An app designed to increase physical activity in inactive women showed early promise in achieving its objective; however, the use of the app for an additional 6 months did not keep their interest in continuing such activity, according to findings published in JAMA Network Open.
“A number of factors have limited the assessment of digital technology-based physical activity interventions,” Yoshimi Fukuoka, PhD, RN, of the Institute for Health & Aging and School of Nursing at the University of California, San Francisco, and colleagues wrote.
“First, studies are frequently short, and only a few have examined maintenance of physical activity after the initial intervention. Second, sample sizes have been small, and only self-reported measures of physical activity have been used in some studies. Third, although app use is associated with behavior change, app use statistics or user engagement information are seldom reported,” they wrote.
Researchers randomly assigned 210 community-dwelling, physically inactive women (mean age, 52.4 years) in an approximate 1:1:1 ratio to either:
- use the app and accelerometer daily for 3 months, then during a 6-month period stop using the app but continue using the accelerometer (regular group);
- use the app and accelerometer daily for 3 months, then during a 6-month period continue using the app but continue using the accelerometer (plus group); or
- use the accelerometer daily for 9 months but not the app (control group).
All participants received brief face-to-face counseling that discussed:
- the physical activity program and set goals;
- brisk walking and the health benefits of physical activity;
- obstacles to increasing physical activity and strategies to overcome them;
- how to value and identify social support while increasing physical activity;
- relapse prevention;
- education about healthy diet and weight maintenance; and
- safety during physical activity.
The app reinforced the discussions and allowed patients to keep a daily diary.
Fukuoka and colleagues found that during the 3-month intervention period, daily steps and levels of moderate to vigorous physical activity increased in the regular and plus groups vs. the control group (between-group differences = 2,060 steps daily; 95% CI, 1,296-2,825; 18.2 minutes of moderate to vigorous physical activity daily; 95% CI, 10.9-25.4).
In addition, during the 6-month maintenance that followed, mean activity levels remained higher in the combined plus and regular groups vs. controls (between-group differences = 1,360 steps daily; 95% CI, 694-2,026), but trends in total daily steps and moderate to vigorous physical activity levels were nearly identical in the plus and regular groups.
In discussing the findings, researchers suggested that the app may have initially worked because it was tailored to the cohort being studied and used what they wrote were “effective behavioral change strategies.”
Fukuoka and colleagues added that study participants may have stopped using the app because they felt they had “mastered the skills” the app tried to teach and that the accelerometer would be sufficient for their physical activity needs moving forward.
“Methods for maintaining gains achieved by app-based physical activity interventions require further development,” researchers concluded. – by Janel Miller
Disclosures : Fukuoka reports she received grants from the NIH and American Heart Association during the conduct of the study. The other authors report no relevant financial disclosures.