Mr. Upula Madhusankha Vishwamithra Amarasinghe
University of Colombo, Sri Lanka
Abstract Title: Development and Implementation of a Theory-Based Mhealth Application to Enhance Physical Activity Among Sedentary Office Workers in Colombo, Sri Lanka
Biography:
Upula Amarasinghe is a results-driven development professional currently serving as an International Program Monitoring and Evaluation Specialist with the Food and Agriculture Organization (FAO) of the United Nations in Samoa. He has extensive experience in designing and implementing programmes across the agriculture, health, and emergency sectors. His expertise includes leading digital transformation initiatives, developing M&E frameworks, and fostering strategic collaboration with government and UN partners. Upula holds a Master of Development Practice and a BSc in Health Promotion. He is currently an MPhil candidate at the University of Colombo's Faculty of Medicine, researching mHealth interventions to promote physical activity.
Research Interest:
Sedentary behaviour among office workers is a significant driver of non-communicable diseases, with low motivation being a key barrier to increasing physical activity. This paper details the rigorous methodology adopted in the theory-based development and implementation of "Activa," an mHealth intervention for sedentary government employees in Sri Lanka. The study employed a quasi-experimental, pre-test, post-test design with 244 employees, utilizing cluster-randomization of four institutions to minimize contamination. This design established four parallel arms to test a dose-response relationship: a control group and three intervention groups receiving progressively intensive motivational content over three months. The development process was explicitly theory-driven; the application’s architecture was designed to target the Motivation component of the COM-B model by operationalizing nine domains from the Theoretical Domains Framework (TDF). This involved a granular mapping of constructs to features; for example, the ‘Behavioural Regulation’ domain was translated into functions for personalized goal-setting and self-monitoring, while the ‘Beliefs about Capabilities’ were targeted by providing feedback on performance to enhance self-efficacy. The primary outcome, motivation, was assessed using the Behavioural Regulations in Exercise Questionnaire (BREQ-3), and the secondary outcome, physical activity, was measured via the International Physical Activity Questionnaire (IPAQ). Data analysis will follow an 'Intention to Treat' principle, providing a conservative and realistic estimate of the intervention's effectiveness. While a formative pilot prompted pragmatic refinements, such as shifting to paper-based data collection to ensure inclusivity, the core research demonstrates a transferable model for deploying theoretically-grounded mHealth interventions that are robust, valid, and executable within real-world constraints. Keywords: mHealth, physical activity, behaviour change, formative evaluation, sedentary behaviour, COM-B model SECOND ABSTRACT: Feasibility and Acceptability of a Theory-Based Mhealth Intervention to Promote Physical Activity in Sri Lanka Physical inactivity among sedentary office workers is a significant public health problem, particularly in low- and middle-income countries where motivation is a crucial barrier. While mobile health (mHealth) applications offer a scalable solution, their effectiveness is often hindered by lack of attention to real-world feasibility and user acceptability. This study details the formative evaluation of "Activa," a theory-based mHealth application, to assess these critical factors among sedentary public sector employees in Colombo, Sri Lanka, with the objective of refining its implementation protocol for a larger trial. The research methods involved a formative pilot study with 70 employees, conducted alongside in-person biophysical measurements to gauge engagement. The results from this pilot, which included diverse age cohorts (n=9 aged <35, n=32 aged 35-45, and n=29 aged >45), revealed significant feasibility barriers, including a wide digital literacy gap, logistical challenges with group onboarding, and user trust issues arising from the APK installation. Data collection built into the application was found to be unacceptable for many users, risking poor data quality. Consequently, the study protocol was significantly refined into a hybrid human-digital model, incorporating expanded on-site support and paper-based data collection. This study concludes that rigorous formative evaluation is indispensable for adapting mHealth interventions to local contexts and contributes a validated, user-centered methodology demonstrating that combining digital tools with high-touch human support is critical for achieving feasibility and acceptability in public health research. Keywords: mHealth, feasibility study, user-centered design, physical activity, implementation science, Sri Lanka