Feasibility and Acceptability of a Novel Behavioral Economic Coaching Session to Address Physical Activity and TV Watching: An Open Pilot Trial.

Background: Behavioral economics (BE) suggests that adults are more likely to engage in enjoyable behaviors that are easily available and accessible (e.g., TV watching) compared to less enjoyable and available alternatives (physical activity). This feasibility trial of a 4-week telehealth program aimed to increase physical activity and reduce TV watching.

Method: Healthy but insufficiently active adults who watched TV for at least 15 h/week (N = 33) were recruited via ResearchMatch and completed a baseline coaching session (~ 30 min), a booster session (week 2, ~ 15 min), and an exit interview via video conference (~ 15 min), as well as online questionnaires. The coaching session included common physical activity promotion strategies and two novel BE components to (1) increase the availability and enjoyment of physical activity, and (2) use TV watching as a reward for physical activity (i.e., contingent TV).

Results: Most participants who attended the follow-up (87.5% out of n = 24) rated component 1 as "useful" or "very useful" and 45.8% rated contingent TV (component 2) as such. Four weeks post coaching session, participants reported an increase in vigorous physical activity (+ 13.9 min/day) and walking (+ 12.1 min/day), and a decrease in sedentary behavior other than TV watching (- 3.5 h/day).

Conclusion: This feasibility trial suggests that an individualized discussion on enjoyable physical activity and contingent TV watching are two behavioral economic approaches that may support behavior change in adults. Future research is needed to replicate these findings in a larger sample using a randomized controlled trial.