BackgroundHigh levels of sedentary behaviour (SB) are associated with negative health consequences. Technology enhanced solutions such as mobile applications, activity monitors, prompting software, texts, emails and websites are being harnessed to reduce SB. The aim of this paper is to evaluate the effectiveness of such technology enhanced interventions aimed at reducing SB in healthy adults and to examine the behaviour change techniques (BCTs) used.MethodsFive electronic databases were searched to identify randomised-controlled trials (RCTs), published up to June 2016. Interventions using computer, mobile or wearable technologies to facilitate a reduction in SB, using a measure of sedentary time as an outcome, were eligible for inclusion. Risk of bias was assessed using the Cochrane Collaboration’s tool and interventions were coded using the BCT Taxonomy (v1).ResultsMeta-analysis of 15/17 RCTs suggested that computer, mobile and wearable technology tools resulted in a mean reduction of −41.28 min per day (min/day) of sitting time (95% CI -60.99, −21.58, I2 = 77%, n = 1402), in favour of the intervention group at end point follow-up. The pooled effects showed mean reductions at short (≤ 3 months), medium (>3 to 6 months), and long-term follow-up (>6 months) of −42.42 min/day, −37.23 min/day and −1.65 min/day, respectively. Overall, 16/17 studies were deemed as having a high or unclear risk of bias, and 1/17 was judged to be at a low risk of bias. A total of 46 BCTs (14 unique) were coded for the computer, mobile and wearable components of the interventions. The most frequently coded were “prompts and cues”, “self-monitoring of behaviour”, “social support (unspecified)” and “goal setting (behaviour)”.ConclusionInterventions using computer, mobile and wearable technologies can be effective in reducing SB. Effectiveness appeared most prominent in the short-term and lessened over time. A range of BCTs have been implemented in these interventions. Future studies need to improve reporting of BCTs within interventions and address the methodological flaws identified within the review through the use of more rigorously controlled study designs with longer-term follow-ups, objective measures of SB and the incorporation of strategies to reduce attrition.Trial registrationThe review protocol was registered with PROSPERO: CRD42016038187 Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-017-0561-4) contains supplementary material, which is available to authorized users.

Background Mobile health (mHealth) apps show vast potential in supporting patients and health care systems with the increasing prevalence and economic costs of noncommunicable diseases (NCDs) worldwide. However, despite the availability of evidence-based mHealth apps, a substantial proportion of users do not adhere to them as intended and may consequently not receive treatment. Therefore, understanding the factors that act as barriers to or facilitators of adherence is a fundamental concern in preventing intervention dropouts and increasing the effectiveness of digital health interventions. Objective This review aimed to help stakeholders develop more effective digital health interventions by identifying factors influencing the continued use of mHealth apps targeting NCDs. We further derived quantified adherence scores for various health domains to validate the qualitative findings and explore adherence benchmarks. Methods A comprehensive systematic literature search (January 2007 to December 2020) was conducted on MEDLINE, Embase, Web of Science, Scopus, and ACM Digital Library. Data on intended use, actual use, and factors influencing adherence were extracted. Intervention-related and patient-related factors with a positive or negative influence on adherence are presented separately for the health domains of NCD self-management, mental health, substance use, nutrition, physical activity, weight loss, multicomponent lifestyle interventions, mindfulness, and other NCDs. Quantified adherence measures, calculated as the ratio between the estimated intended use and actual use, were derived for each study and compared with the qualitative findings. Results The literature search yielded 2862 potentially relevant articles, of which 99 (3.46%) were included as part of the inclusion criteria. A total of 4 intervention-related factors indicated positive effects on adherence across all health domains: personalization or tailoring of the content of mHealth apps to the individual needs of the user, reminders in the form of individualized push notifications, user-friendly and technically stable app design, and personal support complementary to the digital intervention. Social and gamification features were also identified as drivers of app adherence across several health domains. A wide variety of patient-related factors such as user characteristics or recruitment channels further affects adherence. The derived adherence scores of the included mHealth apps averaged 56.0% (SD 24.4%). Conclusions This study contributes to the scarce scientific evidence on factors that positively or negatively influence adherence to mHealth apps and is the first to quantitatively compare adherence relative to the intended use of various health domains. As underlying studies mostly have a pilot character with short study durations, research on factors influencing adherence to mHealth apps is still limited. To facilitate future research on mHealth app adherence, researchers should clearly outline and justify the app’s intended use; report objective data on actual use relative to the intended use; and, ideally, provide long-term use and retention data.

Background: The International Society for Physical Activity and Health (ISPAH) is a leading global organization working to advance research, policy, and practice to promote physical activity. Given the expanding evidence base on interventions to promote physical activity, it was timely to review and update a major ISPAH advocacy document—Investments that Work for Physical Activity (2011). Methods: Eight investment areas were agreed upon through consensus. Literature reviews were conducted to identify key evidence relevant to policymakers in each sector or setting. Results: The 8 investment areas were as follows: whole-of-school programs; active transport; active urban design; health care; public education; sport and recreation; workplaces; and community-wide programs. Evidence suggests that the largest population health benefit will be achieved by combining these investments and implementing a systems-based approach. Conclusions: Establishing consensus on ‘what works’ to change physical activity behavior is a cornerstone of successful advocacy, as is having appropriate resources to communicate key messages to a wide range of stakeholders. ISPAH has created a range of resources related to the new investments described in this paper. These resources are available in the ‘advocacy toolkit’ on the ISPAH website (www.ispah.org/resources).

IntroductionProlonged, uninterrupted periods of sedentary time may be associated with increased risk of Type II diabetes, cardiovascular disease and all-cause mortality even if the minimum recommended levels of daily physical activity are achieved. It is reported that children spend approximately 80% of their day engaged in sedentary behaviours. Since children spend a large portion of their waking time at school, school-based interventions targeting excessive or interrupted periods of sedentary time have been investigated in a number of studies. However, results of the effectiveness of studies to-date have been inconsistent.AimTo conduct a systematic review to evaluate the effectiveness of school-based interventions designed to reduce sedentary behaviour on objectively measured sedentary time in children.MethodsFive electronic databases were searched to retrieve peer-reviewed studies published in English up to and including August 2015. Studies that reported objectively measured sedentary time before and after a school-based intervention to reduce sedentary time were included in the review. Risk of bias was assessed using the Cochrane Collaboration method.ResultsOur search identified eleven papers reporting eight interventions. Studies focused on the physical environment, the curriculum, individual in-class activities, homework activities or a combination of these strategies. Three studies reported decreases in sedentary time following intervention. Study follow-up periods ranged from immediately post-intervention to 12 months. None of the studies were judged to have a low risk of bias.ConclusionsMulticomponent interventions which also include the use of standing desks may be an effective method for reducing children's sedentary time in a school-based intervention. However, longer term trials are needed to determine the sustained effectiveness of such interventions on children's sedentary time.

The aim of this study was to investigate the benefits of a low-volume, vigorous intensity bench stepping programme in sedentary middle-aged adults. Thirty-one healthy but sedentary adults (12 men; 55-64 years) took part in the study. Participants accumulated up to 9 min per day of stepping exercise on three days per week over the 4-week experimental period. Parameters of cardiorespiratory fitness, body composition and lower limb muscle strength were measured on three occasions: TS1 (baseline test), TS2 (following a 4-week control period) and TS3 (following the 4-week intervention). Data were analysed using a repeated-measures ANOVA. Adherence to the programme was excellent (96%). Relative to the insignificant changes following the control period, parameters of cardiorespiratory fitness were significantly improved following training. No alterations in body composition or lower limb muscle strength were detected. These results show that less than 30 min per week of bench step exercise, accumulated in short bouts throughout the day, can improve parameters of cardiorespiratory fitness after only 4 weeks in previously sedentary middle-aged adults. Due to its low-cost, time-efficient and discrete aspects, stepping exercise may have important implications for public health initiatives that promote physical activity in a population who commonly report 'lack of time' as a barrier to physical activity.