Use of information and communication technology to improve health, known as eHealth, is an emerging concept in healthcare that may present opportunities to promote physical activity and well-being actions in adults with obesity. The purpose of this dissertation (psychosocial aspects of sport and physical activity) was to increase knowledge in the emergent area. Study 1 systematically reviewed previous eHealth intervention studies to promote physical activity in adults with obesity. The study design was a systematic review study guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses and other guidelines. Five electronic databases were used. Two researchers screened articles, assessed risk of bias, and extracted data independently. A qualitative data synthesis was conducted. Study 2 evaluated the effectiveness of the Fun For Wellness (FFW) eHealth intervention to promote well-being actions in adults with obesity in the United States of America (USA) in a relatively uncontrolled setting. The FFW intervention is based on self-efficacy theory. The study design was a large-scale, prospective, double-blind, and parallel-group randomized controlled trial. Data collection via self-reports occurred at: baseline, 30 days and 60 days after baseline. Participants were recruited through a recruitment company. A single path model was fit based on the FFW conceptual model.In Study 1, 2276 articles were identified, and 18 studies met all inclusion criteria. Study quality ranged from poor to good. The included studies varied in intervention technology (e.g., web-based, mobile phone-based, physical activity monitor-based), physical activity assessment (e.g., device-based, self-report based), and control group. Behavioral change techniques used in the included studies were consistent with some techniques (e.g., self-monitoring, personalized feedback) that were previously known as effective in the majority of face-to-face interventions, but more automatically and efficiently employed in eHealth using information and communication technology. Overall, Study 1 shows that a web-based or physical activity monitor-based eHealth intervention has the potential to be effective in promoting physical activity in adults with obesity. The use of theory and monitor-based physical activity assessment in eHealth seems to be beneficial to the intervention design and study design. In Study 2, participants (N = 667) who were assigned to the FFW group (nFFW = 331) were provided with 30 days of 24 hr access to FFW. There was evidence of internal structure validity and test-retest reliability in the well-being action scale and well-being action self-efficacy scale. Supportive evidence was provided for the effectiveness of FFW in real-world settings to promote, either directly or indirectly, three dimensions: community, occupational, psychological. Overall, Study 2 shows that the theory-based eHealth intervention has the potential to be effective in promoting well-being actions in adults with obesity.In conclusion, this dissertation shows that an eHealth intervention has the potential to be effective in promoting physical activity and well-being actions in adults with obesity in a relatively uncontrolled setting, particularly when the intervention is web-based or physical activity monitor-based, using theory. The use of monitor-based physical activity assessment in the field is recommended. This dissertation provides a contemporary and salient research base and identifies gaps in the emergent area, indicating that eHealth is promising for adults with obesity. This dissertation will be useful to develop (or refine), implement, and evaluate an eHealth intervention that effectively and efficiently promotes physical activity and well-being actions in adults with obesity in real-world settings.
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