Impact of the simultaneous distribution of e-learning and exercise videos on the health literacy and lifestyle of college students during the COVID-19 pandemic: a randomized controlled trial.

The intervention lasted only four weeks, so nothing here says whether any change would last. About a quarter of those who started dropped out: 46 of the 61 who completed the baseline survey also completed the follow-up, and the authors say this reduced the sample size. Every outcome was self-reported on questionnaires, and the authors state that the short comprehension tests did not remove recall bias. The study was sized for 64 participants and 46 finished, so it may simply have been too small to detect a change in physical activity. The paper never names which outcome was the pre-specified primary one, so the health literacy and health habit results cannot be checked against a registered endpoint. Participants were already active at a moderate level before the study began, and the authors note that people with lower activity levels improve more, which may have left little room for the intervention to show an effect. The control group only answered the questionnaires again, and the paper does not say who was kept unaware of group allocation, so expectations and repeated questioning could account for some of the change.

The authors declare no conflict of interest. The paper does not say who funded the study.

Do not read the health literacy and health habit improvements as evidence that the video programme works. Physical activity and sitting time were no different between groups, and the group that received exercise videos without e-learning improved on none of the measures, so the change came from the e-learning and the short tests rather than from the exercise videos. Both measures that improved were self-reported questionnaires, in a trial where nearly a quarter of participants dropped out.