JMIR Publications

ABSTRACT

Background:

Background:

mHealth is the provision of health care and health information through mobile electronic devices. The prevalence of sedentary behaviors (SB) among older adults is increasing, contributing to adverse health outcomes, and underscoring the urgent need for effective mHealth interventions. However, the evidence on the effectiveness is unclear.

Objective:

Objectives: To examine the effectiveness of mHealth interventions on sedentary behavior of older adults and identify potential moderators of the intervention effects.

Methods:

Methods:

A systematic review and meta-analysis of randomized controlled trials were conducted. A literature search was conducted using multiple databases, including PubMed, Embase, Web of Science and Cochrane. Articles published through October, 2023 were included, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Subgroup analyses assessed variables such as mean age, intervention specifics, behavior change techniques (BCTs) categories, and devices-affected outcomes. Two independent reviewers screened the studies and extracted data, with methodological quality assessed using established criteria. Meta-analyses were performed using Review Manager v5.4 software.

Results:

Results:

Ten mHealth interventions were found, primarily in community and home settings, with durations between 25 days and six months. Three studies aimed to decrease sedentary behavior and seven to increase physical activity (PA). Meta-analyses showed a significant decrease in sedentary behavior (WMD=-59.07, 95% CI: -99.07, -20.20, p=0.003) and an increase in physical activity (SMD=0.22, 95% CI: 0.01, 0.44, p=0.04) among older adults through mHealth interventions compared to conventional or no interventions. Subgroup meta-analysis revealed that mHealth interventions using targeted strategies, such as 12-week programs (SMD= -0.40, 95% CI: -0.70, -0.10, p=0.009), behavior change techniques (SMD= -0.48, 95% CI: -0.80, -0.16, p=0.004), ActivPAL (SMD= -0.50, 95% CI: -0.90, -0.10, p=0.01), and interventions focusing solely on sedentary behavior (SMD= -0.50, 95% CI: -0.90, -0.10, p=0.01), were particularly effective in reducing sedentary behavior among older adults.

Conclusions:

Conclusion: mHealth interventions effectively reduce sedentary behavior and increase physical activity in older adults. Strategies employing specific duration, behavior change techniques, and dedicated monitoring devices, and those particularly targeting sedentary reduction, proved most effective. These results underscore mHealth's potential as a key tool in promoting older adults' well-being through technology-driven public health efforts. Clinical Trial: Registration: CRD42023443926.