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    Original Investigation
    Nutrition, Obesity, and Exercise
    May 24, 2019

    Short- and Long-term Effects of a Mobile Phone App in Conjunction With Brief In-Person Counseling on Physical Activity Among Physically Inactive Women: The mPED Randomized Clinical Trial

    Author Affiliations
    • 1Department of Physiological Nursing, Institute for Health & Aging, School of Nursing, University of California, San Francisco
    • 2Stanford Prevention Research Center, Stanford University, Palo Alto, California
    • 3Department of Epidemiology & Biostatistics, University of California, San Francisco
    JAMA Netw Open. 2019;2(5):e194281. doi:10.1001/jamanetworkopen.2019.4281
    Key Points español 中文 (chinese)

    Question  Does use of a mobile phone–based physical activity education application (app) in conjunction with brief in-person counseling result in an increase of accelerometer-measured physical activity for 3 months and maintaining activity for an additional 6 months?

    Findings  In this randomized clinical trial of 210 community-dwelling physically inactive women, the intervention achieved a statistically and clinically significant increase in total steps and time spent performing moderate to vigorous physical activity compared with the control group in the first 3 months. However, the group who continued use of the app, as compared with the group who discontinued app use, experienced no statistically significant effect on maintaining the increased activity in the following 6 months.

    Meaning  The combination of a mobile phone app and brief in-person counseling increased objectively measured physical activity over 3 months, but use of the app for an additional 6 months did not help to maintain increased activity.

    Abstract

    Importance  Mobile phone applications (apps) and activity trackers allow researchers to remotely deliver an intervention and monitor physical activity but have not been rigorously evaluated for longer periods.

    Objective  To determine whether a mobile phone–based physical activity education app, in conjunction with brief in-person counseling, increases and then maintains levels of physical activity.

    Design, Setting, and Participants  In this parallel randomized clinical trial, community-dwelling physically inactive women recruited between May 2011 and April 2014 were randomized in equal proportions into the control (n = 69), regular (n = 71), and plus (n = 70) groups. Data were analyzed using intention to treat from September 16, 2016, through June 30, 2018.

    Interventions  The regular and plus groups were instructed to use the app on their mobile phone and an accelerometer every day for 3 months and attend brief in-person counseling. During the 6-month maintenance period, the plus group continued to use the app and accelerometer, while the regular group stopped using the app but continued using the accelerometer. The control group used the accelerometer throughout.

    Main Outcomes and Measures  The primary and secondary outcomes were daily accelerometer-measured total steps and time spent in moderate to vigorous physical activity (MVPA).

    Results  The 210 participants had a mean (SD) age of 52.4 (11.0) years. At baseline, the mean (SD) daily total steps by accelerometer in the control, regular, and plus groups were 5384 (2920), 5063 (2526), and 5837 (3235), respectively. During the 3-month intervention period, daily steps and MVPA increased in the combined regular and plus groups compared with the control group (between-group differences, 2060 steps per day; 95% CI, 1296-2825 steps per day; P < .001 and 18.2 min/d MVPA; 95% CI, 10.9-25.4 min/d MVPA; P < .001). During the subsequent 6-month maintenance period, mean activity level remained higher in the combined plus and regular groups than among controls (between-group difference, 1360 steps per day; 95% CI, 694-2026 steps per day; P <. 001), but trends in total daily steps and MVPA were similar in the plus and regular groups.

    Conclusions and Relevance  In this trial, the intervention groups substantially increased their physical activity. However, use of both the app and accelerometer for an additional 6 months after the initial 3-month intervention did not help to maintain increases in physical activity compared with continued use of the accelerometer alone.

    Trial Registration  ClinicalTrials.gov identifier: NCT01280812

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