Context
Mobile health helps providers offer accessible, affordable, tailored behavior change
interventions. However, research assessing mobile health interventions may feature
methodologic shortcomings and poor reporting. This review aims to summarize the characteristics,
methods, and intervention reporting of RCTs evaluating mobile health behavior change
interventions.
Evidence acquisition
This was a methodologic systematic review of RCTs assessing mobile health behavior
change interventions published in PubMed from January 1, 2014 to January 1, 2018,
in journals with the upper half of Impact Factors (Clarivate Analytics). Three reviewers
independently extracted sample characteristics. Primary outcomes were classified as
patient-important or not using definitions from the literature. Any non–patient-important
outcomes were then reclassified by a panel of 3 patients. Intervention reporting was
assessed by the mobile health Evidence Reporting and Assessment checklist. Data were
analyzed in December 2018.
Evidence synthesis
Most of the 231 included RCTs assessed text messaging (51%) or smartphone app (28%)
interventions aiming to change nutrition and physical activity (36%) or treatment
adherence (25%). Only 8% of RCTs had a patient-important primary outcome, follow-up
of ≥6 months, and intent-to-treat analysis. Most primary outcomes were behavioral
measures (60%). Follow-up was <3 months in 29% of RCTs. Regarding reporting, 12 of
the 16 checklist items were reported in less than half of RCTs (e.g., usability/content
testing, 32%; data security, 13%).
Conclusions
Reports of RCTs assessing mobile health behavior change interventions lack information
that would be useful for providers, including reporting of long-term intervention
impact on patient-important primary outcomes and information needed for intervention
replicability.
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© 2019 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
