Meta-analysis: The Effectiveness of mHealth Mobile Application Use to Promote Physical Activity and Ideal Body Weight in Adult with Overweight
Abstract
Background: Globally, overweight and obesity are significant contributors to morbidity and mortality, which in turn can reduce productivity and increase the burden of healthcare costs. Interventions to treat obesity include a comprehensive lifestyle approach (diet, physical activity, and behavioral therapy) to achieve and maintain weight loss. One method for monitoring weight loss program interventions is the use of a mobile health application (mHealth). This study aims to analyze the effectiveness of using mHealth on increasing physical activity and losing weight.
Subjects and Method: This research is a meta-analysis study using PRISMA flowchart guidelines. The article search process was carried out between 2011 and 2021 using databases from PubMed, Google Scholar and ScienceDirect. Based on the database, there were 15 articles that met the inclusion criteria. The analysis was carried out using the RevMan 5.3 . software.
Results: Meta-analysis of 9 randomized controlled trial articles showed that overall mHealth increased physical activity by 0.19 compared to controls (SMD = 0.19; 95% CI= 0.06 to 0.32; p = 0.004). Higher intervention outcomes were obtained from interventions for more than 3 months (SMD = 0.31; 95% CI = 0.13 to 0.49; p < 0.001). Short-term effects for 3 months did not show significant results. A meta-analysis of 15 randomized controlled trial articles concluded that the use of mHealth overall was able to reduce body weight by 0.34 compared with no use of the mHealth application (SMD = -0.34; 95% CI = -0.52 to -0.17; p< 0.001). Higher intervention outcomes were obtained from the 6-month intervention (SMD= -0.52; 95% CI= -0.82 to -0.22; p < 0.001). Short-term effects for 3 months did not show significant results.
Conclusion: Long-term use of the mHealth app is effective for increasing physical activity and losing weight in overweight adults. However, the effect of short-term intervention for 3 months has not shown significant result..
Keywords: mHealth, weight loss, physical activity.
Correspondence:
Farida Nur Aisyiyah. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: faridanur88@gmail.com. Mobile: +62 852-1493-3173.
Journal of Health Promotion and Behavior, (2022), 07(03): 208-224
References
Allen JK, Stephens J, Dennison Himmelfarb CR, Stewart KJ, Hauck S (2013). Randomized Controlled Pilot Study Testing Use of Smartphone Technology for Obesity Treatment. J. Obes., Vol. 2013, e151597. https://doi. org/10.1155/ 2013/151597
Balitbangkes (2019). Laporan Nasional Riset Kesehatan Dasar Tahun 2018 (2018 National Basic Health Research Report). Kementerian Kesehatan
Chau JY, Van der Ploeg HP, Merom D, Chey T, Bauman AE (2012). Cross-sectional Associations between Occupational and Leisuretime Sitting, Phy¬sical Activity and Obesity in Working Adults. Prev. Med., Vol. 54, Issue 3-4, pp. 195–200. doi: 10.1016/J.YPMED.2011.12.020.
Coll JL, Bibiloni MM, Salas R, Pons A, Tur JA (2015). Prevalence and Related Risk Factors of Overweight and Obesity among the Adult Population in the Balearic Islands, a Mediterranean Region. Obes. Facts, Vol.8, pp. 220–233. doi: 10.1159/000435826.
Collins CE, Morgan PJ, Jones P, Fletcher K, Martin J, Aguiar EJ, Lucas A, et al. (2012). A 12-Week Commercial Web-Based Weight-Loss Program for Overweight and Obese Adults: Randomized Controlled Trial Comparing Basic Versus Enhanced Features. J.Med. Internet Res., 14(2), 128–143. https:// doi.org/10.2196 /jmir.1980.
Critical Appraisal Skills Programme (2020). CASP Randomised Controlled Trial Standard Checklist, CASP checklists Oxford. Diakses dari: https://casp-uk.net/casp-tools-checklists/ (pada Tanggal 6 Maret 2022).
Douvani K, Tsoumani O (2019). Mobile Health Applications in Weight Management: A Systematic Literature Review. Am. J. Prev. Med., Vol. 56 (6), pp. 894–903. doi: 10.1016/J.AMEPRE. 2018.12.005.
Fenton S, Burrows TL, Collins CE, Rayward AT, Murawski B, Duncan MJ (2021). Efficacy of a Multi-Component m-Health Diet, Physical Activity, and Sleep Intervention on Dietary Intake in Adults with Overweight and Obesity: A randomised Controlled Trial.Nutrients, Vol. 13, 2468. doi: 10.3390/ nu13072468.
Fukuoka Y, Gay CL, Joiner KL, Vittinghoff E (2015). A Novel Diabetes Prevention Intervention Using a Mobile App. Am. J. Prev. Med., 49(2), 223–237. DOI: 10.1016/j.amepre.2015.01.003
Godino JG, Merchant G, Norman GJ, Donohue MC, Marshall SJ, Fowler JH, Calfas KJ et al. (2016). Using Social and Mobile Tools for Weight Loss in Overweight and Obese Young Adults (Project SMART): a 2 Year, Parallel-Group, Randomised, Controlled Trial.Lancet Diabetes Endocrinol., Vol. 4, pp. 747–575. doi: 10.1016/S2213-8587(16) 30105-X.
Hebden L, Cook A, van der Ploeg HP, King L, Bauman A, Allman-Farinelli M (2014). A Mobile Health Intervention for Weight Management Among Young Adults: A Pilot Randomised Controlled Trial. J Hum Nutr Diet, 27(4), 322–332. https://doi.org/10.-1111/jhn.12155.
Hernández-Reyes A, Camar-Martos F, Molino-Luque R, Moreno-Rojas R (2020). Effect of an mHealth Intervention Using a Pedometer App with Full in-Person Counseling on Body Composition of Overweight Adults: Randomized Controlled Weight Loss Trial. JMIR mHealth and uHealth, Vol. 8, Issue 5, e16999. doi: 10.2196/-16999.
Hutchesson MJ, Rollo ME, Krukowski R, Ells L, Harvey J, Morgan PJ, Callister R, et al. (2015). eHealth Interventions for the Prevention and Treatment of Overweight and Obesity in Adults: A Systematic Review with Meta-Analysis. Obesity Reviews, Vol.16, pp. 376–392. doi: 10.1111/obr.12268
Islam MM, Poly TN, Walther BA, Li YC (2020). Use of Mobile Phone App Interventions to Promote Weight Loss: Meta-Analysis. JMIR mHealth and uHealth, Vol. 8, Issue 7, e17039. doi: 10.2196/17039
Jensen MD, Ryan DH, Apovian CM, Ard JD, Comuzzie AG, Donato KA, Hu FB, et al. (2014). 2013 AHA/ACC/TOS Guidel¬ine for the Management of Overweight and Obesity in Adults. J. Am. Coll. Cardiol., Vol. 63, No. 25, pp. 2985–3023. doi: 10.1016/j.jacc.2013.11.004
Jeon KJ, Lee O, Kim HK, Han SN (2011). Comparison of the Dietary Intake and Clinical Characteristics of Obese and Normal Weight Adults. NRP, Vol. 5, Issue 4, pp. 329–336. doi: 10.4162/-nrp.¬2011. 5.4.329
Karlinda (2020). Meta-analisis Pengaruh Komorbiditas Obesitas Dan Diabetes Melitus Terhadap Mortalitas Pasien Strok. (Tesis). Universitas Sebelas Maret.
Kim JY, Oh S, Steinhubl S, Kim S, Bae WK, Han JS, Kim JH, et al. (2015). Effectiveness of 6 Months of Tailored Text Message Reminders for Obese male Participants in a Worksite Weight Loss Program: Randomized Controlled Trial. JMIR MHealth and UHealth,3(1). https://doi.org/ 10.2196/mhealth.3949
Lee CH, Cheung B, Yi GH, Oh B, Oh YH (2018). Mobile Health, Physical Acti-vity, and Obesity: Subanalysis of a Randomized Controlled Trial. Medi-cine, 97: 38 (e12309). doi: 10.1097/-MD. 0000000000012309
Little P, Stuart B, Hobbs FR, Kelly J, Smith ER, Bradbury KJ, Hughes S, et al. (2016). An Internet-Based Intervention with Brief Nurse Support to Manage Obesity in Primary Care (POWeR+): a Pragmatic, Parallel-group, Randomised Controlled Trial.Lancet Diabetes and Endocrinol., 4(10), 821–828. DOI: 10.1016/S2213-8587(16)300997
Mateo GF, Granado-Font E, Ferré-Grau C, Montaña-Carreras X (2015). Mobile Phone Apps to Promote Weight Loss and Increase Physical Activity: A Systematic Review and Meta-Analysis. J. Med. Internet Res., 17(11). DOI: 10.2196/JMIR.4836
Morgan PJ, Callister R, Collins CE, Plot-nikoff RC, Young MD, Berry N, McElduff P, et al. (2013). The SHED-IT Community Trial: a Randomized Controlled Trial of Internet and Paper-Based Weight Loss Programs Tailored for Overweight and Obese Men. Ann Behav Med, 45, 139–152. https://doi.org/10.1007/s12160-012-9424-z
Nakata Y, Sasai H, Tsujimoto T, Hashimoto K, Kobayashi H (2019). Web-based Intervention to Promote Weight-Loss Maintenance Using an Activity Moni-tor: A Randomized Controlled Trial. Prev. Med. Rep., 14 (2019) 100839. doi: 10.1016/J.PMEDR.2019. 100839
Oh B, Cho B, Han MK, Choi H, Lee MN, Kang HC, Lee CH et al. (2015). The Effectiveness of Mobile Phone-Based Care for Weight Control in metabolic Syndrome Patients: Randomized Controlled Trial. JMIR MHealth and UHealth, 3(3), e83. https://doi.org/10.2196/mhealth.4222
Riaz H, Khan MS, Siddiqi TJ, Usman MS, Shah N, Goyal A, Khan SS et al. (2018). Association Between Obesity and Cardiovascular Outcomes: A Systematic Review and Meta-analysis of Mendelian Randomization Studies. JAMA Network Open, 1(7), e183788. doi:10.1001/jamanetwork open.2018.3788
Ruhee RT, Suzuki K (2018). Dietary Fiber and Its Effect on Obesity: A Review Article. Advances in Medical Research, 01(01). DOI: 10.35248/2564-8942. 2018. 1.2.
Spring B, Pellegrini CA, Pfammatter A, Duncan JM, Pictor A, McFadden HG, Siddique J et al. (2017). Effects of an abbreviated obesity intervention sup-por¬ted by mobile technology: The engaged randomized clinical trial. Obesity, 25(7), 1191–1198. https://doi.org/10.1002/oby.21842
Stephens JD, Yager AM, Allen J (2017). Smartphone Technology and Text Messaging for Weight Loss in Young Adults: A Randomized Controlled Trial. J. Cardiovasc. Nurs., 32(1), 39–46. DOI: 10.1097/JCN.000000 0000000307
Strazzullo P, D'Elia L, Cairella G, Garbagnati F, Cappucio FP, Scalfi L (2010). Excess Body Weight and Incidence of Stroke: Meta-Analysis of Prospective Studies with 2 Million Participants. Stroke, 41 (5), pp. 418-426. doi: 10.1161/STROKE AHA.109.576967.
Sudikno, Julianti ED, Sari YD, Sari YP (2020). The Relationship of Physical Activities on Obesity in Adults in Indo-nesia. pp. 96-100. dalam 4th Internasional Symposium on Health Reasearch (ISHR 2019). Advances in Helath Sciences Research, Vol. 22.
doi: 10.2991/ahsr.k.200215.019.
Sudikno, Syarief H, Dwiriani CM, Riyadi H (2015). Faktor Risiko Obesitas Sentral Pada Orang Dewasa Umur 25-65 Tahun Di Indonesia (Analisis Data Riset Kesehatan Dasar 2013) (Risk Factors Central Obesity in 25-65 Year-Old Indonesian Adults [Analysis Data of Basic Health Research 2013]). Penelitian Gizi dan Makanan, Vol. 38 (2), pp. 111–120.
Svetkey LP, Batch BC, Lin PH, Intille SS, Corsino L, Tyson CC, Bosworth HB et al (2015). Cell Phone Intervention for You (CITY): A Randomized, Controlled Trial of Behavioral Weight Loss Intervention for Young Adults Using Mobile Technology. Obesity,23(11), 2133–2141. DOI: 10.1002/OBY.21226
Turner-McGrievy GM, Beets MW, Moore JB, Kaczynski AT, Barr-Anderson DJ, Tate DF (2013). Comparison of Traditional versus Mobile App Self-Monitoring of Physical Activity and Dietary Intake Among Overweight Adults Participating in an mHealth Weight Loss Program. J. Am. Med. Inform. Assoc., 20, 513–518. DOI: 10.1136/amiajnl-2012-001510
Turner-McGrievy GM, Tate D (2011). Tweets, apps, and pods: Results of the 6-month Mobile Pounds Off Digitally (Mobile POD) Randomized Weight-Loss Intervention Among Adults. J. Med. Internet Res., 13(4), 1–14. DOI: 10.2196/jmir.1841
Turner-McGrievy GM, Wilcox S, Boutté A, Hutto BE, Singletary C, Muth ER, Hoover AW (2017). The Dietary Intervention to Enhance Tracking with Mo-bile Devices (DIET Mobile) Study: A 6-Month Randomized Weight Loss Trial. Obesity, Vol. 25 (8), pp. 1336–1342. doi: 10.1002/oby.21889.
WHO (2021). Obesity and Overweight. Diakses dari: https://www.who.int/ news-room/fact-sheets/detail/obesity-and-overweight (pada Tanggal: 11 Januari 2022).
Zhang J, Jemmott JB (2019). Mobile App-Based Small-Group Physical Activity Intervention for Young African American Women: a Pilot Randomized Controlled Trial. Prev. Sci., 20(6), 863–872. DOI: 10. 1007/S11121-019-01006-4
Zheng H, Chen C (2015). Body Mass Index and Risk of Knee Osteoarthritis: Systematic Review and Meta-Analysis of Prospective Studies. BMJ Open,Vol. 5 (12), e007568. doi: 10.1136/BMJ-OPEN-2014-007568
