JMIR Publications

ABSTRACT

Background:

Increasing physical activity (PA) levels in adolescents ages 12-18 is associated with prevention of unhealthy weight gain and improvement in cardiovascular fitness. The widespread availability of mobile health (mHealth) and wearable devices offers self-monitoring and motivational features for increasing PA levels as well as improving adherence to exercise programs.

Objective:

The aim of this scoping review is to identify the efficacy or effectiveness of mHealth intervention strategies for facilitating PA among adolescents.

Methods:

We conducted a systematic search for peer-reviewed studies published between 2008 and 2017 in the following electronic databases: PubMed, Google Scholar, PsychINFO, or SportDiscus. The search terms used include (mHealth OR “mobile health” OR apps) AND (“physical activity” OR exercise) AND (children OR adolescents OR teens OR “young adults” OR kids) AND (efficacy OR effectiveness). Articles published outside of the date range (07/10/2008 – 09/01/2017) and non-English articles were removed pre-abstract review. Three reviewers assessed all abstracts against the inclusion and exclusion criteria. Any uncertainty or differences in opinion were discussed as a group. If the disagreement was still unresolved, the abstract was included in the full article review. The inclusion criteria were that the studies shall 1) have a mHealth component, 2) target participants between 12 and 18 years old, 3) have results on efficacy or effectiveness, and 4) assess PA-related outcomes. Reviews, abstracts only, protocols without results, SMS-only interventions were excluded. We also extracted potentially relevant papers from reviews. At least two reviewers examined all full articles for fit with criteria and extracted data for analysis. Data extracted from selected studies included study population, study type, components of PA intervention, and PA outcomes results.

Results:

95 articles were initially identified and reviewers pulled 18 additional articles from excluded review papers. Only 15 articles were passed onto full review and 13 were kept for analysis. The included studies differed in the sizes of the study populations (11- 607 participants), locations of the study sites (7 countries), study setting, and study design. The most common measures reported were subjective weekly PA (4/13) and objective daily moderate-to-vigorous physical activity (MVPA, 4/13) of the 19 different PA outcomes assessed. Only 6/13 studies with a control or comparison group showed a significant improvement in PA outcomes between the intervention group and the control or comparison group. Of those 6, 4 permitted isolation of mHealth intervention components in the analysis.

Conclusions:

Our findings indicate that PA outcomes for adolescents improved over time through mHealth interventions use; however, the lack of consistency in chosen PA outcome measures, paucity of significant outcomes via between group analyses, and the weak study designs that prevent separating the effects of intervention components calls into question their true effect.