JMIR Publications

ABSTRACT

Background:

Several reviews of mobile health physical activity (mHealth PA) interventions suggest their beneficial effects on behavior change in adolescents and adults. Due 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.

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 aiming at promoting PA in adults and adolescents (with sub-analysis conducted for the latter). Two groups of studies were additionally included: reviews/content analyses of PA trackers and meta-analyses exploring BCTs and their efficacy.

Results:

Included articles (148) were categorized into 10 groups: commercial smartphone application 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; application development descriptive studies; qualitative follow-up studies; 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 either did not state the coding methods, used various evaluation frameworks or used different versions of Michie and colleagues’ behavior change techniques (BCTs) taxonomy. In addition, there is no overall consensus on the best behavior change theory or model that should be used in smartphone-based interventions for PA promotion. Common reported systematic practices and methods could be successfully identified. They include PA recommendations; trial designs (RCT trials, experimental trials, rapid design trials); mixed methods data collection (surveys, questionnaires, interviews, focus groups discussions); scales to assess application quality; and industry-recognized reporting guidelines.

Conclusions:

Smartphone-based mHealth interventions aimed at the promotion of PA in adolescents and adults show promising results for behavior change. Though there is a plethora of published studies for 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.