mActive: A Randomized Clinical Trial of an Automated mHealth Intervention for Physical Activity Promotion

We hypothesized that a fully automated mobile health (mHealth) intervention with tracking and texting components would increase physical activity. mActive enrolled smartphone users aged 18 to 69 years at an ambulatory cardiology center in Baltimore, Maryland. We used sequential randomization to eval...

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Bibliographic Details
Published in:Journal of the American Heart Association 2015-11, Vol.4 (11)
Main Authors: Martin, Seth S, Feldman, David I, Blumenthal, Roger S, Jones, Steven R, Post, Wendy S, McKibben, Rebeccah A, Michos, Erin D, Ndumele, Chiadi E, Ratchford, Elizabeth V, Coresh, Josef, Blaha, Michael J
Format: Article
Language:English
Subjects:
Actigraphy - instrumentation
Adolescent
Adult
Aged
Algorithms
Automation
Baltimore
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - physiopathology
Cardiovascular Diseases - prevention & control
Cardiovascular Diseases - psychology
Cell Phone
Counseling
Exercise
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Health Promotion - methods
Health Status
Humans
Male
Middle Aged
Mobile Applications
Motivation
Motor Activity
Original Research
Pilot Projects
Risk Factors
Risk Reduction Behavior
Telemedicine - instrumentation
Telemedicine - methods
Text Messaging
Time Factors
Young Adult
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Summary:We hypothesized that a fully automated mobile health (mHealth) intervention with tracking and texting components would increase physical activity. mActive enrolled smartphone users aged 18 to 69 years at an ambulatory cardiology center in Baltimore, Maryland. We used sequential randomization to evaluate the intervention's 2 core components. After establishing baseline activity during a blinded run-in (week 1), in phase I (weeks 2 to 3), we randomized 2:1 to unblinded versus blinded tracking. Unblinding allowed continuous access to activity data through a smartphone interface. In phase II (weeks 4 to 5), we randomized unblinded participants 1:1 to smart texts versus no texts. Smart texts provided smartphone-delivered coaching 3 times/day aimed at individual encouragement and fostering feedback loops by a fully automated, physician-written, theory-based algorithm using real-time activity data and 16 personal factors with a 10 000 steps/day goal. Forty-eight outpatients (46% women, 21% nonwhite) enrolled with a mean±SD age of 58±8 years, body mass index of 31±6 kg/m(2), and baseline activity of 9670±4350 steps/day. Daily activity data capture was 97.4%. The phase I change in activity was nonsignificantly higher in unblinded participants versus blinded controls by 1024 daily steps (95% confidence interval [CI], -580 to 2628; P=0.21). In phase II, participants receiving texts increased their daily steps over those not receiving texts by 2534 (95% CI, 1318 to 3750; P
ISSN:2047-9980
2047-9980
DOI:10.1161/jaha.115.002239