JMIR Publications

ABSTRACT

Background:

With the global progression of population aging, promoting walking as a health behavior to maintain and improve well-being among older adults has become increasingly important. Recently, the advancement and widespread adoption of information and communication technology (ICT) and mobile health (mHealth) have facilitated health interventions using smartphone applications (apps). However, the effectiveness and components of app-based interventions designed to encourage walking vary considerably among existing studies. This study proposes a systematic review using the Behavior Change Technique (BCT) Taxonomy to clarify and categorize these approaches in the context of health behavior promotion.

Objective:

This systematic review aimed to examine existing research to determine the impact of smartphone app usage on walking behavior among community-dwelling older adults. The goal is to summarize the current findings and identify areas that require further investigation.

Methods:

Eligible studies included those published in English or Japanese between March 1, 2015, and February 28, 2025, that targeted community-dwelling older adults, employed smartphone app-based interventions, and reported walking-related outcomes. The review question was “Does the use of smartphone applications promote walking behavior among community-dwelling older adults?” A search strategy was developed using keywords such as “older,” “smartphone,” and “walking.” Risk of bias was assessed using Study Quality Assessment Tools. The functionalities of the apps described in the included studies were analyzed to identify the intended BCTs, based on the BCT Taxonomy.

Results:

Of the 296 studies initially retrieved, 8 met the inclusion criteria. These studies vary in terms of participant characteristics, intervention duration, app features, and outcomes. None of the included studies were full-scale randomized controlled trials (RCTs), and most were pilot studies. Intervention durations were typically 12 weeks or less. While several apps aim directly to increase walking, others also incorporate functions that promote social interaction among users. Apps that demonstrated statistically significant improvements in walking behavior commonly employed BCTs from the following clusters: (1) Goals and Planning, (2) Feedback and Monitoring, and (4) Shaping Knowledge.

Conclusions:

The use of smartphone apps that enable older adults to acquire knowledge about walking, set and plan goals, and monitor their walking behavior was shown to be effective in promoting walking. Given the rapid evolution of ICT, further research with robust study designs and sufficient sample sizes is essential for developing and evaluating effective digital interventions for older adults. This review highlights the need for continued investigation to keep pace with technological advancements and ensure that the health benefits of digital tools are maximized in aging populations.