Previously submitted to: Journal of Medical Internet Research (no longer under consideration since Apr 08, 2025)
Date Submitted: Feb 18, 2024
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Effectiveness of Two Highly Popular Apps: a Randomized Crossover Trial to Increase Physical Activity Among Inactive Adults
ABSTRACT
Background:
Despite widespread use, smartphone apps for physical activity (PA) lack rigorous evaluation. This study examined the impact of two top PA apps through a crossover trial.
Objective:
To assess the feasibility, acceptability, and effectiveness of two smartphone apps in increasing physical activity among inactive UK adults.
Methods:
A randomized crossover trial was conducted with inactive UK smartphone users. After a 1-week baseline period, participants were allocated to two PA apps: a 7-minute workout and a Couch to 5k program. Assessments at 3 and 5 weeks included feasibility and effectiveness, using intention-to-treat analysis.
Results:
209 participants accessed the screening survey. 104 were eligible and consented, 63.5% (66/104) were enrolled and randomized. 87% completed the trial. For accelerometer-measured outcomes, there were no significant differences for mean change but 16/51 participants (31.4%) increased their time in moderate to vigorous PA (MVPA) by 20% from baseline following the introduction of the intervention (95% CI= 19.1% to 45.39). Self-reported PA outcomes showed significant increases: total time spent in PA (LSM= 32.52, p<.005), moderate PA (LSM= 113.68, p<.024), walking (LSM= 375.0, p<.007), and total PA (LSM= 489.46, p<.010). Sedentary behavior decreased (LSM= -123.23, p<.001). Exercise self-efficacy (LSM= 41.78, p<.0001) and intentions increased (LSM= 5.23, p<.0001). Lower baseline activity was associated with larger increase in PA (p< 0.03 for all measures).There were no significant differences between the two apps
Conclusions:
Crossover trial is a feasible and acceptable method to study apps and can be used to accelerate the evidence generation for digital health. The two PA apps showed promising results, with an impact observed for 20% increase in MVPA, self-reported PA, intentions and exercise self-efficacy. The biggest improvements were in the participants with low baseline PA, who have the greatest unmet need. The study detected no differences between the apps. Clinical Trial: ClinicalTrials.gov NCT03565627
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