Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jun 27, 2017
Date Accepted: Feb 7, 2019
(closed for review but you can still tweet)
Effects of mHealth including Wearable Activity Trackers to Increase Physical Activity Outcomes among Healthy Children and Adolescents: A Systematic Review
ABSTRACT
Background:
A variety of children and adolescents are incapable to meet the current recommendations on physical activity (PA), with the result that health- related benefits of regular PA are not achieved. Nowadays, technology-based programs represent an appealing and promising option for children and adolescents to promote PA.
Objective:
The present review systematically evaluated the effects of mobile health (mHealth) and wearable activity trackers on PA and related outcomes in this target group.
Methods:
Electronic databases CENTRAL, PubMed, Scopus, SPORTDiscus and Web of Science were searched to retrieve English language articles published in peer-reviewed journals from January 2012 to June 2018. Included were articles that contained descriptions of interventions designed to increase PA among children (6-12 years old) and/or adolescents (13-18 years old), and that measured at least one PA-related cognitive, psychosocial, or behavioral outcome. The interventions had to be based on mHealth tools (mobile phones, smartphones, tablets or mobile applications) or wearable activity trackers. Randomized controlled trials (RCTs) and non-randomized controlled trials, cohort studies, before-and-after studies, and cross-sectional studies were considered, but only controlled studies with PA comparison between groups were assessed for methodological quality.
Results:
In total, 857 articles were identified. Finally, 7 studies (5 with tools of mHealth, 2 with wearable activity trackers) met the inclusion criteria. All studies with tools of mHealth used a RCT design, and 3 were of high methodological quality. Intervention delivery ranged from 4 weeks to 12 months, whereby mainly smartphone applications were used as tool (80%). Intervention delivery in studies with wearable activity trackers covered a period from 22 sessions during school recess and 8 weeks. Trackers were used as intervention and evaluation tool. No evidence was found for the effect of mHealth tools respectively wearable activity trackers on PA-related outcomes.
Conclusions:
Given the small number of studies, poor compliance with accelerometers as measuring instrument for PA, risk of bias, missing RCTs in relation to wearable activity trackers, and the heterogeneity of intervention programs, caution is warranted regarding the comparability of the studies and their effects. There is a clear need for future studies to develop PA interventions grounded on intervention mapping with a high methodological study design for specific target groups to achieve meaningful evidence.
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