Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review.

Stephanie Schoeppe,Mitch J Duncan,Wendy Van Lippevelde,Stephanie Alley,Susan L Williams,Nicola A Bray,Corneel Vandelanotte

doi:10.1186/s12966-016-0454-y

Abstract

BackgroundHealth and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. This systematic review examined the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour in children and adults.MethodsSystematic literature searches were conducted in five databases to identify papers published between 2006 and 2016. Studies were included if they used a smartphone app in an intervention to improve diet, physical activity and/or sedentary behaviour for prevention. Interventions could be stand-alone interventions using an app only, or multi-component interventions including an app as one of several intervention components. Outcomes measured were changes in the health behaviours and related health outcomes (i.e., fitness, body weight, blood pressure, glucose, cholesterol, quality of life). Study inclusion and methodological quality were independently assessed by two reviewers.ResultsTwenty-seven studies were included, most were randomised controlled trials (n = 19; 70%). Twenty-three studies targeted adults (17 showed significant health improvements) and four studies targeted children (two demonstrated significant health improvements). Twenty-one studies targeted physical activity (14 showed significant health improvements), 13 studies targeted diet (seven showed significant health improvements) and five studies targeted sedentary behaviour (two showed significant health improvements). More studies (n = 12; 63%) of those reporting significant effects detected between-group improvements in the health behaviour or related health outcomes, whilst fewer studies (n = 8; 42%) reported significant within-group improvements. A larger proportion of multi-component interventions (8 out of 13; 62%) showed significant between-group improvements compared to stand-alone app interventions (5 out of 14; 36%). Eleven studies reported app usage statistics, and three of them demonstrated that higher app usage was associated with improved health outcomes.ConclusionsThis review provided modest evidence that app-based interventions to improve diet, physical activity and sedentary behaviours can be effective. Multi-component interventions appear to be more effective than stand-alone app interventions, however, this remains to be confirmed in controlled trials. Future research is needed on the optimal number and combination of app features, behaviour change techniques, and level of participant contact needed to maximise user engagement and intervention efficacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12966-016-0454-y) contains supplementary material, which is available to authorized users.

Highlights

Health and fitness applications have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear
This review aimed to address these gaps in the literature by systematically synthesising evidence for the efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour for non-communicable diseases (NCDs) prevention
Systematic search strategies were designed using a combination of thesaurus and free terms covering the following terms: application, app, smartphone, smart phone, tablet, mobile game, game, physical activity, walk, physical fitness, leisure activity, motor activity, exercise, sport, sedentary, sedentary behaviour, sedentary behavior, sitting, screen time, inactive, diet, dietary, nutrition, nutritional, healthy eating, food, fruit, vegetable, snack, soft drink, carbonated beverage, intervention, program, programme, health promotion, prevention and trial

Summary

Introduction

Health and fitness applications (apps) have gained popularity in interventions to improve diet, physical activity and sedentary behaviours but their efficacy is unclear. Physical activity and sedentary behaviour are key modifiable risk factors for these diseases and improving these behaviours is considered essential to reducing the financial and health burden of these NCDs [1]. Physical inactivity and sedentary behaviour are known to track from childhood into adulthood and are difficult to change later in life [2, 3]. This exacerbates associated health problems and demonstrates why preventing the development of these health risk factors throughout the lifespan is important. Clever use of apps in health promotion and prevention of disease has enabled researchers to apply health behaviour changes techniques (e.g., goal setting, self-monitoring, performance feedback) that have proven to facilitate health behaviour change across diverse population groups and settings [7, 8]

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