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Meta-Analysis
. 2020 Oct 12;22(10):e23954.
doi: 10.2196/23954.

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Mickael Ringeval  1 , Gerit Wagner  2 , James Denford  3 , Guy Paré  2 , Spyros Kitsiou  4
Affiliations
Meta-Analysis

Fitbit-Based Interventions for Healthy Lifestyle Outcomes: Systematic Review and Meta-Analysis

Mickael Ringeval et al. J Med Internet Res. .

Abstract

Background: Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status.

Objective: The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes.

Methods: A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components.

Results: Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD -1.48, 95% CI -2.81 to -0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD -10.62, 95% CI -35.50 to 14.27; P=.40 and standardized MD -0.11, 95% CI -0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component.

Conclusions: The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support.

Trial registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450.

Keywords: Fitbit; fuzzy-set qualitative comparative analysis; healthy lifestyle; literature review; meta-analysis; wearables.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Flow diagram. RCT: randomized controlled trial.
Figure 2
Figure 2
Number of Fitbit-based randomized controlled trials published each year.
Figure 3
Figure 3
Risk of bias summary for each included study.
Figure 4
Figure 4
Forest plot of mean difference in steps per day in studies comparing an intervention that included a Fitbit device with a control group that did not utilize such a device.
Figure 5
Figure 5
Forest plot of mean difference in moderate-to-vigorous physical activity (MVPA; min/day) in studies comparing an intervention that included a Fitbit device with a control group that did not utilize such a device.
Figure 6
Figure 6
Forest plot of mean difference in weight (kg) in studies comparing an intervention that included a Fitbit device with a control group that did not utilize such a device.
Figure 7
Figure 7
Forest plot of sedentary behaviors (min/day) in studies comparing an intervention that included a Fitbit device with a control group that did not utilize such a device.
Figure 8
Figure 8
Fuzzy-set qualitative comparative analysis configurations associated with improvements in healthy lifestyle outcomes.
See this image and copyright information in PMC

References

    1. Zhou B, Lu Y, Hajifathalian K, Bentham J, Di Cesare M, Danaei G, Bixby H, Cowan M, Ali M, Taddei C, Lo W, Reis-Santos B, Stevens G, Riley L, Miranda J, Bjerregaard P, Rivera J, Fouad H, Ma G, Mbanya J, McGarvey S, Mohan V, Onat A, Pilav A, Ramachandran A, Romdhane H, Paciorek C, Bennett J, Ezzati M, Abdeen Z, Abdul Kadir K, Abu-Rmeileh N, Acosta-Cazares B, Adams R, Aekplakorn W, Aguilar-Salinas C, Agyemang C, Ahmadvand A, Al-Othman A, Alkerwi A, Amouyel P, Amuzu A, Andersen L, Anderssen S, Anjana R, Aounallah-Skhiri H, Aris T, Arlappa N, Arveiler D, Assah F, Avdicová M, Azizi F, Balakrishna N, Bandosz P, Barbagallo C, Barceló A, Batieha A, Baur L, Romdhane H, Benet M, Bernabe-Ortiz A, Bharadwaj S, Bhargava S, Bi Y, Bjerregaard P, Bjertness E, Bjertness M, Björkelund C, Blokstra A, Bo S, Boehm B, Boissonnet C, Bovet P, Brajkovich I, Breckenkamp J, Brenner H, Brewster L, Brian G, Bruno G, Bugge A, Cabrera de León A, Can G, Cândido A, Capuano V, Carlsson A, Carvalho M, Casanueva F, Casas J. Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. The Lancet. 2016 Apr 09;387(10027):1513–1530. doi: 10.1016/S0140-6736(16)00618-8. - DOI - PMC - PubMed
    1. Tuchman A. Diabetes and the public's health. The Lancet. 2009 Oct 03;374(9696):1140–1141. doi: 10.1016/s0140-6736(09)61730-x. - DOI - PubMed
    1. Kohl HW, Craig CL, Lambert EV, Inoue S, Alkandari JR, Leetongin G, Kahlmeier S. The pandemic of physical inactivity: global action for public health. The Lancet. 2012 Jul 21;380(9838):294–305. doi: 10.1016/S0140-6736(12)60898-8. - DOI - PubMed
    1. Heath GW, Parra DC, Sarmiento OL, Andersen LB, Owen N, Goenka S, Montes F, Brownson RC. Evidence-based intervention in physical activity: lessons from around the world. The Lancet. 2012 Jul 21;380(9838):272–281. doi: 10.1016/S0140-6736(12)60816-2. - DOI - PMC - PubMed
    1. Global status report on noncommunicable diseases. World Health Organization. 2014. [2020-10-02]. http://www.who.int/nmh/publications/ncd-status-report-2014/en/