1
|
He Z, Hassan MA, Saiz-González P, Ryu S, Wang R, Gao Z. Smartphone app-based interventions on physical activity behaviors and psychological correlates in healthy young adults: A systematic review. PLoS One 2024; 19:e0301088. [PMID: 38578729 PMCID: PMC10997080 DOI: 10.1371/journal.pone.0301088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 03/09/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND The issue of low physical activity (PA) levels among the youth is a longstanding concern. Smartphone applications offer a promising avenue for delivering interventions that are both accessible and engaging. Up to now, there appears to be a gap in the literature, with no systematic reviews assessing the efficacy of smartphone apps in encouraging increased physical activity among healthy young adults. OBJECTIVE To synthesize the effects of a smartphone app-based intervention on PA and PA-related psychological correlates in healthy young adults (18-35 years old). METHODS A search was conducted on eighteen databases: PubMed, Medline, Web of Science, SPORTDiscus, Scopus, Academic Search Premier, Communication and Mass Media Complete, Article First, Biomed Central, BioOne, EBSCOHost, JSTOR, ProQuest, SAGE Reference Online, ScienceDirect, SpringerLink, Taylor&Francis, and Wiley Online. The search covered the period up until December 2023. This research included all randomized controlled trials (RCTs) that evaluated the effectiveness of smartphone app-based interventions on PA and PA related psychological outcomes in healthy young adults. The overall impact was determined by vote counting based on the direction of effect and aggregating p values. The quality of the evidence was evaluated using an 8-item scale. This study has been registered in the PROSPERO database with the identification number CRD42023390033. RESULTS A total of 8403 articles were retrieved, and based on the predefined inclusion and exclusion criteria, seven articles were selected for inclusion. Among these articles, four high-quality RCTs were identified, and the results of vote counting and combining p values methods suggested that smartphone-based app interventions did not demonstrate significant effectiveness in improving PA and PA-related psychological outcomes. However, some improvements were observed. The analysis results, which were categorized into fitness apps and health apps based on the characteristics of the interventions, also failed to demonstrate significant intervention effects. CONCLUSION The findings indicate that, currently, there are no significant effects of smartphone app interventions on improving PA and PA-related psychological outcomes in healthy young adults aged 18-35 years. It is important to note that these findings should be interpreted with caution due to the limited number of included studies. Future research should focus on employing high-quality study designs to determine the true effects of interventions and analyze various smartphone app interventions. These analyses should encompass different app characteristics (e.g., fitness app and health app), various combinations (e.g., fitness app alone and fitness app in combination with other interventions), diverse intervention goals (e.g., PA and PA along with other outcomes), and multiple intervention characteristics (e.g., frequency and duration).
Collapse
Affiliation(s)
- Zihao He
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Mohamed A. Hassan
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
- Department of Methods and Curriculum, Physical Education College for Men, Helwan University, Cairo, Egypt
| | - Pablo Saiz-González
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Suryeon Ryu
- School of Kinesiology, University of Minnesota-Twin Cities, Minneapolis, Minnesota, United States of America
| | - Ronghui Wang
- School of Sport Science, Beijing Sport University, Haidian, Beijing, China
| | - Zan Gao
- Department of Kinesiology, Recreation, and Sport Studies, The University of Tennessee, Knoxville, Tennessee, United States of America
| |
Collapse
|
2
|
Schwartz J, Rhodes RE, Oh P, Bredin SSD, Perotto MB, González AG, Warburton DER. Increasing Health Behaviors and Psychological Measures with an Adapted Version of the ACCELERATION Program. Int J Behav Med 2024:10.1007/s12529-024-10279-1. [PMID: 38557740 DOI: 10.1007/s12529-024-10279-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Recent evidence highlights the importance of interventions tackling physical inactivity and unhealthy eating in lower-income countries. The purpose of this study was to examine the effectiveness of the Canadian ACCELERATION lifestyle program adapted to Brazilians. The main outcomes of the study were changes in the engagement in weekly moderate-to-vigorous physical activity (MVPA) and in the daily consumption of fruits/vegetables. METHODS The adapted intervention consisted of a 12-week quasi-randomized controlled trial delivered through email. The data from the original Canadian experimental group (CE, n = 194) and the two groups of Portuguese-speaking Brazilians living in Canada in the adapted program - Brazilian experimental (BE, n = 41) and Brazilian control (BC, n = 35) - were assessed at baseline and post-intervention. The data of the 270 participants were analyzed using two-way repeated measures factorial ANCOVA (group x time) for ratio variables and Chi-square and McNemar tests for the categorical variables. RESULTS The BE group had a significant increase in MVPA (mean difference, 95% CI: 86.3, 38.1-134.4 min/week) and fruits/vegetables intake (3.2, 1.4-5.1 servings/day) after the intervention (both p < 0.001). The proportion of participants engaging in ≥ 150 min of MVPA increased from 4.9% to 73.2%, while adoption of a healthy diet increased from 4.9% to 53.7% in the BE group (both p < 0.001). The CE group also improved on these variables (p < 0.05) with no difference vs the BE group (p > 0.05), whereas BC did not show changes (p > 0.05). CONCLUSION The Brazilian version of the ACCELERATION program effectively promoted positive health behavior changes in its participants and has the potential to contribute to the fight against risk factors for chronic diseases in Brazilians.
Collapse
Affiliation(s)
- Juliano Schwartz
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada.
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Paul Oh
- Cardiac Rehabilitation and Prevention Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Shannon S D Bredin
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
| | - Maira B Perotto
- West Toronto Diabetes Education Program, LAMP Community Health Centre, Toronto, ON, Canada
| | - Alejandro Gaytán González
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
- Institute of Applied Sciences for Physical Activity and Sport, University of Guadalajara, Guadalajara, Mexico
| | - Darren E R Warburton
- Physical Activity Promotion and Chronic Disease Prevention Unit, University of British Columbia, Vancouver, BC, Canada
| |
Collapse
|
3
|
Fabbrizio A, Fucarino A, Cantoia M, De Giorgio A, Garrido ND, Iuliano E, Reis VM, Sausa M, Vilaça-Alves J, Zimatore G, Baldari C, Macaluso F. Smart Devices for Health and Wellness Applied to Tele-Exercise: An Overview of New Trends and Technologies Such as IoT and AI. Healthcare (Basel) 2023; 11:1805. [PMID: 37372922 DOI: 10.3390/healthcare11121805] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/08/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
This descriptive article explores the use of smart devices for health and wellness in the context of telehealth, highlighting rapidly evolving technologies such as the Internet of Things (IoT) and Artificial Intelligence (AI). Key innovations, benefits, challenges, and opportunities related to the adoption of these technologies are outlined. The article provides a descriptive and accessible approach to understanding the evolution and impact of smart devices in the tele-exercise reality. Nowadays, technological advances provide solutions that were unthinkable just a few years ago. The habits of the general population have also changed over the past few years. Hence, there is a need to investigate this issue and draw the attention of the scientific community to this topic by describing the benefits and challenges associated with each topic. If individuals no longer go to exercise, the exercise must go to their homes instead.
Collapse
Affiliation(s)
- Antonio Fabbrizio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Alberto Fucarino
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Manuela Cantoia
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Andrea De Giorgio
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Nuno D Garrido
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
| | - Enzo Iuliano
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Victor Machado Reis
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
| | - Martina Sausa
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - José Vilaça-Alves
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 5000-801 Vila Real, Portugal
- Sciences Department, University of Tras-os-Montes & Alto Douro, 5000-801 Vila Real, Portugal
| | - Giovanna Zimatore
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Carlo Baldari
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| | - Filippo Macaluso
- Department of Theoretical and Applied Sciences, eCampus University, 22060 Novedrate, Italy
| |
Collapse
|
4
|
Rodríguez-González P, Iglesias D, Fernandez-Rio J, Gao Z. Effectiveness of interventions using apps to improve physical activity, sedentary behavior and diet: An umbrella review. Complement Ther Clin Pract 2023; 50:101711. [PMID: 36509032 DOI: 10.1016/j.ctcp.2022.101711] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 11/09/2022] [Accepted: 11/17/2022] [Indexed: 11/23/2022]
Abstract
Technology has been recently found to be an effective tool to deliver public health interventions [1]. More specifically, the effects of interventions using apps to improve health have been targeted lately [2]. The goal of the present study was to conduct a systematic review of systematic reviews to summarize the scientific evidence. Three research questions were formulated to guide the research: RQ1. Are interventions using apps effective to improve PA? RQ2. Are interventions using apps effective to improve sedentary behavior? RQ3. Are interventions using apps effective to improve diet? This review of reviews was registered with PROSPERO (CRD42022345909). Systematic reviews were included following the PICOTS framework (population, intervention, comparator, outcomes, time and setting). In addition, reviews with several research objectives were included only when they comprised more than two-thirds of the studies analyzing one or more of the objectives of this review. As a result, 12 systematic reviews were selected for data extraction. Findings uncovered that apps could be effective to improve individuals' PA, sedentary behavior and diet. However, elements like the intervention components, the context/environment/setting, the length of the intervention or the population targeted should be carefully considered in future studies.
Collapse
Affiliation(s)
- Pablo Rodríguez-González
- School of Kinesiology, University of Minnesota Twin Cities, USA; Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Damián Iglesias
- Teacher Training College, University of Extremadura, Cáceres, Spain
| | - Javier Fernandez-Rio
- Faculty of Teacher Training and Education, University of Oviedo, Asturias, Spain
| | - Zan Gao
- School of Kinesiology, University of Minnesota Twin Cities, USA.
| |
Collapse
|
5
|
Vieira WDO, Ostolin TLVDP, Simões MDSMP, Proença NL, Dourado VZ. Profile of adults users of smartphone applications for monitoring the level of physical activity and associated factors: A cross-sectional study. Front Public Health 2022; 10:966470. [PMID: 36203689 PMCID: PMC9530973 DOI: 10.3389/fpubh.2022.966470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background There are currently more than 200 million smartphones in Brazil. The potential of mobile technologies for favorable changes in health behavior such as physical activity has been previously described in the literature. Results of surveys in developed countries indicate that applications (APPs) are developed for people who are better educated, younger, and with higher incomes compared to non-users. However, the profile of users in developing countries like Brazil is not well-known. Understanding the profile of APP users might ease the development turned to physically inactive people and those at higher cardiovascular risk. Furthermore, the physiological and functional factors associated with the use of such APP are unknown. Objectives To characterize the profile of APP users to monitor the physical activity level (PAL) and assess the demographic, socioeconomic, clinical, physiological, and functional characteristics associated with the use of smartphone APPs to monitor physical activity in Brazilian adults. Methods We assessed 176 asymptomatic men and 178 women (43 ± 12 years; 27 ± 5 kg/m2). We initially asked participants about their current use of a smartphone APP containing PAL monitoring functionality, such as exercise session logs and/or step counts. In a cross-sectional design, we investigated schooling, socioeconomic status (Critério Brasil), and classic self-reported cardiovascular risk factors. We evaluated several physiological and functional variables such as maximum O2 consumption on a treadmill (VO2 max), blood pressure, body composition (bioelectrical impedance), handgrip strength, and isokinetic muscle strength of the dominant lower limb. Participants used a triaxial accelerometer for 7 days to quantify daily physical activity. We also assessed health-related quality of life (WHOQOL BREF), perceived stress (PSS14 Scale), and the built environment (NEWS Scale). We compared continuous variables using the Student's t-test and categorical variables using the χ2 test, between APP users and non-users. After univariate analysis, we included the main variables associated with the use of APP in a multiple logistic regression model. Results One hundred and two participants (28.3%), unrelated to gender, reported using a smartphone APP for physical activity at the time of assessment. Except for perceived stress and the built environment that were not associated with the use of APP, users of APP were younger and had higher education, lower cardiovascular risk, better socioeconomic status, a better quality of life, better cardiorespiratory function, better body composition, greater physical fitness and more moderate to vigorous physical activity in daily life. The results of the multiple logistic regression showed that age, hypertension, VO2 max, socioeconomic status (Critério Brasil), and quality of life (WHOQOL BREF total score) were the variables most significantly associated with the use of the APP. Conclusions Our results indicate that smartphone APPs to monitor physical activity are developed for younger adults with better socioeconomic status, lower cardiovascular risk, higher quality of life, and greater cardiorespiratory fitness. Greater efforts are needed to develop a science-based APP for people who most need this technology, enabling greater potential to prevent undesirable health outcomes in asymptomatic adults.
Collapse
Affiliation(s)
- Wesley de Oliveira Vieira
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Thatiane Lopes Valentim di Paschoale Ostolin
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Maria do Socorro Morais Pereira Simões
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Neli Leite Proença
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Victor Zuniga Dourado
- Laboratory of Epidemiology and Human Movement, Department of Human Movement Sciences, Institute of Health and Society, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
- Lown Scholars Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| |
Collapse
|
6
|
Chrismas BCR, Majed L, Al-Mohannadi AS, Sayegh S. Adherence and retention to the self-managed community-based Step Into Health program in Qatar (2012-2019). Front Public Health 2022; 10:927386. [PMID: 36199850 PMCID: PMC9527577 DOI: 10.3389/fpubh.2022.927386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 08/15/2022] [Indexed: 01/24/2023] Open
Abstract
Purpose Investigate adherence and retention to the "Step Into Health (SIH)" initiative (www.stepintohealth.qa [website access only available from within the State of Qatar]), a Qatari self-managed community-based health program, from 2012 to 2019. Methods Participants (16,711; 16-80 years; 37% females, 34% Qatari) used a pedometer or smartphone application (app) to measure step count. Absolute adherence (ADH) and retention (RET) were calculated, with ADH (%) the ratio between number of days data and SIH enrollment length (RET). Linear Mixed Models identified differences in ADH between RET groups, main effects (i.e., sex, device, age, BMI, nationality) and interaction effects for ADH (RET entered as a covariate). Results Average ADH and RET to SIH (irrespective of sex, age, device and BMI) was 50% (±31%), and 16% (±20%), respectively, with ADH differing significantly between RET groups (F = 460.2, p < 0.001). RET (as a covariate) revealed a significant main effect for device (F = 12.00, p < 0.001) and age (F = 4.31, p = 0.001) on ADH observed. There was a significant association between RET and sex (p < 0.001), device (p < 0.001), and age groups 16-25 y (p < 0.001), and 26-35 y (p < 0.001). There were no significant main effects for sex or BMI on ADH, and no interaction effects (p ≥ 0.21) observed. Conclusions Follow-up data (e.g., interviews, focus groups, etc.) determining why differences in ADH and RET are observed appears prudent. To convert those that lapsed and/or abandoned SIH/PA into committed long-term PA adherers. This would be a first step to develop targeted public health promotions and initiatives to enhance health outcomes at a population level.
Collapse
Affiliation(s)
- Bryna C. R. Chrismas
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar,*Correspondence: Bryna C. R. Chrismas
| | - Lina Majed
- Department of Physical Education, College of Education, Qatar University, Doha, Qatar
| | - Abdulla Saeed Al-Mohannadi
- World Innovation Summit for Health, Qatar Foundation, Doha, Qatar,Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| | - Suzan Sayegh
- Aspetar Orthopedic and Sports Medicine Hospital, Doha, Qatar
| |
Collapse
|
7
|
De Santis KK, Jahnel T, Matthias K, Mergenthal L, Al Khayyal H, Zeeb H. Evaluation of Digital Interventions for Physical Activity Promotion: Scoping Review. JMIR Public Health Surveill 2022; 8:e37820. [PMID: 35604757 PMCID: PMC9171604 DOI: 10.2196/37820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/06/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
Background Digital interventions are interventions supported by digital tools or technologies, such as mobile apps, wearables, or web-based software. Digital interventions in the context of public health are specifically designed to promote and improve health. Recent reviews have shown that many digital interventions target physical activity promotion; however, it is unclear how such digital interventions are evaluated. Objective We aimed to investigate evaluation strategies in the context of digital interventions for physical activity promotion using a scoping review of published reviews. We focused on the target (ie, user outcomes or tool performance), methods (ie, tool data or self-reported data), and theoretical frameworks of the evaluation strategies. Methods A protocol for this study was preregistered and published. From among 300 reviews published up to March 19, 2021 in Medline, PsycINFO, and CINAHL databases, 40 reviews (1 rapid, 9 scoping, and 30 systematic) were included in this scoping review. Two authors independently performed study selection and data coding. Consensus was reached by discussion. If applicable, data were coded quantitatively into predefined categories or qualitatively using definitions or author statements from the included reviews. Data were analyzed using either descriptive statistics, for quantitative data (relative frequencies out of all studies), or narrative synthesis focusing on common themes, for qualitative data. Results Most reviews that were included in our scoping review were published in the period from 2019 to 2021 and originated from Europe or Australia. Most primary studies cited in the reviews included adult populations in clinical or nonclinical settings, and focused on mobile apps or wearables for physical activity promotion. The evaluation target was a user outcome (efficacy, acceptability, usability, feasibility, or engagement) in 38 of the 40 reviews or tool performance in 24 of the 40 reviews. Evaluation methods relied upon objective tool data (in 35/40 reviews) or other data from self-reports or assessments (in 28/40 reviews). Evaluation frameworks based on behavior change theory, including goal setting, self-monitoring, feedback on behavior, and educational or motivational content, were mentioned in 22 out of 40 reviews. Behavior change theory was included in the development phases of digital interventions according to the findings of 20 out of 22 reviews. Conclusions The evaluation of digital interventions is a high priority according to the reviews included in this scoping review. Evaluations of digital interventions, including mobile apps or wearables for physical activity promotion, typically target user outcomes and rely upon objective tool data. Behavior change theory may provide useful guidance not only for development of digital interventions but also for the evaluation of user outcomes in the context of physical activity promotion. Future research should investigate factors that could improve the efficacy of digital interventions and the standardization of terminology and reporting in this field. International Registered Report Identifier (IRRID) RR2-10.2196/35332
Collapse
Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany
| | - Tina Jahnel
- Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany
| | - Hatem Al Khayyal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty of Engineering and Mathematics, Bielefeld University of Applied Science, Bielefeld, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology- BIPS, Bremen, Germany.,Leibniz-Science Campus Digital Public Health Bremen, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| |
Collapse
|
8
|
Jones AC, Grout L, Wilson N, Nghiem N, Cleghorn C. The Cost-effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Weight Loss: Updated Modeling Study. JMIR Form Res 2022; 6:e29291. [PMID: 35438643 PMCID: PMC9066337 DOI: 10.2196/29291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/21/2021] [Accepted: 12/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Evidence suggests that smartphone apps can be effective in the self-management of weight. Given the low cost, broad reach, and apparent effectiveness of weight loss apps, governments may seek to encourage their uptake as a tool to reduce excess weight in the population. Mass media campaigns are 1 mechanism for promoting app use. However, the cost and potential cost-effectiveness are important considerations. OBJECTIVE The aim of our study was to use modeling to assess the health impacts, health system costs, cost-effectiveness, and health equity of a mass media campaign to promote high-quality smartphone apps for weight loss in New Zealand. METHODS We used an established proportional multistate life table model that simulates the 2011 New Zealand adult population over the lifetime, subgrouped by age, sex, and ethnicity (Māori [Indigenous] or non-Māori). The risk factor was BMI. The model compared business as usual to a one-off mass media campaign intervention, which included the pooled effect size from a recent meta-analysis of smartphone weight loss apps. The resulting impact on BMI and BMI-related diseases was captured through changes in health gain (quality-adjusted life years) and in health system costs. The difference in total health system costs was the net sum of intervention costs and downstream cost offsets because of altered disease rates. An annual discount rate of 3% was applied to health gains and health system costs. Multiple scenarios and sensitivity analyses were conducted, including an equity adjustment. RESULTS Across the remaining lifetime of the modeled 2011 New Zealand population, the mass media campaign to promote weight loss app use had an estimated overall health gain of 181 (95% uncertainty interval 113-270) quality-adjusted life years and health care costs of -NZ $606,000 (-US $408,000; 95% uncertainty interval -NZ $2,540,000 [-US $1,709,000] to NZ $907,000 [US $610,000]). The mean health care costs were negative, representing overall savings to the health system. Across the outcomes examined in this study, the modeled mass media campaign to promote weight loss apps among the general population would be expected to provide higher per capita health gain for Māori and hence reduce health inequities arising from high BMI, assuming that the intervention would be as effective for Māori as it is for non-Māori. CONCLUSIONS A modeled mass media campaign to encourage the adoption of smartphone apps to promote weight loss among the New Zealand adult population is expected to yield an overall gain in health and to be cost-saving to the health system. Although other interventions in the nutrition and physical activity space are even more beneficial to health and produce larger cost savings (eg, fiscal policies and food reformulation), governments may choose to include strategies to promote health app use as complementary measures.
Collapse
Affiliation(s)
- Amanda C Jones
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Leah Grout
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nick Wilson
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Nhung Nghiem
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Christine Cleghorn
- Department of Public Health, University of Otago, Wellington, New Zealand
| |
Collapse
|
9
|
De Santis KK, Jahnel T, Mergenthal L, Zeeb H, Matthias K. Evaluation of Digital Interventions for Physical Activity Promotion: Protocol for a Scoping Review. JMIR Res Protoc 2022; 11:e35332. [PMID: 35238321 PMCID: PMC8931641 DOI: 10.2196/35332] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/12/2022] [Accepted: 02/03/2022] [Indexed: 12/24/2022] Open
Abstract
Background Digital interventions (DIs) could support physical activity (PA) promotion, according to recent reviews. However, it remains unclear if and how DIs for PA promotion are evaluated; thus, it is unclear if they support behavior change in real-world settings. A mapping of evidence from published reviews is required to focus on the evaluation of DIs for PA promotion. Objective The aim of our study is to investigate evaluation strategies for any outcome in the context of DIs for PA promotion by conducting a scoping review of published reviews. Methods Our scoping review adheres to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. The information sources include bibliographic databases (MEDLINE, PsycINFO, and CINAHL) and the bibliographies of the selected studies. The electronic search strategy was developed and conducted in collaboration with an experienced database specialist. The electronic search was conducted in English with no limits up to March 19, 2021, for sources with the terms digital intervention AND evaluation AND physical activity in titles or abstracts. After deduplication, 300 reviews selected from 4912 search results were assessed for eligibility by 2 authors working independently. The inclusion criteria were (1) healthy or clinical samples (population), (2) DIs for PA promotion (intervention), (3) comparisons to any other intervention or no intervention (comparison), (4) evaluation strategies (methods, results, or frameworks) for any outcome in the context of DIs for PA promotion (outcome), and (5) any published review (study type). According to the consensus reached during a discussion, 40 reviews met the inclusion criteria—36 from the electronic search and 4 from the manual search of the bibliographies of the 36 reviews. All reviews reported the evaluation strategies for any outcomes in the context of DIs for PA promotion in healthy or clinical samples. Data coding and the quality appraisal of systematic reviews are currently being performed independently by 2 authors. Results Our scoping review includes data from 40 published reviews (1 rapid review, 9 scoping reviews, and 30 systematic reviews). The focus of data coding is on evaluation strategies in the context of DIs for PA promotion and on the critical appraisal of the included systematic reviews. The final consensus regarding all data is expected in early 2022. Conclusions Interventions for PA promotion that are supported by digital technologies require evaluation to ensure their efficacy in real-world settings. Our scoping review is needed because it addresses novel objectives that focus on such evaluations and are not answered in the published reviews identified in our search. The evaluation strategies addressing DIs for PA promotion will be mapped to synthesize the results that have been reported in published reviews so far. International Registered Report Identifier (IRRID) DERR1-10.2196/35332
Collapse
Affiliation(s)
- Karina Karolina De Santis
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Tina Jahnel
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty 11 Human and Health Sciences, University of Bremen, Bremen, Germany
| | - Lea Mergenthal
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Hajo Zeeb
- Department of Prevention and Evaluation, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Katja Matthias
- Faculty of Electrical Engineering and Computer Science, University of Applied Science Stralsund, Stralsund, Germany
| |
Collapse
|
10
|
Elfghi M, Dunne D, Jones J, Gibson I, Flaherty G, McEvoy JW, Sultan S, Jordan F, Tawfick W. Mobile health technologies to improve walking distance in people with intermittent claudication. Hippokratia 2021. [DOI: 10.1002/14651858.cd014717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Marah Elfghi
- College of Medicine; National University of Ireland Galway; Galway Ireland
| | - Denise Dunne
- National Institute for Prevention and Cardiovascular Health; Croí Heart and Stroke Centre; Newcastle, Galway Ireland
- Croí Heart and Stroke Centre; Newcastle, Galway Ireland
| | - Jennifer Jones
- Croí, The West of Ireland Cardiac Foundation; Galway Ireland
| | - Irene Gibson
- Croí, The West of Ireland Cardiac Foundation; Galway Ireland
| | - Gerard Flaherty
- School of Medicine; National University of Ireland; Galway Ireland
| | | | - Sherif Sultan
- Vascular Surgery; Galway University Hospital; Galway Ireland
| | - Fionnuala Jordan
- School of Nursing and Midwifery; National University of Ireland Galway; Galway Ireland
| | - Wael Tawfick
- Department of Vascular and Endovascular Surgery; Western Vascular Institute, University College Hospital; Galway Ireland
| |
Collapse
|
11
|
Foresight for the Fitness Sector: Results from a European Delphi Study and Its Relevance in the Time of COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238941. [PMID: 33271932 PMCID: PMC7730891 DOI: 10.3390/ijerph17238941] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 02/02/2023]
Abstract
The fitness sector is an essential player in the promotion of physical activity and healthy behaviour in Europe. However, the sector is confronted with numerous socio-demographic trends that will shape its ability to be financially successful and contribute to public health. The sector must understand current drivers of change and the skills its workforce needs to navigate them. As such, using the results of a 2019 Delphi Survey of over 50 fitness experts from 26 countries, we aim to define the drivers of change facing the sector and identify the skills needed by the fitness workforce to navigate these changes. We find that several technological, social, health and economic trends affect the sector. As a result, so-called soft skills such as communication or customer service, along with digital technology skills, are becoming increasingly important. There is also growing recognition that fitness professionals need to be trained to work with a number of special populations. Furthermore, we argue that many of the trends identified here—such as the increasing use of technology or the focus on individual customer needs—have been accelerated by the COVID-19 pandemic. We conclude by arguing that well-developed, pan-European qualifications are needed to address these common issues.
Collapse
|