Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial

Abstract

Background: Physical inactivity is a major, potentially modifiable, risk factor for cardiovascular disease, cancer, and other chronic diseases. Effective, simple, and generalisable interventions that will increase physical activity in populations are needed.

Aim: To evaluate the effectiveness of a smartphone application (app) to increase physical activity in primary care.

Design and setting: An 8-week, open-label, randomised controlled trial in rural, primary care in the west of Ireland.

Method: Android smartphone users >16 years of age were recruited. All participants were provided with similar physical activity goals and information on the benefits of exercise. The intervention group was provided with a smartphone app and detailed instructions on how to use it to achieve these goals. The primary outcome was change in physical activity, as measured by a daily step count between baseline and follow-up.

Results: A total of 139 patients were referred by their primary care health professional or self-referred. In total, 37 (27%) were screened out and 12 (9%) declined to participate, leaving 90 (65%) patients who were randomised. Of these, 78 provided baseline data (intervention = 37; control = 41) and 77 provided outcome data (intervention = 37; control = 40). The mean daily step count at baseline for intervention and control groups was 4365 and 5138 steps per day respectively. After adjusting, there was evidence of a significant treatment effect (P = 0.009); the difference in mean improvement in daily step count from week 1 to week 8 inclusive was 1029 (95% confidence interval 214 to 1843) steps per day, favouring the intervention. Improvements in physical activity in the intervention group were sustained until the end of the trial.

Conclusion: A simple smartphone app significantly increased physical activity over 8 weeks in a primary care population.

Keywords: exercise; health behaviour; primary care; randomised controlled trial; technology.

Figure 1

Participant recruitment and follow-up. ^aApplication killer is a piece of software present on some smartphones that can restrict the automatic functions of smartphone applications.

Figure 2

Daily step count with smoothed mean steps using a log to the base 10 for control and intervention groups.

Figure 3

8-week improvement in mean steps in control and intervention groups.