WhatsApp-based Intervention for Promoting Physical Activity Among Female College Students, Saudi Arabia: a Randomized Controlled Trial

Alshahrani, Amal, Aesha Siddiqui, Shamsun Khalil, Shehata Farag, Najim Alshahrani, Abdullah Alsabaani, and Hassan Korairi

Eastern Mediterranean Health Journal 27, no. 8 (2021): 782-789

Context

Over the past few decades, Saudi Arabia has experienced rapid economic growth and technological development that have changed peoples’ lifestyles. It has also become one of the world’s most connected countries, with 73% of people using mobile phones. A popular free communications application for Saudi  youth is WhatsApp, making it an attractive option for connecting with young people about their health. This study sought to determine whether a WhatsApp-based intervention could promote physical activity among female college students. 

Intervention

To facilitate the intervention, participants used the WhatsApp application on their personal devices. At the beginning of the study period, students received a brief, 15-minute orientation via WhatsApp that covered the importance of regular exercise and the benefit of maintaining healthy habits. After this orientation, participants received three to four messages a week for 10 weeks; these texts were supported by literature reviews and promoted physical activity among the students.

Evaluation

Design: The students were randomly assigned to the intervention or control group (randomized controlled trial). Students in the control group did not receive the WhatsApp messages and were asked to maintain their usual physical activity during the study. Both groups completed the World Health Organization (WHO) Global Physical Activity Questionnaire at baseline and at the 10-week follow-up. The study examined three self-reported outcomes:  energy expenditure during physical activity (using metabolic equivalent of task, or MET), total physical activity (MET minutes/week), and whether participants met the WHO’s criteria for minimum weekly physical activity. It looked at students’ physical activity in three settings: at work, during travel, and in recreation. 

Sample: The study looked for female students at King Khalid University between ages 18-28 who owned a smartphone with WhatsApp and the internet. Using a convenience sample, 120 students were recruited, and 110 provided informed consent. Seven students did not complete the study, resulting in a final sample of 103 students. Seventy percent of the students were ages 20 or over, over 90% were single, and the majority (69%) had a father with a university or postgraduate degree.

Results

Students in the intervention group saw their mean MET increase each week, while the control group saw no change in this measure. In addition, the intervention group saw a 21% increase in the share of students meeting the WHO activity criteria, while the control group saw a 6% decrease. At follow-up, 91% of students who received the intervention met the WHO criteria, compared to 70% in the control group. Participants significantly improved in total physical activity in each of the three settings (at work, during travel, and in recreation) since participating in the intervention.  

Limitations: Limitations of the study include the results not being generalizable because of the study’s limited setting and the use of self-reported measures to examine changes in physical activity levels.  

Conclusion

It may be difficult for young Saudi women to participate in in-person exercise programs because of the social limitations they face. These findings demonstrate that a WhatsApp-based messaging intervention could be effective in reaching young women individually and improving their physical activity levels. The results, while not generalizable to the wider population, are encouraging. Given the ease with which the intervention can be implemented, the authors recommend further research involving a larger, multicenter sample and a longer study period to examine whether the positive changes in health behavior can be replicated and maintained in this young population.