Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 2, 2021
Date Accepted: Mar 15, 2022
How is adherence to mHealth physical activity intervention measured and what factors affect the adherence? A scoping review and proposed framework
ABSTRACT
Background:
Mobile health (mHealth) is widely used as an innovative approach to delivering physical activity programmes. Users’ adherence to mHealth is important to ensure mHealth-based programmes’ effectiveness.
Objective:
We aimed to (1) review literature on the methods used to assess adherence, factors that could affect users’ adherence, and the investigation of the association between adherence and health outcomes; and (2) develop a framework to understand the role of adherence in influencing the effectiveness of mHealth physical activity programme.
Methods:
Medline, PsycINFO, EMBASE and CINAHL database were searched to identify studies that focused on mHealth-based physical activities in adults. We used critical interpretive synthesis methods to summarise data collected.
Results:
Forty-one papers were included in this review. We identified 31 specific adherence measurement methods, which were summarised into eight indicators and these indicators were mapped to four dimensions: length, breadth, depth and interaction (participation). Users’ characteristics (five factors), technology-related factors (12 factors) and contextual factors (one factor) were reported to have impacts on adherence. Included studies reveal that adherence is significantly associated with intervention outcomes, including health behaviours, psychological indicators, and clinical indicators. A framework is developed based on these review findings.
Conclusions:
This study developed an adherence framework linking the adherence predictors, comprehensive adherence assessment and clinical effectiveness together. This framework could provide evidence for measuring adherence comprehensively, and guide further studies on adherence to mHealth-based physical activity interventions. Future research should validate the utility of this proposed framework.
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