[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 34.204.191.0. Please contact the publisher to request reinstatement.
[Skip to Content Landing]
Original Investigation
May 2017

Mobile Health Interventions for Improving Health Outcomes in Youth: A Meta-analysis

Author Affiliations
  • 1Department of Clinical & Health Psychology, University of Florida, Gainesville
  • 2Clinical Child Psychology Program, University of Kansas, Lawrence
  • 3Life Span Institute, University of Kansas, Lawrence
JAMA Pediatr. 2017;171(5):461-469. doi:10.1001/jamapediatrics.2017.0042
Key Points

Question  How effective are mobile health interventions for improving health outcomes in youth 18 years or younger?

Findings  Thirty-seven studies evaluating the use of mobile health interventions in approximately 30 000 participants were included in the meta-analysis. Mobile health interventions had a small but significant positive effect on health outcomes in youth.

Meaning  Mobile health interventions appear to be a viable health behavior change intervention modality for youth.

Abstract

Importance  Mobile health interventions are increasingly popular in pediatrics; however, it is unclear how effective these interventions are in changing health outcomes.

Objective  To determine the effectiveness of mobile health interventions for improving health outcomes in youth 18 years or younger.

Data Sources  Studies published through November 30, 2016, were collected through PubMed, Cumulative Index to Nursing and Allied Health Literature, Educational Resources Information Center, and PsychINFO. Backward and forward literature searches were conducted on articles meeting study inclusion criteria. Search terms included telemedicine, eHealth, mobile health, mHealth, app, and mobile application.

Study Selection  Search results were limited to infants, children, adolescents, or young adults when possible. Studies were included if quantitative methods were used to evaluate an application of mobile intervention technology in a primary or secondary capacity to promote or modify health behavior in youth 18 years or younger. Studies were excluded if the article was an unpublished dissertation or thesis, the mean age of participants was older than 18 years, the study did not assess a health behavior and disease outcome, or the article did not include sufficient statistics. Inclusion and exclusion criteria were applied by 2 independent coders with 20% overlap. Of 9773 unique articles, 36 articles (containing 37 unique studies with a total of 29 822 participants) met the inclusion criteria.

Data Extraction and Synthesis  Of 9773 unique articles, 36 articles (containing 37 unique studies) with a total of 29 822 participants met the inclusion criteria. Effect sizes were calculated from statistical tests that could be converted to standardized mean differences. All aggregate effect sizes and moderator variables were tested using random-effects models.

Main Outcomes and Measures  Change in health behavior or disease control.

Results  A total of 29 822 participants were included in the studies. In studies that reported sex, the total number of females was 11 226 (53.2%). Of those reporting age, the average was 11.35 years. The random effects aggregate effect size of mobile health interventions was significant (n = 37; Cohen d = 0.22; 95% CI, 0.14-0.29). The random effects model indicated that providing mobile health intervention to a caregiver increased the strength of the intervention effect. Studies that involved caregivers in the intervention produced effect sizes (n = 16; Cohen d = 0.28; 95% CI, 0.18-0.39) larger than those that did not include caregivers (n = 21; Cohen d = 0.13; 95% CI, 0.02-0.25). Other coded variables did not moderate study effect size.

Conclusions and Relevance  Mobile health interventions appear to be a viable health behavior change intervention modality for youth. Given the ubiquity of mobile phones, mobile health interventions offer promise in improving public health.

×