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

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Abstract
Background: Health 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. Methods: Systematic 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. Results: Twenty-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. Conclusions: This 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 standalone 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.
Keywords
RANDOMIZED CONTROLLED-TRIAL, OF-THE-LITERATURE, SCHOOL-BASED, INTERVENTIONS, SMARTPHONE APPLICATION, HEALTH BEHAVIOR, OBESITY, PREVENTION, MOBILE PHONES, VEGETABLE CONSUMPTION, WEIGHT MANAGEMENT, ADOLESCENT BOYS, Systematic review, Literature searches, Smartphone applications, Programs, Efficacy, Healthy eating, Exercise, Sitting, Health behaviour

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MLA
Schoeppe, Stephanie et al. “Efficacy of Interventions That Use Apps to Improve Diet, Physical Activity and Sedentary Behaviour : a Systematic Review.” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY 13 (2016): n. pag. Print.
APA
Schoeppe, S., Alley, S., Van Lippevelde, W., Bray, N. A., Williams, S. L., Duncan, M. J., & Vandelanotte, C. (2016). Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour : a systematic review. INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, 13.
Chicago author-date
Schoeppe, Stephanie, Stephanie Alley, Wendy Van Lippevelde, Nicola A Bray, Susan L Williams, Mitch J Duncan, and Corneel Vandelanotte. 2016. “Efficacy of Interventions That Use Apps to Improve Diet, Physical Activity and Sedentary Behaviour : a Systematic Review.” International Journal of Behavioral Nutrition and Physical Activity 13.
Chicago author-date (all authors)
Schoeppe, Stephanie, Stephanie Alley, Wendy Van Lippevelde, Nicola A Bray, Susan L Williams, Mitch J Duncan, and Corneel Vandelanotte. 2016. “Efficacy of Interventions That Use Apps to Improve Diet, Physical Activity and Sedentary Behaviour : a Systematic Review.” International Journal of Behavioral Nutrition and Physical Activity 13.
Vancouver
1.
Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour : a systematic review. INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY. 2016;13.
IEEE
[1]
S. Schoeppe et al., “Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour : a systematic review,” INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY, vol. 13, 2016.
@article{8543488,
  abstract     = {Background: Health 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. 
Methods: Systematic 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. 
Results: Twenty-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. 
Conclusions: This 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 standalone 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.},
  articleno    = {127},
  author       = {Schoeppe, Stephanie and Alley, Stephanie and Van Lippevelde, Wendy and Bray, Nicola A and Williams, Susan L and Duncan, Mitch J and Vandelanotte, Corneel},
  issn         = {1479-5868},
  journal      = {INTERNATIONAL JOURNAL OF BEHAVIORAL NUTRITION AND PHYSICAL ACTIVITY},
  keywords     = {RANDOMIZED CONTROLLED-TRIAL,OF-THE-LITERATURE,SCHOOL-BASED,INTERVENTIONS,SMARTPHONE APPLICATION,HEALTH BEHAVIOR,OBESITY,PREVENTION,MOBILE PHONES,VEGETABLE CONSUMPTION,WEIGHT MANAGEMENT,ADOLESCENT BOYS,Systematic review,Literature searches,Smartphone applications,Programs,Efficacy,Healthy eating,Exercise,Sitting,Health behaviour},
  language     = {eng},
  pages        = {26},
  title        = {Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour : a systematic review},
  url          = {http://dx.doi.org/10.1186/s12966-016-0454-y},
  volume       = {13},
  year         = {2016},
}

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