Using an electronic activity monitor system as an intervention modality: A systematic review

BackgroundObesity is a growing global health concern that may lead to cardiovascular disease, type II diabetes, and cancer. Several systematic reviews have shown that technology is successful in combating obesity through increased physical activity, but there is no known review on interventions that use an electronic activity monitor system (EAMS). EAMSs are defined as a wearable device that objectively measures lifestyle physical activity and can provide feedback, beyond the display of basic activity count information, via the monitor display or through a partnering application to elicit continual self-monitoring of activity behavior. These devices improve upon standard pedometers because they have the ability to provide visual feedback on activity progression, verbal encouragement, and social comparison. This systematic review aimed to synthesize the efficacy and feasibility results of EAMSs within published physical activity interventions.MethodsElectronic databases and journal references were searched for relevant articles. Data sources included CINAHL, Cochrane CENTRAL, Medline Ovid, PsycINFO, and clinicaltrials.gov. Out of the 1,574 retrieved, 11 articles met the inclusion criteria. These articles were reviewed for quality and content based on a risk of bias tool and intervention components.ResultsMost articles were determined to be of medium quality while two were of low quality, and one of high quality. Significant pre-post improvements in the EAMS group were found in five of nine studies for physical activity and in four of five studies for weight. One found a significant increase in physical activity and two studies found significant weight loss in the intervention group compared with the comparator group. The EAMS interventions appear to be feasible with most studies reporting continual wear of the device during waking hours and a higher retention rate of participants in the EAMS groups.ConclusionThese studies provide preliminary evidence suggesting that EAMS can increase physical activity and decrease weight significantly, but their efficacy compared to other interventions has not yet been demonstrated. More high-quality randomized controlled trials are needed to evaluate the overall effect of EAMS, examine which EAMS features are most effective, and determine which populations are most receptive to an EAMS.

[1]  S. Michie,et al.  A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy , 2011, Psychology & health.

[2]  Gregory J Welk,et al.  Validity of consumer-based physical activity monitors. , 2014, Medicine and science in sports and exercise.

[3]  T. Wadden,et al.  Behavioral treatment of obesity. , 2003, Endocrinology and metabolism clinics of North America.

[4]  D. Tate,et al.  Tweets, Apps, and Pods: Results of the 6-Month Mobile Pounds Off Digitally (Mobile POD) Randomized Weight-Loss Intervention Among Adults , 2011, Journal of medical Internet research.

[5]  M. H. van den Berg,et al.  Internet-Based Physical Activity Interventions: A Systematic Review of the Literature , 2007, Journal of medical Internet research.

[6]  C. Abraham,et al.  Self-Directed Interventions to Promote Weight Loss: A Systematic Review of Reviews , 2014, Journal of medical Internet research.

[7]  Arlen C. Moller,et al.  A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial , 2012, BMC Public Health.

[8]  Alison Kirk,et al.  Using an individualised consultation and activPAL™ feedback to reduce sedentary time in older Scottish adults: results of a feasibility and pilot study. , 2013, Preventive medicine.

[9]  Elizabeth J Lyons,et al.  Behavior Change Techniques Implemented in Electronic Lifestyle Activity Monitors: A Systematic Content Analysis , 2014, Journal of medical Internet research.

[10]  Gabriel A. Koepp,et al.  "Go4Life" exercise counseling, accelerometer feedback, and activity levels in older people. , 2014, Archives of gerontology and geriatrics.

[11]  D. Tate,et al.  Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study , 2006, BMJ : British Medical Journal.

[12]  Monique Tabak,et al.  Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD. , 2014, Patient education and counseling.

[13]  S. Gortmaker,et al.  Health and economic burden of the projected obesity trends in the USA and the UK , 2011, The Lancet.

[14]  W. Mechelen,et al.  Concurrent validity of the PAM accelerometer relative to the MTI Actigraph using oxygen consumption as a reference , 2008, Scandinavian journal of medicine & science in sports.

[15]  C. Foster,et al.  Face-to-face versus remote and web 2.0 interventions for promoting physical activity. , 2013, The Cochrane database of systematic reviews.

[16]  F. Barwais,et al.  Physical activity, sedentary behavior and total wellness changes among sedentary adults: a 4-week randomized controlled trial , 2013, Health and Quality of Life Outcomes.

[17]  R. Glasgow,et al.  Evaluating the public health impact of health promotion interventions: the RE-AIM framework. , 1999, American journal of public health.

[18]  Bryan K. Smith,et al.  American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. , 2009, Medicine and science in sports and exercise.

[19]  L. Lyzwinski,et al.  A Systematic Review and Meta-Analysis of Mobile Devices and Weight Loss with an Intervention Content Analysis , 2014, Journal of personalized medicine.

[20]  M. Sevick,et al.  Self-monitoring in weight loss: a systematic review of the literature. , 2011, Journal of the American Dietetic Association.

[21]  H. Chambliss,et al.  Computerized self-monitoring and technology-assisted feedback for weight loss with and without an enhanced behavioral component. , 2011, Patient education and counseling.

[22]  J Fortún,et al.  Ca-125: A Useful Marker to Distinguish Pulmonary Tuberculosis from Other Pulmonary Infections , 2009, The open respiratory medicine journal.

[23]  K. Flegal,et al.  Prevalence of Childhood and Adult Obesity in the United States, 2011–2012 , 2014 .

[24]  C. Dolea,et al.  World Health Organization , 1949, International Organization.

[25]  D. Asch,et al.  Wearable devices as facilitators, not drivers, of health behavior change. , 2015, JAMA.

[26]  P. Cudd,et al.  Interventions employing mobile technology for overweight and obesity: an early systematic review of randomized controlled trials , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[27]  C. Gore-felton,et al.  A review of efficacious technology-based weight-loss interventions: five key components. , 2010, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[28]  J. Mata,et al.  The effect of physical activity on weight loss is mediated by eating self-regulation. , 2010, Patient education and counseling.

[29]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[30]  Christine A Pellegrini,et al.  The Comparison of a Technology‐Based System and an In‐Person Behavioral Weight Loss Intervention , 2010, Obesity.

[31]  Andrea Furlan,et al.  Updated Method Guidelines for Systematic Reviews in the Cochrane Collaboration Back Review Group , 2003, Spine.

[32]  S. Blair,et al.  An economic analysis of traditional and technology-based approaches to weight loss. , 2012, American journal of preventive medicine.

[33]  R. Wing,et al.  Are standard behavioral weight loss programs effective for young adults? , 2009, International Journal of Obesity.

[34]  K. McPherson.  Reducing the global prevalence of overweight and obesity , 2014, The Lancet.

[35]  B. Hamborg.  Obesity and physical activity. , 1980, Scandinavian journal of social medicine. Supplementum.

[36]  Margaret L Fruin,et al.  Validity of a multi-sensor armband in estimating rest and exercise energy expenditure. , 2004, Medicine and science in sports and exercise.

[37]  Nicholas D. Gilson,et al.  Measuring and Influencing Physical Activity with Smartphone Technology: A Systematic Review , 2014, Sports Medicine.

[38]  J. Hardin,et al.  Electronic feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial , 2011, The international journal of behavioral nutrition and physical activity.

[39]  E. Wouters,et al.  Effect of ‘activity monitor-based’ counseling on physical activity and health-related outcomes in patients with chronic diseases: A systematic review and meta-analysis , 2013, Annals of medicine.

[40]  Deborah F Tate,et al.  The Efficacy of a Technology‐based System in a Short‐term Behavioral Weight Loss Intervention , 2007, Obesity.

[41]  D. Bond,et al.  Review of Innovations in Digital Health Technology to Promote Weight Control , 2014, Current Diabetes Reports.

[42]  A. Bauman,et al.  Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. , 2007, Circulation.

[43]  J. Takács,et al.  Validation of the Fitbit One activity monitor device during treadmill walking. , 2014, Journal of science and medicine in sport.

[44]  C. Abraham,et al.  Effective techniques in healthy eating and physical activity interventions: a meta-regression. , 2009, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[45]  Aki Vehtari,et al.  The effectiveness of physical activity monitoring and distance counseling in an occupational setting – Results from a randomized controlled trial (CoAct) , 2012, BMC Public Health.

[46]  J. S. Sodhi,et al.  Using Internet and Mobile Phone Technology to Deliver an Automated Physical Activity Program: Randomized Controlled Trial , 2007, Journal of medical Internet research.

[47]  Barbara E Ainsworth,et al.  Objective and subjective measures of sedentary behavior and physical activity. , 2010, Medicine and science in sports and exercise.

[48]  R. Winett,et al.  Using Internet technology to deliver a behavioral weight loss program. , 2001, JAMA.

[49]  Willem Van Mechelen,et al.  Feasibility and Effectiveness of Online Physical Activity Advice Based on a Personal Activity Monitor: Randomized Controlled Trial , 2009, Journal of medical Internet research.

[50]  C. Abraham,et al.  The Behavior Change Technique Taxonomy (v1) of 93 Hierarchically Clustered Techniques: Building an International Consensus for the Reporting of Behavior Change Interventions , 2013, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[51]  A. Alwan.  Global status report on noncommunicable diseases 2010. , 2011 .