mHealth Lifestyle Program Implemented on a Global Scale
Can a moble-health (mHealth) program to reduce physical inactivity be implemented on a large scale?
This study prospectively collected data on the efficacy of an mHealth intervention; Stepathlon. Participants completed a Stepathlon, an annual 100-day global event, which has occurred between 2012 and 2015. Participants were organized in worksite-based teams, issued pedometers, and encouraged to increase daily steps and physical activity as part of team-based race. The program was conducted via an interactive multi-platform app available on mobile devices and the worldwide web. Outcomes of interest included change in step counts, number of exercise days, sedentary time (sitting hours), and change in weight.
A total of 69,219 adults participated from 481 employers, in 1,481 cities (64 countries). Mean age of participants was 36 ± 9 years, 23.9% were female, 8.0% were from high-income countries, and 92.0% were from lower-middle income countries. After Stepathlon completion, participants recorded improved step count (+3,519 steps/day; 95% confidence interval [CI], 3484-355; p < 0.0001), exercise days (+0.89 days: 95% CI, 0.87-0.92; p < 0.0001), sitting duration (-0.74 hours; 95% CI, -0.78 to -0.71; p < 0.0001), and weight (-1.45 kg; 95% CI, -1.53 to -1.38; p < 0.0001). Improvements occurred in women and men, in all geographic regions, and in both high- and lower-middle income countries, and reproduced in 2012, 2013, and 2014 cohorts. Predictors of weight loss included step increase, sitting duration decrease, and increase in exercise days (all p < 0.0001).
The investigators concluded that an mHealth program to improve physical activity, implemented in a large cohort from across the globe, was associated with short-term reproducible large-scale improvements in physical activity, sitting, and weight.
This study supports the concept that mHealth programs can be implemented on a large scale with real impact on health across large populations. Further research related to sustainability both for the program and for the long-term adherence by participants is recommended.
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