SMART MOVE - a smartphone-based intervention to promote physical activity in primary care: study protocol for a randomized controlled trial

Abstract

BackgroundSedentary lifestyles are now becoming a major concern for governments of developed and developing countries with physical inactivity related to increased all-cause mortality, lower quality of life, and increased risk of obesity, diabetes, hypertension and many other chronic diseases. The powerful onboard computing capacity of smartphones, along with the unique relationship individuals have with their mobile phones, suggests that mobile devices have the potential to influence behavior. However, no previous trials have been conducted using smartphone technology to promote physical activity. This project has the potential to provide robust evidence in this area of innovation. The aim of this study is to evaluate the effectiveness of a smartphone application as an intervention to promote physical activity in primary care.Methods/designA two-group, parallel randomized controlled trial (RCT) with a main outcome measure of mean difference in daily step count between baseline and follow up over eight weeks. A minimum of 80 active android smartphone users over 16 years of age who are able to undertake moderate physical activity are randomly assigned to the intervention group (n = 40) or to a control group (n = 40) for an eight week period. After randomization, all participants will complete a baseline period of one week during which a baseline mean daily step count will be established. The intervention group will be instructed in the usability features of the smartphone application, will be encouraged to try to achieve 10,000 steps per day as an exercise goal and will be given an exercise promotion leaflet. The control group will be encouraged to try to walk an additional 30 minutes per day along with their normal activity (the equivalent of 10,000 steps) as an exercise goal and will be given an exercise promotion leaflet. The primary outcome is mean difference in daily step count between baseline and follow-up. Secondary outcomes are systolic and diastolic blood pressure, resting heart rate, mental health score using HADS and quality of life score using Euroqol. Randomization and allocation to the intervention and groups will be carried out by an independent researcher, ensuring the allocation sequence is concealed from the study researchers until the interventions are assigned. The primary analysis is based on mean daily step count, comparing the mean difference in daily step count between the baseline and the trial periods in the intervention and control groups at follow up.Trial registrationCurrent Controlled Trials ISRCTN99944116

Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial

“…For the adjusted analysis (primary analysis), a generalised, additive, mixed model was used and explanatory variables identified a priori. 18 The model was adjusted for the non-linear relationship that was evident between the primary outcome and time, the correlation within subject over time, baseline step count, age, sex, socioeconomic status, BMI, blood pressure, heart resting rate, mental health, quality of life, and smartphone literacy.…”

“…17 Enrolment into the study commenced on 15 August 2012 and all final outcome assessments were completed by 1 June 2013. The full study protocol has been published elsewhere 18 and the study was carried out without any deviations from the protocol. Patients were eligible for the study if they were over the age of 16 years and active Android smartphone users; patients were excluded if they:…”

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review

“…Figure 2 trial or outcome studies, five articles focused on software design and evaluation and the remaining articles are on focus groups and interview studies on stakeholders' opinions on smart phone apps for physical activity (see Table 1). [25] × × [26] × [27] × × × × × × × × × [28] × × × × × × × × [29] × × × × [30] × × × [31] × [32] × × × × × × × × × × × × [33] × × [34] × × × × × × × [35] × × × × [36] × × × × × × [37] × [38] × × × [39] × × × × × [40] × [41] × [42] × × × × [43] × × [44] Illustrations in figure 2 and table 2 show features that are highly present in articles on physical activity intervention studies, those features that were occasionally mentioned, or those that were not cited often in these articles. Visualisation of persuasive features is presented to provide more insights about the highlights, 9 gaps and blank spots [45] in current mobile application persuasive design features on physical activity.…”

Smartphones and Health Promotion: A Review of the Evidence

“…The mobile phone, using the smart phone technology, serves as a means of delivering the physical activity intervention, setting individualized weekly physical activity goals, and providing self-monitoring (activity diary), immediate feedback and social support [22]. The first one aimed to promote physical activity in primary care, while the second one examined the feasibility and efficacy of an abbreviated smartphone-supported weight loss program [40,42].…”