Mobile health interventions to promote physical activity and reduce sedentary behaviour in the workplace: A systematic review

Abstract

Objective This systematic review aimed to assess the effectiveness, feasibility and acceptability of mobile health (mHealth) technology (including wearable activity monitors and smartphone applications) for promoting physical activity (PA) and reducing sedentary behaviour (SB) in workplace settings. Methods Systematic searches were conducted in seven electronic databases (MEDLINE, SPORTDiscus, Scopus, EMBASE, PsycINFO, Web of Science and the Cochrane library). Studies were included if mHealth was a major intervention component, PA/SB was a primary outcome, and participants were recruited and/or the intervention was delivered in the workplace. Study quality was assessed using the Effective Public Health Practice Project (EPHPP) tool. Interventions were coded for behaviour change techniques (BCTs) using the Coventry, Aberdeen and London – Refined (CALO-RE) taxonomy. Results Twenty-five experimental and quasi-experimental studies were included. Studies were highly heterogeneous and only one was rated as ‘strong’ methodological quality. Common BCTs included self-monitoring, feedback, goal-setting and social comparison. A total of 14/25 (56%) studies reported a significant increase in PA, and 4/10 (40%) reported a significant reduction in sedentary time; 11/16 (69%) studies reported a significant impact on secondary outcomes including reductions in weight, systolic blood pressure and total cholesterol. While overall acceptability was high, a large decline in technology use and engagement was observed over time. Conclusions While methodological quality was generally weak, there is reasonable evidence for mHealth in a workplace context as a feasible, acceptable and effective tool to promote PA. The impact in the longer term and on SB is less clear. Higher quality, mixed methods studies are needed to explore the reasons for decline in engagement with time and the longer-term potential of mHealth in workplace interventions. Protocol registration: The review protocol was registered with PROSPERO: CRD42017058856

Key facets to build up eHealth and mHealth interventions to enhance physical activity, sedentary behavior and nutrition in healthy subjects – An umbrella review

“…Sixty-four of these articles were excluded due to above mentioned exclusion criteria. This resulted in a total of 11 systematic reviews and meta-analyses which were included in this umbrella review [46][47][48][49][50][51][52][53][54][55][56] (for more details see Flow-Chart in Figure 1). The updated search located 472 additional articles which were all excluded after title and abstract screening.…”

“…The duration of interventions ranged from one session to 24 months, with the majority (92%) of interventions lasting at least four weeks. Sample sizes ranged from 458 [50] to 73,417 participants [52] for the reviews and added up to 114,430 participants throughout all studies. The full details of study characteristics of articles included in the umbrella review are displayed in Table 1.…”

“…*** please insert Table 1 about here *** Two reviews focused on children and adolescents [46,55], four focused adults [47,48,52,53] and ve included participants of all ages [49-51, 54, 56]. Five systematic reviews focused on PA outcomes [46,[48][49][50]55], one meta-analysis focused on SB outcomes [47], and one meta-analysis and one systematic review included both PA and SB outcomes [51,52]. HE was the main outcome in two meta-analyses [53,54], and one systematic review included PA, SB and HE as main outcomes [56].…”

“…The most common reported theories were social cognitive theory (n = 29), transtheoretical model (n = 16), theory of planned behavior (n = 10), self-determination theory (n = 10) and I-change model (n = 7). Four reviews [47,51,52,54] coded the use of BCTs using a taxonomy of behavior change [19,20] and two reviews [46,50] reported BCTs without coding them. The BCTs, which were most frequently reported by the reviews, were goal setting (n = 5), self-monitoring (n = 4), social support (n = 4), prompts/cues (n = 4), feedback on the behavior (n = 3) and instruction on how to perform the behavior (n = 2).…”

“…SB SB (i.e. sitting time (overall and occupational), sedentary time (overall and occupational), screen time, and computer activity) was assessed by two systematic reviews (SB outcome in 13 studies) [47,56] and two metaanalyses (SB outcome in 20 studies) [51,52]. Of the 33 studies included in these reviews, 15 studies used devicemeasured outcomes, 16 used self-report (one not validated), and two used a combination of both measures.…”