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mHealth Lifestyle Program Implemented on a Global Scale
Study Questions:
Can a moble-health (mHealth) program to reduce physical inactivity be implemented on a large scale?
Methods:
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.
Results:
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).
Conclusions:
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.
Perspective:
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.
Keywords: Exercise, Health Promotion, Internet, Life Style, Motor Activity, Primary Prevention, Telemedicine, Weight Loss, Weight Reduction Programs
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