Smartphone-Based Interventions for Physical Activity Promotion: Scoping Review of the Evidence Over the Last 10 Years

Abstract

Background Several reviews of mobile health (mHealth) physical activity (PA) interventions suggest their beneficial effects on behavior change in adolescents and adults. Owing to the ubiquitous presence of smartphones, their use in mHealth PA interventions seems obvious; nevertheless, there are gaps in the literature on the evaluation reporting processes and best practices of such interventions. Objective The primary objective of this review is to analyze the development and evaluation trajectory of smartphone-based mHealth PA interventions and to review systematic theory- and evidence-based practices and methods that are implemented along this trajectory. The secondary objective is to identify the range of evidence (both quantitative and qualitative) available on smartphone-based mHealth PA interventions to provide a comprehensive tabular and narrative review of the available literature in terms of its nature, features, and volume. Methods We conducted a scoping review of qualitative and quantitative studies examining smartphone-based PA interventions published between 2008 and 2018. In line with scoping review guidelines, studies were not rejected based on their research design or quality. This review, therefore, includes experimental and descriptive studies, as well as reviews addressing smartphone-based mHealth interventions aimed at promoting PA in all age groups (with a subanalysis conducted for adolescents). Two groups of studies were additionally included: reviews or content analyses of PA trackers and meta-analyses exploring behavior change techniques and their efficacy. Results Included articles (N=148) were categorized into 10 groups: commercial smartphone app content analyses, smartphone-based intervention review studies, activity tracker content analyses, activity tracker review studies, meta-analyses of PA intervention studies, smartphone-based intervention studies, qualitative formative studies, app development descriptive studies, qualitative follow-up studies, and other related articles. Only 24 articles targeted children or adolescents (age range: 5-19 years). There is no agreed evaluation framework or taxonomy to code or report smartphone-based PA interventions. Researchers did not state the coding method, used various evaluation frameworks, or used different versions of behavior change technique taxonomies. In addition, there is no consensus on the best behavior change theory or model that should be used in smartphone-based interventions for PA promotion. Commonly reported systematic practices and methods have been successfully identified. They include PA recommendations, trial designs (randomized controlled trials, experimental trials, and rapid design trials), mixed methods data collection (surveys, questionnaires, interviews, and focus group discussions), scales to assess app quality, and industry-recognized reporting guidelines. Conclusions Smartphone-based mHealth interventions aimed at promoting PA showed promising results for behavior change. Although there is a plethora of published studies on the adult target group, the number of studies and consequently the evidence base for adolescents is limited. Overall, the efficacy of smartphone-based mHealth PA interventions can be considerably improved through a more systematic approach of developing, reporting, and coding of the interventions.

Variability in Physical Inactivity Responses of University Students during COVID-19 Pandemic: A Monitoring of Daily Step Counts Using a Smartphone Application

“…Walking at a pace of approximately 1000 steps per 10 min has been reported to be equivalent to moderate physical activity, and people are encouraged to achieve at least 3000 step/day during 30 min for 5 days in a week [ 39 ]. A long-term continuous monitoring of daily step count and promoting physical activity through mobile health (mHealth) devices and applications may be effective interventions during and after the COVID-19 pandemic, taking advantage of the high rate of smartphone ownership among university students [ 20 , 40 , 41 , 42 , 43 , 44 ]. We believe that mHealth is expected to become an effective tool when opportunities for commuting to university decrease due to the increase in online classes.…”

A WeChat-Based Rehabilitation Platform for Children and Adolescents with Congenital Heart Disease to Promote Cardiac FITness (HeartFIT): Protocol for a Mixed-Methods Strategy from Evidence-Based Design to Pilot Study

“…Over the past decade, there is a growing trend in the design of digital health systems that are aimed to promote physical fitness for individuals with chronic conditions. 46 Overall, the efficacy of digital health interventions can be considerably enhanced through a more systematic approach to designing, developing, and reporting of the interventions. 46 However, the majority of studies targets adult population; and even fewer studies focused on children and adolescents.…”

A Smartphone App to Increase Immunizations in the Pediatric Solid Organ Transplant Population: Development and Initial Usability Study

“…While human resources are an important component in the overall strategy to address immunization rates, provider-driven interventions (ie, phone call reminders and individually created calendar reminders) are expensive and difficult to sustain. Health information technology tools, including health care mobile apps for use on a personal smartphone or desktop computer, have been demonstrated to be a sustainable strategy for facilitating patient provider communication, disseminating high-quality evidence-based information to end users on a global scale, increasing adherence to medical regimens and tracking when medical interventions are due, and improving outcomes in chronic illnesses [8][9][10][11][12]. mHealth (mobile health) apps have been successfully created and implemented to facilitate immunization delivery [13][14][15][16][17][18][19][20].…”