Department of Human Movement, Faculty of Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany.
Department of Biological Psychology and Neuroergonomics, Institute for Psychology and Occupational Science, Technical University Berlin, Berlin, Germany.
JMIR Mhealth Uhealth. 2022 May 11;10(5):e35920. doi: 10.2196/35920.
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.
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.
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.
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 (χ=4.0; P=.04; I=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.
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.
PROSPERO CRD42020209417; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417.
儿童和青少年越来越不符合身体活动（PA）的建议。因此，儿童和青少年中不足的 PA（IPA）和久坐行为（SB）是使用个体化移动健康（mHealth）干预措施的相关行为改变领域。
本综述和荟萃分析调查了 mHealth 干预措施对 IPA 和 SB 的有效性，特别关注个体化的年龄和水平。
检索了 2000 年 1 月至 2021 年 3 月期间发表的随机对照试验，使用 PubMed、Scopus、Web of Science、SPORTDiscus 和 Cochrane Library。纳入了针对儿童和青少年初级预防的 mHealth 干预措施，这些干预措施针对与 IPA 和 SB 相关的行为改变。纳入的研究在内容特征和方法学质量方面进行了比较，并进行了叙述性总结。此外，还进行了荟萃分析，随后进行了探索性荟萃回归分析，以检验年龄和个体化对总体效果的调节作用。
根据纳入标准，初步确定的 828 项研究中，有 1.3%（11/828）被纳入定性综合分析，有 1.2%（10/828）被纳入荟萃分析。试验共纳入 1515 名参与者（平均年龄（11.69，SD 0.788 岁；65%为男性，35%为女性）自我报告（3/11，27%）或设备测量（8/11，73%）健康数据，记录 SB 和 IPA 的持续时间，平均为 9.3（SD 5.6）周。高水平个体化的研究显著降低了不足的 PA 水平（Cohen d=0.33；95% CI 0.08-0.58；Z=2.55；P=.01），而低水平个体化的研究（Cohen d=-0.06；95% CI -0.32 至 0.20；Z=0.48；P=.63）或针对 SB（Cohen d=-0.11；95% CI -0.01 至 0.23；Z=1.73；P=.08）则没有总体显著效果。研究的异质性为中等到低，高水平个体化和低水平个体化试验之间存在显著的亚组差异（χ=4.0；P=.04；I=75.2%）。年龄作为一个调节变量显示出较小的影响；然而，结果并不显著，这可能是由于研究的效能不足。
证据表明，针对儿童和青少年的 mHealth 干预措施可以适度促进 IPA 的减少，但不能减少 SB。此外，针对 IPA 减少的个体化 mHealth 干预措施似乎对青少年比儿童更有效。尽管迄今为止，只有少数 mHealth 研究涉及不活跃和久坐的年轻人，而且它们的证据质量为中等，但这些发现表明个体化的相关性，另一方面，使用 mHealth 干预措施减少 SB 的困难。
PROSPERO CRD42020209417；https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=209417.
