Table 1.
Characteristics of included studies.
| Author Year Country |
Setting/workplace | Study design | Participants | Type of mHealth technology/toola | Intervention | Control/comparison group(s) | Aim | Primary PA/SB outcome(s) (OB or SR) | Secondary outcome(s) | Length of follow-up |
|---|---|---|---|---|---|---|---|---|---|---|
| Brakenridge et al. 2016 (protocol)37 Brakenridge et al. 2016 (results)38 Australia |
International property and infrastructure group (Lendlease) | Cluster RCT |
n = 153 54% M, 46% F Age IG: 37.6±7.8 CG: 40.0±8.0 Office workers (at least 0.5 FTE) |
Wearable activity monitor and smartphone app | Waist-worn ‘LUMOback’ activity monitor (LUMO Bodytech, USA) and associated smartphone app with organisational support. | Organisational support only – e.g. manager support, e-mails and educational materials. | SB | Average time per day spent sitting (work hours and overall) (OB, activPAL3™ accelerometer) |
Average time per day spent in prolonged sitting bouts (30 min or more), standing and stepping Daily steps Average time period between sitting bouts Job performance, job control and work satisfactionStress, physical and mental health-related QoL Activity monitor usage |
12 months |
| Finkelstein et al. 2015 (protocol and baseline data)39 Finkelstein et al. 2016 (results)40 Singapore |
13 organisations (various industries and government sectors) | RCT (4-arm) |
n = 800 46% M, 54% F Age IG1: 35.4±8.3 IG2: 35.5±8.6 IG3: 35.5±8.4 CG: 35.6±8.6 Mostly desk-based employees (full-time) |
Wearable activity monitor (and website) | Waist-worn Fitbit Zip activity monitor (Fitbit, USA) and associated website.Monetary incentives: IG1 = Fitbit only IG2 = Fitbit and charity donation IG3 = Fitbit and cash Educational booklets on PA. |
No activity monitor or incentives. Educational booklets on PA only. |
PA | MVPA bout minutes per week (OB, ActiGraph™ GT-3x+ accelerometer) |
Mean daily step count % of participants meeting 70,000 weekly step goal Weight Systolic BP Cardiorespiratory fitness Quality of life Weekly step count Sedentary, light, moderate and vigorous PA (min/week) Participants meeting 150 min per week moderate PA Participants meeting 10,000 daily step target |
12 months |
| Ganesan et al. 201641 64 countries (majority of participants from India (90.2%), Australia (5%), New Zealand (1.1%) and Singapore (0.6%)) |
481 employers (private and public sector organisations) in 1481 cities | Prospective cohort (pre- and post- uncontrolled) |
n = 69,219 76% M, 24% F Age 36.0±8.4 Adult employees |
Smartphone app | Non-interactive pedometer and ‘Stepathlon’ mobile app (also available as website). | No control or comparison group | PA + SB | Daily steps (SR, pedometer data entered by participants) |
Number of exercise days/week Exercise duration (<30 or ≥30 min/day) Sitting duration (hours/day) Weight in kilograms |
100 days (approx.) |
| Gilson et al. 2016 (baseline data and smartphone use)55 Gilson et al. 2017 (results)56 Australia |
Two large Australian haulage companies | Prospective cohort (pre- and post- uncontrolled feasibility study) |
n = 44 100% M, 0% F Age 47.0±10.1 Truck drivers |
Wearable activity monitor and smartphone app | Wrist-worn Jawbone UP activity monitor (Jawbone, USA) used with associated smartphone app. Monetary incentives (vouchers for attaining step goals and logging diet) |
No control or comparison group | PA + SB | Proportions of work time and non-work time spent physically active, sedentary and stationary + (i.e. sitting with upper limb movement or standing) (OB – GENEActiv™ wrist accelerometer) |
Workday diet (fruit, vegetable, saturated fat and sugar intake) Engagement with the intervention Qualitative outcomes (interviews) –driver and depot manager experiences; perceived impact of the intervention; barriers to PA |
28 weeks (approx.) |
| Gremaud et al. 201860 USA | Academic organisation (university) | RCT |
n = 146 25% M, 75% F Age IG: 40.6±11.7 CG: 40.3±11.1 Sedentary office workers (full-time) |
Wearable activity monitor and smartphone app (web-based) | Waist-worn Fitbit Zip activity monitor (Fitbit, USA) used with ‘MapTrek’ app for gamified walking. | Activity monitor only | PA + SB | Daily steps Daily active minutes (minutes with ≥100 steps/min) (OB – data from Fitbit) |
Bouts of sedentary behaviour (consecutive minutes with 0 steps) | 10 weeks |
| Jones 201642 USA | Academic medical centre (Wake Forest Baptist Health) | Prospective cluster trial (with asynchronous control group) |
n = 47 18% M, 82% F Age Overall mean = 50.8, range 25 to 74 years (SD not reported) Sedentary employees |
Wearable activity monitor (and computer software) | Clip-on Fitbit One activity monitor (Fitbit, USA) and associated software, with wellness education. IG1 = Fitbit only IG2 = Fitbit and shared active workstations |
Usual treatment (blinded activity monitors for data collection) | PA + SB | Daily steps Daily sedentary time BMI (OB – steps and sedentary time from Fitbit. BMI assessed objectively) |
Life satisfaction Anxiety (state and trait) Health-related quality of life Self-reported sleep patterns |
6 months |
| Koyle 201343 USA | Academic medical centre (University of Utah Health Care) | RCT |
n = 73 0% M, 100% F Age 46.5±7.6 Physically inactive employees (<150 min exercise per week) |
Smartphone app with integrated accelerometer (and motivational text messages) | ‘Adidas miCoach’ smartphone app to track walking exercise. Educational materials on PA. Tailored motivational text messages. |
Smartphone app and educational materials (same as intervention group). No motivational text messages. | PA | Walking distance and duration (OB – smartphone app-integrated accelerometer for collection of PA data) |
Walking for exercise self-efficacy beliefs Likeliness of participating in other forms of PA beyond walking Height and weight (BMI) Resting pulse rate Systolic BP Qualitative experiences of the intervention (survey) |
6 weeks |
| Losina et al. 201757 USA | Academic medical centre (Brigham and Women’s Hospital, Boston, Massachusetts) | Prospective cohort (pre- and post- uncontrolled feasibility study) |
n = 292 17% M, 83% F Age 38±11 Sedentary, non-clinician hospital employees |
Wearable activity monitor (linked with websites) | Wrist-worn Fitbit Flex activity monitor (Fitbit, USA) used with Fitbit website and study website for monitoring PA and progress. Monetary incentives (individual and team) for meeting PA goals. |
No control or comparison group | PA | Average weekly minutes of MVPA Proportion of participants meeting weekly MVPA goals and CDC PA guidelines (OB – step data from Fitbit converted to weekly minutes of MVPA) |
Fitbit wear adherence (number of weeks wearing Fitbit for ≥10 h/day and ≥4 days/week) Participant satisfaction with programme |
26 weeks (including two pre-intervention weeks) |
| Neil-Sztramko et al. 201758 Canada | Multiple workplaces in Greater Vancouver (nursing, emergency services, casinos and airport) | Prospective cohort (pre- and post- uncontrolled feasibility study) |
n = 20 0% M, 100% F Age 42.2±8.6 Female shift workers |
Wearable activity monitor and smartphone app (or website) | Wrist-worn Fitbit Flex activity monitor (Fitbit, USA) used with Fitbit app and/or website. Distance-based behavioural counselling (telephone/online) |
No control or comparison group | PA | MVPA (total min/week and min/week bouts ≥10 mins) (OB - ActiGraph™ GT-3x+ accelerometer) |
Daily steps Sedentary time (min/week bouts ≥10 mins) Self-reported PA and sedentary timeBody weight and BMI Physical and mental health-related QoL Sleep quantity and quality Feasibility outcomes: demand (reach and recruitment), implementation (delivery and resources) and acceptability (attrition and adherence to intervention, participant satisfaction). |
12 weeks |
| Olsen et al. 201861 Australia | Financial services organisation (Brisbane) | Prospective cohort (pre- and post- uncontrolled pilot) |
n = 49 31% M, 69% Fb Age 39.5±8.7 Flexible workers (e.g. work from home 1 day/week) |
Wearable activity monitor and smartphone app | Wrist-worn Jawbone activity monitor (Jawbone, USA) used with associated app. Group-based action planning session. Weekly e-mail reminders and resources. Healthy living seminar |
No control or comparison group | SB | Sitting time (including overall and occupational, min/day) (OB - ActiGraph™ GT-3x+ accelerometer, also self-reported sitting time assessed using adapted version of Workforce Sitting Questionnaire) |
Light PA and MVPA (min/day, accelerometer-assessed) Self-reported PA (min/week, assessed using adapted version of Active Australia survey) Acceptability of the intervention (survey-assessed) |
6 weeks |
| Patel et al. 201644 (study 1) USA | Academic organisation (University of Pennsylvania) | RCT (4-arm) |
n = 281 (279 completed baseline assessment) 22% M, 78% F Age IG1: 37.1±10.9 IG2: 40.3±11.2 IG3: 41.9±11.6 CG: 39.4±12.2 Overweight and obese employees (BMI ≥27 kg/m2) |
Smartphone app with integrated accelerometer | ‘Moves’ smartphone app (Proto Geo Oy, Finland) for step tracking. Daily feedback on steps. Monetary incentives: IG1 = gain incentive IG2 = lottery incentive IG3 = loss incentive |
Smartphone app and daily feedback (as intervention group). No financial incentives. | PA | Proportion of participant-days 7000 step goal achieved during intervention (OB – smartphone app-integrated accelerometer) |
Proportion of participant-days 7000 step goal achieved during follow-up Daily steps – intervention and follow-up |
26 weeks |
| Patel et al. 201645 (study 2) USA | Health insurance organisation (Independence Blue Cross) | RCT (4-arm) |
n = 304 23% M, 77% F Age IG1: 39.3±10.2 IG2: 38.7±10.2 IG3:41.2±10.8 CG: 43.2±10.0 Mostly sedentary employees |
Smartphone app with integrated accelerometer | ‘Moves’ smartphone app (Proto Geo Oy, Finland) for step tracking. Daily feedback on steps. Monetary incentives: IG1 = individual IG2 = team IG3 = combined |
Smartphone app and daily feedback (as intervention group). No financial incentives. | PA | Proportion of participant-days 7000 step goal achieved during intervention (OB – smartphone app-integrated accelerometer) |
Proportion of participant-days 7000 step goal achieved during follow-up Daily steps – intervention and follow-up |
26 weeks |
| Patel et al. 201862 USA | Academic organisation (University of Pennsylvania) | RCT (4 arm) |
n = 209 23% M, 77% F Age IG1: 41.2±11.1 IG2: 40.6±10.5 IG3: 42.9±10.3 CG: 40.0±11.0 Overweight and obese employees (BMI ≥27 kg/m2) |
Smartphone app with integrated accelerometer | ‘Moves’ smartphone app (Proto Geo Oy, Finland) for step tracking. Daily feedback on steps. Monetary incentives: IG1 = higher frequency, smaller reward lottery IG2 = jackpot lottery IG3 = combined lottery |
Smartphone app and daily feedback (as intervention group). No financial incentives. | PA | Proportion of participant-days 7000 step goal achieved during intervention (OB – smartphone app-integrated accelerometer) |
Proportion of participant-days 7000 step goal achieved during follow-up Daily steps – intervention and follow-up |
26 weeks |
| Poirier et al. 201646 USA | Wellbeing improvement company (Healthways Inc) | RCT |
n = 265 34% M, 66% F Age IG: 40.3±11.4 CG: 39.6±12.0 Headquarter-based employees |
Wearable activity monitor (linked with website, and optional text messages) | Hip- or shoe-worn Pebble+ activity monitor (Fitlinxx Inc, USA) used with ‘Walkadoo’ internet-based program. Electronic messaging. | One week of blinded activity monitor wear, then instructed to maintain their usual activity routine. | PA | Daily steps (OB – activity monitor and website) |
Proportion of participants increasing steps by 1000/day Engagement with intervention – wear time, e-mail opening and website visits |
6 weeks |
| Reijonsaari et al. 2009 (protocol)47 Reijonsaari et al. 2012 (results)48 Finland |
Insurance company | RCT |
n = 544 (521 included in analysis) 36% M, 64% F Age IG: 43±10.0 CG: 44±10.0 Mainly clerical employees (working ≥8 h per week) |
Wearable activity monitor (linked with website) | Belt-worn ‘AM 200’ activity monitor/ accelerometer (PAM BV, Netherlands) used with associated website. Educational materials on PA. Written results of fitness tests. Distance counselling (telephone/online) |
Educational materials on PA. Written results of fitness tests. | PA | Weekly MET-minutes of total activity Work productivity Sickness absence (SR – MET-minutes from IPAQ, productivity from QQ instrument but objective sickness absence data) |
Body weight (kg) Waist circumference (cm) Body fat percentage Systolic and diastolic BP (mmHg) Aerobic fitness (maximal oxygen uptake, VO2 max, ml/kg/min) |
12 months |
| Reed et al. 201863 Canada | Tertiary care cardiovascular institute (University of Ottawa Heart Institute) | Parallel-group randomised trial (3-arm) |
n = 76 3% M, 97% F Age 46.3±10.9 Nurses |
Wearable activity monitor (linked with website) | Ankle-worn Tractivity® activity monitor (Tractivity®, Vancouver, BC) linked with website for monitoring PA and taking part in challenges: IG1 = individual challenge IG2 = friend challenge IG3 = team challenge |
No control or comparison group | PA | MVPA (weekly minutes in bouts ≥10 mins) Daily steps (OB – data from Tractivity® activity monitor) |
Body mass (kg) BMI Waist circumference Body fat % Resting systolic BP |
6 weeks |
| Rowe-Roberts et al. 201449 Australia | Private healthcare and insurance company (Australian Unity group) | Prospective cohort (uncontrolled pilot) |
n = 212 38% M, 62% F Age 42% under 35 35% 35-44 15% 45-54 8% 55+ Adult employees |
Wearable activity monitor | Waist-worn Fitbit Ultra activity monitor (Fitbit, USA) | No control or comparison group | PA | Daily steps (OB – step data from Fitbit) |
AUSDRISK (Australian Type 2 Diabetes Risk Assessment Tool) score Engagement with intervention (activity monitor wear) Qualitative outcomes (survey and focus groups) – experiences, engagement and activity, preferred motivational strategies |
7 months |
| Schrager et al. 201750 USA | Academic emergency medicine residency | Prospective cohort (pre- and post- uncontrolled pilot) |
n = 30 53% M, 47% F Age Median 28 years (IQR = 4.0) Physicians on a single site |
Wearable activity monitor and smartphone app (or website) | Wrist-worn Fitbit Flex activity monitor (Fitbit, USA) used with Fitbit app and/or website | No control or comparison group | PA | Days per week with ≥30 min PA (SR) |
Days per week with ≥10,000 steps or ≥30 min of active time (as measured by Fitbit at one month) Qualitative outcomes (survey) – adoption and use of device, measures of wellness, changes in PA behaviour |
6 months |
| Simons et al. 2018 (app development and feasibility)64 Simons et al. 2018 (results of RCT)65 Belgium |
Multiple workplaces in Flanders, Belgium (including retail, catering, social employment and factories) | Study 2, 2018b = Cluster RCT (study 1, 2018a was a qualitative evaluation and impact on PA/SB not reported) |
n = 130 (29 clusters) 49% M, 51% F Age IG: 24.8±3.1 CG: 25.1±3.0 Lower educated (i.e. no university or college degree) working young adults, not meeting PA guidelines at baseline (<150 min MVPA/week) |
Wearable activity monitor and smartphone app | Wrist-worn Fitbit Charge activity monitor (Fitbit, USA) used with ‘Active Coach’ app for monitoring PA | Educational brochure on PA only (generic information) | PA | Daily minutes of light, moderate and vigorous intensity PA (OB - ActiGraph™ GT-3x+ accelerometer) |
Daily steps (from Fitbit) Self-reported context-specific PA (IPAQ) Psychosocial variables: social support, attitude (perceived benefits and barriers), self-efficacy, knowledge and intentions Engagement: usage statisticsProcess evaluation interviews: Opinions on Fitbit and app (e.g. usability, preferred features) |
21 weeks |
| Skogstad et al. 201651 Norway | Road maintenance enterprise | Prospective cohort (pre- and post- uncontrolled) |
n = 121 64% M, 36% F Age M = 41.8±12.0 F = 42.6±12.5 24% road workers, 76% office workers |
Wearable activity monitor (linked with website) | Wrist-worn Tappa® activity monitor/ accelerometer used with associated website (Dytt®) for step tracking.Rewards given for best performances. | No control or comparison group | PA | Weekly exercise frequency and duration (SR) |
Aerobic fitness (maximal oxygen uptake, VO2 max, ml/kg/min) Systolic and diastolic BP (mm Hg) Resting heart rate Lipids (total, HDL and LDL cholesterol) C-reactive protein (CRP) Glycosylated haemoglobin (HbA1c) |
8 weeks (approx.) |
| Slootmaker et al. 200952 Netherlands | 8 worksites surrounding Amsterdam (mainly office settings) | RCT |
n = 102 40% M, 60% F Age IG: 32.5±3.4 CG: 31.2±3.5 Mainly office workers |
Wearable activity monitor (linked with website) | Belt-worn ‘AM 101’ activity monitor/ accelerometer (PAM BV, Netherlands) used with associated website (PAM COACH). | Educational booklet on PA only | PA + SB | Weekly PA and sedentary time – weekly minutes of light, moderate and vigorous intensity activity and sedentary minutes (SR – assessed by the AQuAA questionnaire) |
Self-reported determinants of PA – including behavioural intention, attitude, social influence, self-efficacy, knowledge of PA recommendations Aerobic fitness (maximal oxygen uptake, VO2 max, ml/kg/min) Body composition – body weight and height (BMI), waist and hip circumference, skin fold thickness (% body fat) |
8 months |
| Thorndike et al. 201453 USA | Healthcare organisation (Massachusetts General Hospital) | Phase 1 = RCT Phase 2 = team-based prospective cohort (pre- and post- uncontrolled) |
n = 104 46% M, 54% F Age Mean and range (SD not reported) IG: 29 (23–36) CG: 29 (25–37) Physicians-in-training |
Wearable activity monitor (linked with website) | Fitbit activity monitor (Fitbit, USA) used with Fitbit website. Gift card lottery for wearing device (phase 1) and highest steps (phase 2). Workplace initiatives: access to fitness centres, personal training and nutritionists, weekly healthy lunch |
Phase 1 – blinded activity monitor (no access to website). Gift card lottery and workplace initiatives (as intervention group). Phase 2 – no control or comparison group |
PA | Daily step count (phase 1 median and mean steps/day, phase 2 mean steps/day) (OB – step data from Fitbit) |
Proportion of days activity monitor was worn (i.e. compliance) Weight BMI Waist circumference Systolic and diastolic BP Lipids (total, HDL and LDL cholesterol) Use/engagement with the wider wellness programme (e.g. fitness centre, nutrition) |
12 weeks |
| Torquati et al. 201866 Australia | Two metropolitan hospitals in Brisbane (private and public) | Prospective cohort (pre- and post- uncontrolled pilot) |
n = 47 13% M, 87% F Age 41.4±12.1 Nurses and nursing managers |
Smartphone app | Smartphone app for PA and diet with non-interactive pedometer and dedicated Facebook group | No control or comparison group | PA + SB | Time spent sedentary and in light activity and MVPA Daily steps (OB - ActiGraph™ GT-3x+ accelerometer) |
Diet behaviour: Food Frequency Questionnaire (FFQ) Weight BMI Waist circumference Blood pressure Self-rated health PA and diet self-efficacy Social support Feasibility outcomes (including qualitative interviews): reach, adoption (use) and implementation |
6 months |
| van Dantzig et al. 201354 Netherlands |
Offices at various companies in Netherlands (no further detail given) | Experiment 2 = RCT (experiment 1 was a small qualitative evaluation and impact on PA/SB not reported) |
n = 86 60% M, 40% F Age IG: 44.5±7.9 CG: 44.3±8.0 Sedentary office workers |
Wearable activity monitor (linked with website, and persuasive text messages) | Clip-on commercial activity monitor (tri-axial accelerometer, model not stated) linked with personal web page for viewing PA data. Timely persuasive text messages on smartphones. |
Activity monitor only. No text messages. |
SB | Computer activity (minutes, proxy for SB) Physical activity (minutes) (OB – computer activity from computer software; PA from activity monitor) |
Engagement with the intervention (proportion of text messages read) | 6 weeks |
| Yeung et al. 201759 USA | Academic hospital residency (Cincinnati, Ohio) | Prospective cohort (pre- and post- uncontrolled crossover study) |
n = 86 38% M, 62% Fb Ageb 62% 21–30 31% 31–40 5% 41–50 Internal medicine residents |
Wearable activity monitor and smartphone app (or website) | Wrist-worn Fitbit Flex (Fitbit, USA) used with Fitbit app and/or website for monitoring steps (weeks 1–4 blinded, weeks 5–8 unblinded). Optional in-app activity tracking group for weeks 5–8. | No control or comparison group | PA | Daily steps (comparison of blinded vs. unblinded periods) (OB – step data from Fitbit) |
Proportion of participants achieving ≥10,000 steps/day | 8 weeks |
M: male; F: female; IG: intervention group; CG: control/comparison group; FTE: full time equivalent; PA: physical activity; SB: sedentary behaviour; OB: objective; SR: self-reported; QoL: quality of life; RCT: randomised controlled trial; ± or SD: standard deviation; MVPA: moderate to vigorous physical activity; BP: blood pressure; BMI: body mass index; MET: metabolic equivalent; IPAQ: international physical activity questionnaire; QQ: Quantity and Quality questionnaire; IQR: Interquartile Range; HDL: high-density lipoprotein; LDL: low-density lipoprotein; AQuAA: Activity Questionnaire for Adolescents and Adults; CDC: Centers for Disease Control and Prevention
aTools may be referred to as activity monitors or trackers in the literature; the term ‘monitor’ is used here for consistency.
bYeung et al. and Olsen et al. report gender and age of study completers only.