Effectiveness of healthcare interventions using objective feedback on physical activity: A systematic review and metaanalysis

Objective: To determine the effectiveness of healthcare interventions promoting physical activity, which use objective feedback on physical activity delivered using wearable activity monitors as part of the intervention. Intervention groups are compared with control groups receiving usual care or interventions without objective feedback. Data sources: PubMed, EMBASE, MEDLINE and Cochrane Library were searched to identify randomized controlled trials. Study selection: Randomized controlled trials published after 2007 with (former) healthcare patients ≥ 21 years of age were included if physical activity was measured objectively using a wearable monitor for both feedback and outcome assessment. The main goal of included studies was promoting physical activity. Any concurrent strategies were related only to promoting physical activity. Data extraction: Effect sizes were calculated using a fixed-effects model with standardized mean difference. Information on study characteristics and interventions strategies were extracted from study descriptions. Data synthesis: Fourteen studies met the inclusion criteria (total n = 1,902), and 2 studies were excluded from meta-analysis. The overall effect size was in favour of the intervention groups (0.34, 95% CI 0.23-0.44, p < 0.01). Study characteristics and intervention strategies varied widely. Conclusion: Healthcare interventions using feedback on objectively monitored physical activity have a moderately positive effect on levels of physical activity. Further research is needed to determine which strategies are most effective to promote physical activity in healthcare programmes.