TY  - JOUR
AU  - Joung, Kyung-In
AU  - An, Sook Hee
AU  - Bang, Joon Seok
AU  - Kim, Kwang Joon
PY  - 2025
DA  - 2025/2/25
TI  - Comparative Effectiveness of Wearable Devices and Built-In Step Counters in Reducing Metabolic Syndrome Risk in South Korea: Population-Based Cohort Study
JO  - JMIR Mhealth Uhealth
SP  - e64527
VL  - 13
KW  - wearable devices
KW  - built-in step counters
KW  - mobile health
KW  - public health intervention
KW  - physical activity
KW  - health behavior
KW  - metabolic syndrome
KW  - population-based
KW  - cohort study
KW  - South Korea
KW  - mobile health technologies
KW  - effectiveness
KW  - activity tracker
KW  - mobile app
KW  - retrospective
KW  - logistic regression
KW  - mHealth
KW  - digital health
KW  - mobile phone
AB  - Background: Mobile health technologies show promise in addressing metabolic syndrome, but their comparative effectiveness in large-scale public health interventions remains unclear. Objective: This study aims to compare the effectiveness of wearable devices (wearable activity trackers) and mobile app–based activity trackers (built-in step counters) in promoting walking practice, improving health behaviors, and reducing metabolic syndrome risk within a national mobile health care program operated by the Korea Health Promotion Institute. Methods: This retrospective cohort study analyzed data from 46,579 participants in South Korea’s national mobile health care program (2020‐2022). Participants used wearable devices for 12 weeks, after which some switched to built-in step counters. The study collected data on demographics, health behaviors, and metabolic syndrome risk factors at baseline, 12 weeks, and 24 weeks. Outcomes included changes in walking practice, health behaviors, and metabolic syndrome risk factors. Metabolic syndrome risk was assessed based on 5 factors: blood pressure, fasting glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Health behaviors included low-sodium diet preference, nutrition label reading, regular breakfast consumption, aerobic physical activity, and regular walking. To address potential selection bias, propensity score matching was performed, balancing the 2 groups on baseline characteristics including age, gender, education level, occupation, insurance type, smoking status, and alcohol consumption. Results: Both wearable activity tracker and built-in step counter groups exhibited significant improvements across all evaluated outcomes. The improvement rates for regular walking practice, health behavior changes, and metabolic syndrome risk reduction were high in both groups, with percentages ranging from 45.2% to 60.8%. After propensity score matching, both device types showed substantial improvements across all indicators. The built-in step counter group demonstrated greater reductions in metabolic syndrome risk compared to the wearable device group (odds ratio [OR] 1.20, 95% CI 1.05‐1.36). No significant differences were found in overall health behavior improvements (OR 0.95, 95% CI 0.83‐1.09) or walking practice (OR 0.84, 95% CI 0.70‐1.01) between the 2 groups. Age-specific subgroup analyses revealed that the association between built-in step counters and metabolic syndrome risk reduction was more pronounced in young adults aged 19‐39 years (OR 1.35, 95% CI 1.09‐1.68). Among Android use subgroups, built-in step counters were associated with a higher reduction in health risk factors (OR 1.20, 95% CI 1.03‐1.39). Conclusions: Both wearable devices and built-in step counters effectively reduced metabolic syndrome risk in a large-scale public health intervention, with built-in step counters showing a slight advantage. The findings suggest that personalized device recommendations based on individual characteristics, such as age and specific health risk factors, may enhance the effectiveness of mobile health interventions. Future research should explore the mechanisms behind these differences and their long-term impacts on health outcomes. 
SN  - 2291-5222
UR  - https://mhealth.jmir.org/2025/1/e64527
UR  - https://doi.org/10.2196/64527
DO  - 10.2196/64527
ID  - info:doi/10.2196/64527
ER  -