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The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis

Western, Max, Armstrong, Miranda, Islam, Ishrat, Morgan, Kelly, Jones, Una and Kelson, Mark 2021. The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity 18 , 148. 10.1186/s12966-021-01218-4

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Background: Digital technologies such as wearables, websites and mobile applications are increasingly used in interventions targeting physical activity (PA). Increasing access to such technologies makes an attractive prospect for helping individuals of low socioeconomic status (SES) in becoming more active and healthier. However, little is known about their efectiveness in such populations. The aim of this systematic review was to explore whether digital inter�ventions were efective in promoting PA in low SES populations, whether interventions are of equal beneft to higher SES individuals and whether the number or type of behaviour change techniques (BCTs) used in digital PA interven�tions was associated with intervention efects. Methods: A systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Library, published between January 1990 and March 2020. Randomised con�trolled trials, using digital technology as the primary intervention tool, and a control group that did not receive any digital technology-based intervention were included, provided they had a measure of PA as an outcome. Lastly, stud�ies that did not have any measure of SES were excluded from the review. Risk of Bias was assessed using the Cochrane Risk of Bias tool version 2. Results: Of the 14,589 records initially identifed, 19 studies were included in the fnal meta-analysis. Using random�efects models, in low SES there was a standardised mean diference (SMD (95%CI)) in PA between intervention and control groups of 0.06 (−0.08,0.20). In high SES the SMD was 0.34 (0.22,0.45). Heterogeneity was modest in both low (I2=0.18) and high (I2=0) SES groups. The studies used a range of digital technologies and BCTs in their interventions, but the main fndings were consistent across all of the sub-group analyses (digital interventions with a PA only focus, country, chronic disease, and duration of intervention) and there was no association with the number or type of BCTs. Discussion: Digital interventions targeting PA do not show equivalent efcacy for people of low and high SES. For people of low SES, there is no evidence that digital PA interventions are efective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate efectiveness. To reduce inequalities and improve efectiveness, future development of digital interventions aimed at improving PA must make more efort to meet the needs of low SES people within the target population

Item Type: Article
Date Type: Publication
Status: Published
Schools: Social Sciences (Includes Criminology and Education)
Healthcare Sciences
Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License
Publisher: BioMed Central
ISSN: 1479-5868
Date of First Compliant Deposit: 25 November 2021
Date of Acceptance: 20 October 2021
Last Modified: 25 Nov 2021 11:00

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