Abstract
Background-We hypothesized that a fully automated mobile health (mHealth) intervention with tracking and texting components would increase physical activity. Methods and Results-mActive enrolled smartphone users aged 18 to 69 years at an ambulatory cardiology center in Baltimore, Maryland. We used sequential randomization to evaluate the intervention's 2 core components. After establishing baseline activity during a blinded run-in (week 1), in phase I (weeks 2 to 3), we randomized 2:1 to unblinded versus blinded tracking. Unblinding allowed continuous access to activity data through a smartphone interface. In phase II (weeks 4 to 5), we randomized unblinded participants 1:1 to smart texts versus no texts. Smart texts provided smartphone-delivered coaching 3 times/day aimed at individual encouragement and fostering feedback loops by a fully automated, physician-written, theory-based algorithm using realtime activity data and 16 personal factors with a 10 000 steps/day goal. Forty-eight outpatients (46% women, 21% nonwhite) enrolled with a mean±SD age of 58±8 years, body mass index of 31±6 kg/m2, and baseline activity of 9670±4350 steps/day. Daily activity data capture was 97.4%. The phase I change in activity was nonsignificantly higher in unblinded participants versus blinded controls by 1024 daily steps (95% confidence interval [CI], -580 to 2628; P=0.21). In phase II, participants receiving texts increased their daily steps over those not receiving texts by 2534 (95% CI, 1318 to 3750; P < 0.001) and over blinded controls by 3376 (95% CI, 1951 to 4801; P < 0.001). Conclusions-An automated tracking-texting intervention increased physical activity with, but not without, the texting component. These results support new mHealth tracking technologies as facilitators in need of behavior change drivers.
Original language | English (US) |
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Article number | e002239 |
Journal | Journal of the American Heart Association |
Volume | 4 |
Issue number | 11 |
DOIs | |
State | Published - Nov 1 2015 |
Keywords
- Accelerometer
- Activity tracker
- Automation
- Cardiovascular disease
- Digital health
- EHealth
- MHealth
- Pedometer
- Physical activity
- Prevention
- Smartphone
- Text messages
- Texting
- Wearable device
- Wearable sensor
- health technology
- mobile phone
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine