Abstract 15928: A Mobile Health Driven Walking Program Improves Quality of Life but not Fitness or Fatness in Obese Sedentary Women

Abstract

Background: Many mHealth programs exist for increasing physical activity (PA) yet few have been tested for their effects on fitness, fatness, and health related quality of life (HRQOL). Methods: We conducted a 3-month randomized trial that examined 2 message formats that promoted the 10,000 steps/day walking program. Women (n=70), aged 48±12 years, BMI 35.0 ±3.8, with self-report of no regular (PA), were given a FitBit and smartphone, which automatically sent daily step data to us daily. Daily messages with feedback about meeting step goals and motivation to add 500 more daily steps/week were sent to the subject’s smartphone. We compared the Multimedia Messaging Service (MMS) consisting of audio, video and graphs versus the Short Message Service (SMS), or plain text messages. Message content was the same for both groups. Outcomes included the 6-minute walk test, weight, waist and hip circumferences, BMI, SF-36, and Profile of Mood States (POMS). We hypothesized that MMS subjects would be more engaged, walk more, and attain greater gains in study outcomes. Results: We delayed messaging for the first 2 weeks to establish a daily step baseline, which was 6665 ±2270. There were no group differences in daily steps at baseline or at any time point in the study. Daily steps in Month 1 was 6926±2465; Month 2, 7327± 3310; and Month 3, 6642±2914. The increases from baseline to the full Month 1 (p=0.004) and Month 1 to 2 (p=0.025) were significant but not the decrease from Month 2 to 3. The FitBit was worn 91% of study days in both groups. There were no changes or group differences in any fitness or fatness measure. Both groups similarly improved SF-36 General Health (p=0.02) and Vitality (p=0.01); and POMS Fatigue (p=0.01), Vigor (p=0.001), Tension-Anxiety (p=0.03), and Total Mood Score, (p=0.02). Conclusions: Baseline steps were about 2-3 times more than expected for sedentary women. It seems that the novelty of using a tracking device accelerated the planned progression for walking, with a much higher than expected step count initially and then a slight drop over time. An average of 10,000 steps/day was not met. There were no changes in physical measures though indicators of HRQOL improved. Contrary to our hypothesis, the different messaging formats did not affect outcomes.