to provide a comprehensive analysis of the ZTEx intervention's effectiveness in addressing insomnia. By investigating the intervention's structure, participation rates, and contextual factors that impact its outcomes, this research aims to identify any issues that may hinder its success. Furthermore, this analysis contributes to our knowledge of lifestyle-integrated interventions and offers valuable insights into the implementation of behavior change initiatives centered around exercise. Methods This study employed mixed methods to assess its implementation and impact on insomnia, emphasizing acceptability, feasibility, and the examination of facilitators and barriers through qualitative (n=35) and quantitative data (n=140). The study followed the UK Medical Research Council framework, focusing on implementation, context, and mechanisms of impact to understand the ZTEx program's function and influence. Key aspects included evaluating the intervention's reach, fidelity, and acceptability, alongside the identification of contextual factors like compliance and barriers to exercise adherence. Mechanisms influencing the intervention's effects, such as changes in fatigue levels and the relationship between ZTEx adherence and insomnia symptom severity, were explored, aiming to integrate ZTEx into participants' lifestyles effectively and improve sleep quality. Result This process evaluation explored the implementation and impact of the ZTEx program on sleep quality in physically inactive adults with insomnia, identifying facilitators and barriers to exercise adherence. Recruited mainly via mass emails from Hong Kong Polytechnic University, the study involved 140 participants, majority with post-secondary education, desiring to integrate exercise into their lives for health improvement. While high initial acceptability and desire for lifestyle change were observed, challenges in maintaining fidelity and engagement over time emerged, with some benefit from WhatsApp reminders. Despite these challenges, qualitative insights highlighted ZTEx's success in enhancing physical well-being and lifestyle modification through a comprehensive, accessible approach underpinned by the COM-B model and Behaviour Change Wheel (BCW) framework, suggesting potential for broader health promotion strategies. However, mediation analysis indicated unclear connections between exercise frequency, fatigue reduction, and insomnia improvement, highlighting areas for future research. Conclusion Our mixed-methods study of the ZTEx program highlights its effectiveness in integrating exercise into lives of those with insomnia, identifying both facilitators like its flexibility, and barriers like resistance to change. Success relies on addressing behavior through capability, opportunity, and motivation, underscoring the importance of personalized approaches and continuous evaluation for improving sleep and quality of life. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7995.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 3.42 MB | Adobe PDF | View/Open |
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