JMIR Publications

ABSTRACT

Background:

Mobile health technologies show promise in addressing metabolic syndrome, but their comparative effectiveness in large-scale public health interventions remains unclear.

Objective:

To compare the effectiveness of wearable devices (wearable activity tracker) and mobile app-based activity trackers (built-in step counters) in promoting walking practice, improving health behaviors, and reducing metabolic syndrome risk within a national mobile healthcare program operated by the Korea Health Promotion Institute (KHPI).

Methods:

This retrospective cohort study analyzed data from 46,579 participants in South Korea's national mobile healthcare program (2020-2022). Participants used wearable devices for 12 weeks, after which some switched to built-in step counters. Outcomes included changes in walking practice, health behaviors, and metabolic syndrome risk factors. Multivariate logistic regression and propensity score matching were used to assess the association between device type and outcomes.

Results:

Both device types showed substantial improvements across all indicators. After full adjustment, wearable devices showed a non-significant advantage in promoting walking practice (OR 0.83, 95% CI 0.66-1.06). No significant differences were found in overall health behavior improvements (OR 0.94, 95% CI 0.84-1.04). Notably, built-in step counter users demonstrated greater reductions in metabolic syndrome risk (OR 1.15, 95% CI 1.03-1.30). Age-specific subgroup analyses revealed that the association between built-in step counters and metabolic syndrome risk reduction was more pronounced in young adults (OR 1.21, 95% CI 1.01-1.45).

Conclusions:

Both wearable devices and built-in step counters effectively reduced metabolic syndrome risk in a large-scale public health intervention. The findings suggest that personalized device recommendations based on individual characteristics may enhance the effectiveness of mobile health interventions.