Impact of a primary care-based mobile health intervention to 'sit less and move more' on HbA1c, blood pressure, and other clinical outcomes in office employees with type 2 diabetes: A randomized controlled trial

Abstract

Background: Type 2 diabetes (T2D) is a prevalent and costly disease, with sedentary behaviour and physical inactivity as modifiable contributors. Mobile health (mHealth) applications provide complementary strategies for T2D management, but their impact on clinical outcomes remains unclear.

Objective: This study evaluated the efficacy of an mHealth programme promoting "sit less and move more" at work, prescribed in clinical practice, on clinical and cardiovascular risk factors in office employees with T2D.

Methods: A randomized controlled trial compared usual care (n = 25) with a 13-week mHealth intervention (n = 29) using the Walk@Work-App and web-based tools. Outcomes included HbA1c, glycemia, lipid profile, domain-specific sedentary behaviour (Workforce Sitting Questionnaire), objective physical activity and sedentary behaviour (ActivPal), blood pressure, and BMI at baseline, 6, and 12 months.

Results: Compared to the control group and at 12 months, the intervention group showed a significant reduction in HbA1c (p < 0.05), systolic and diastolic blood pressure (p < 0.05). Sitting time decreased during leisure activities while watching TV (p = 0.0052) and using electronic devices (p = 0.0397). The number of sedentary breaks and time spent in sedentary bouts <20 min/day increased (p < 0.05).

Conclusions: An mHealth programme effectively reduced sedentary behaviour, improved HbA1c and blood pressure, serving as a cost-effective lifestyle intervention for adults with T2D.

Trial registration: ClinicalTrials.gov NCT04092738.https://clinicaltrials.gov/ct2/show/NCT04092738.

Keywords: Behaviour change; Desk-based job; Digital intervention; Mobile applications; Office employees; Physical activity; Primary healthcare; Randomized controlled trial; Sedentary behaviour; Self-management; Smartphone; Type 2 diabetes; Workplace; mhealth.