Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults.

Methods

Systematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers.

Results

Twenty-seven studies were included, most were randomised controlled trials ( n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies ( n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies ( n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes.

Conclusions

This review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than stand-alone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy.

Electronic supplementary material

The online version of this article (doi:10.1186/s12966-016-0454-y) contains supplementary material, which is available to authorized users.

Related collections

Most cited references 47

Record: found
Abstract: found
Article: found

Is Open Access

Meta-analysis of internet-delivered interventions to increase physical activity levels

Cally Davies, John Spence, Corneel Vandelanotte … (2012)

Many internet-delivered physical activity behaviour change programs have been developed and evaluated. However, further evidence is required to ascertain the overall effectiveness of such interventions. The objective of the present review was to evaluate the effectiveness of internet-delivered interventions to increase physical activity, whilst also examining the effect of intervention moderators. A systematic search strategy identified relevant studies published in the English-language from Pubmed, Proquest, Scopus, PsychINFO, CINHAL, and Sport Discuss (January 1990 – June 2011). Eligible studies were required to include an internet-delivered intervention, target an adult population, measure and target physical activity as an outcome variable, and include a comparison group that did not receive internet-delivered materials. Studies were coded independently by two investigators. Overall effect sizes were combined based on the fixed effect model. Homogeneity and subsequent exploratory moderator analysis was undertaken. A total of 34 articles were identified for inclusion. The overall mean effect of internet-delivered interventions on physical activity was d = 0.14 (p = 0.00). Fixed-effect analysis revealed significant heterogeneity across studies (Q = 73.75; p = 0.00). Moderating variables such as larger sample size, screening for baseline physical activity levels and the inclusion of educational components significantly increased intervention effectiveness. Results of the meta-analysis support the delivery of internet-delivered interventions in producing positive changes in physical activity, however effect sizes were small. The ability of internet-delivered interventions to produce meaningful change in long-term physical activity remains unclear.

0 comments Cited 240 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: found

Is Open Access

Apps to promote physical activity among adults: a review and content analysis

Anouk Middelweerd, Julia Mollee, C Natalie van der Wal … (2014)

Background In May 2013, the iTunes and Google Play stores contained 23,490 and 17,756 smartphone applications (apps) categorized as Health and Fitness, respectively. The quality of these apps, in terms of applying established health behavior change techniques, remains unclear. Methods The study sample was identified through systematic searches in iTunes and Google Play. Search terms were based on Boolean logic and included AND combinations for physical activity, healthy lifestyle, exercise, fitness, coach, assistant, motivation, and support. Sixty-four apps were downloaded, reviewed, and rated based on the taxonomy of behavior change techniques used in the interventions. Mean and ranges were calculated for the number of observed behavior change techniques. Using nonparametric tests, we compared the number of techniques observed in free and paid apps and in iTunes and Google Play. Results On average, the reviewed apps included 5 behavior change techniques (range 2–8). Techniques such as self-monitoring, providing feedback on performance, and goal-setting were used most frequently, whereas some techniques such as motivational interviewing, stress management, relapse prevention, self-talk, role models, and prompted barrier identification were not. No differences in the number of behavior change techniques between free and paid apps, or between the app stores were found. Conclusions The present study demonstrated that apps promoting physical activity applied an average of 5 out of 23 possible behavior change techniques. This number was not different for paid and free apps or between app stores. The most frequently used behavior change techniques in apps were similar to those most frequently used in other types of physical activity promotion interventions.

0 comments Cited 219 times – based on 0 reviews      Review now

Record: found
Abstract: found
Article: not found

Effectiveness of web-based interventions in achieving weight loss and weight loss maintenance in overweight and obese adults: a systematic review with meta-analysis.

M. Neve, P Morgan, P R Jones … (2010)

The objectives of this systematic review are to evaluate the effectiveness of web-based interventions on weight loss and maintenance and identify which components of web-based interventions are associated with greater weight change and low attrition rates. A literature search from 1995 to April 2008 was conducted. Studies were eligible for inclusion if: participants were aged >or=18 years with a body mass index >or=25, at least one study arm involved a web-based intervention with the primary aim of weight loss or maintenance, and reported weight-related outcomes. Eighteen studies met the inclusion criteria. Thirteen studies aimed to achieve weight loss, and five focused on weight maintenance. Heterogeneity was evident among the studies with seven research questions examined across interventions of varying intensity. Seven studies were assessed for effectiveness based on percentage weight change, with four studies deemed effective. Although the four meta-analyses suggest meaningful weight change, it is not possible to determine the effectiveness of web-based interventions in achieving weight loss or maintenance due to heterogeneity of designs and thus the small number of comparable studies. Higher usage of website features may be associated with positive weight change, but we do not know what features improve this effect or reduce attrition.

0 comments Cited 184 times – based on 0 reviews      Review now

All references

Author and article information

Contributors

Stephanie Schoeppe: +61 7 4923 2271 , s.schoeppe@cqu.edu.au

Stephanie Alley: +61 7 4923 2263 , s.alley@cqu.edu.au

Wendy Van Lippevelde: +32 9 332 83 65 , Wendy.VanLippevelde@UGent.be

Nicola A. Bray: +61 405 440471 , nicola.bray@cqumail.com

Susan L. Williams: +61 7 4923 2213 , s.p.williams@cqu.edu.au

Mitch J. Duncan: +61 2 4921 7805 , Mitch.Duncan@newcastle.edu.au

Corneel Vandelanotte: +61 7 4923 2183 , c.vandelanotte@cqu.edu.au

Journal

Journal ID (nlm-ta): Int J Behav Nutr Phys Act

Journal ID (iso-abbrev): Int J Behav Nutr Phys Act

Title: The International Journal of Behavioral Nutrition and Physical Activity

Publisher: BioMed Central (London )

ISSN (Electronic): 1479-5868

Publication date (Electronic): 7 December 2016

Publication date PMC-release: 7 December 2016

Publication date Collection: 2016

Volume: 13

Electronic Location Identifier: 127

Affiliations

[1 ]Central Queensland University, School of Health, Medical and Applied Sciences, Physical Activity Research Group, Building 77, Bruce Highway, Rockhampton, QLD 4702 Australia

[2 ]Ghent University, Department of Public Health, De Pintelaan 185-4 K3 room 036, 9000 Ghent, Belgium

[3 ]Central Queensland University, School of Health, Medical and Applied Sciences, Building 6, Bruce Highway, Rockhampton, QLD 4702 Australia

[4 ]The University of Newcastle, School of Medicine & Public Health, Priority Research Centre for Physical Activity and Nutrition, University Drive, Callaghan, NSW 2308 Australia

Article

Publisher ID: 454

DOI: 10.1186/s12966-016-0454-y

PMC ID: 5142356

PubMed ID: 27927218

SO-VID: 0fbf0b25-9385-4671-beaf-0c40adbf75be

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 6 July 2016

Date accepted : 24 November 2016

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001030, National Heart Foundation of Australia;

Award ID: ID 100427

Award ID: ID 100029

Award Recipient : Mitch J. Duncan Corneel Vandelanotte

Funded by: FundRef http://dx.doi.org/10.13039/501100000925, National Health and Medical Research Council;

Award ID: GNT1125586

Award Recipient : Stephanie Schoeppe

Custom metadata

ScienceOpen disciplines: Nutrition & Dietetics

Keywords: systematic review,literature searches,smartphone applications,programs,efficacy,healthy eating,exercise,sitting,health behaviour

Data availability: