TY  - JOUR
AU  - Baumann, Hannes
AU  - Fiedler, Janis
AU  - Wunsch, Kathrin
AU  - Woll, Alexander
AU  - Wollesen, Bettina
PY  - 2022
DA  - 2022/5/11
TI  - mHealth Interventions to Reduce Physical Inactivity and Sedentary Behavior in Children and Adolescents: Systematic Review and Meta-analysis of Randomized Controlled Trials
JO  - JMIR Mhealth Uhealth
SP  - e35920
VL  - 10
IS  - 5
KW  - health behavior change
KW  - individualization
KW  - sedentary behavior
KW  - physical activity
KW  - tailored interventions
KW  - personalized medicine
KW  - health app
KW  - mobile phone
AB  - Background: Children and adolescents increasingly do not meet physical activity (PA) recommendations. Hence, insufficient PA (IPA) and sedentary behavior (SB) among children and adolescents are relevant behavior change domains for using individualized mobile health (mHealth) interventions. Objective: This review and meta-analysis investigated the effectiveness of mHealth interventions on IPA and SB, with a special focus on the age and level of individualization. Methods: PubMed, Scopus, Web of Science, SPORTDiscus, and Cochrane Library were searched for randomized controlled trials published between January 2000 and March 2021. mHealth interventions for primary prevention in children and adolescents addressing behavior change related to IPA and SB were included. Included studies were compared for content characteristics and methodological quality and summarized narratively. In addition, a meta-analysis with a subsequent exploratory meta-regression examining the moderating effects of age and individualization on overall effectiveness was performed. Results: On the basis of the inclusion criteria, 1.3% (11/828) of the preliminary identified studies were included in the qualitative synthesis, and 1.2% (10/828) were included in the meta-analysis. Trials included a total of 1515 participants (mean age (11.69, SD 0.788 years; 65% male and 35% female) self-reported (3/11, 27%) or device-measured (8/11, 73%) health data on the duration of SB and IPA for an average of 9.3 (SD 5.6) weeks. Studies with high levels of individualization significantly decreased insufficient PA levels (Cohen d=0.33; 95% CI 0.08-0.58; Z=2.55; P=.01), whereas those with low levels of individualization (Cohen d=−0.06; 95% CI −0.32 to 0.20; Z=0.48; P=.63) or targeting SB (Cohen d=−0.11; 95% CI −0.01 to 0.23; Z=1.73; P=.08) indicated no overall significant effect. The heterogeneity of the studies was moderate to low, and significant subgroup differences were found between trials with high and low levels of individualization (χ21=4.0; P=.04; I2=75.2%). Age as a moderator variable showed a small effect; however, the results were not significant, which might have been because of being underpowered. Conclusions: Evidence suggests that mHealth interventions for children and adolescents can foster moderate reductions in IPA but not SB. Moreover, individualized mHealth interventions to reduce IPA seem to be more effective for adolescents than for children. Although, to date, only a few mHealth studies have addressed inactive and sedentary young people, and their quality of evidence is moderate, these findings indicate the relevance of individualization on the one hand and the difficulties in reducing SB using mHealth interventions on the other. Trial Registration: PROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2022/5/e35920
UR  - https://doi.org/10.2196/35920
UR  - http://www.ncbi.nlm.nih.gov/pubmed/35544294
DO  - 10.2196/35920
ID  - info:doi/10.2196/35920
ER  -