JMIR Publications

ABSTRACT

Background:

The Middle East and North Africa (MENA) region faces unique challenges to promote physical activity and reduce of sedentary behaviors, where prevalence of insufficient physical activity is higher than the global average. Mobile technologies present a promising approach to deliver behavioral interventions; however, little is known about the effectiveness as well as users’ perspectives of these technologies in the MENA region.

Objective:

To evaluate the effectiveness of mobile interventions targeting physical activity and sedentary behaviors in the MENA region, and to explore users’ perspectives of these interventions.

Methods:

A systematic search of five databases (MEDLINE, Embase, CINAHL, Scopus, and Global Index Medicus) was performed. Any primary research studies (adults and adolescents, regardless of medical condition) conducted in the MENA region that investigated the use of mobile technologies, and reported any measures of physical activity, sedentary behaviors, or users’ perceptions were included. We conducted a narrative synthesis for all studies, and a meta-analysis of randomized controlled trials (RCTs).

Results:

A total of 27 articles describing 22 unique interventions (10 RCTs) and four non-experimental studies were included (n= 6141, 46% women). Half of the interventions included mobile apps, while the other half examined text messages. The main app functions were goal setting and self-monitoring of activity, while text messages were primarily used to deliver educational content. Users in experimental studies described several benefits of the interventions (e.g., gain knowledge and get reminders to be active). Engagement with the intervention was poorly reported; few studies examined users’ perspectives on the appropriateness or cultural fit of the intervention. Non-experimental studies examined users’ perspectives of mobile apps and fitness trackers, and reported several barriers to adopt their use, such as perceived lack of usefulness, loss of interests and technical issues. The meta-analysis of included RCTs showed a positive effect on physical activity outcomes favoring mobile interventions (standardized mean difference [SMD] 0.45, 95% CI 0.17 to 0.73). Only two RCTs measured sedentary behaviors; both reported positive changes.

Conclusions:

The use of mobile interventions for physical activity and sedentary behaviors in the MENA region is in early stages, with preliminary evidence of effectiveness. Policymakers and researchers need to invest in high-quality studies to evaluate long-term effectiveness, intervention engagement, and implementation outcomes, which can inform the design of culturally and socially appropriate interventions for countries in the MENA region. Clinical Trial: Protocol Registration: The review protocol was registered at PROSPERO (ID: CRD42023392699).