Population-Wide mHealth Interventions Promoting Healthy Movement Behaviors: Systematic Review of the Real-World Evidence.

Abstract

Background: Mobile health (mHealth) interventions offer scalable opportunities to promote healthy movement behaviors, but their real-world effectiveness and implementation remain unclear. This review aims to evaluate scaled-up mHealth interventions targeting physical activity, sedentary behavior, and sleep at a population level and in real-world settings using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework.

Methods: Systematic searches were conducted across 5 databases (PubMed, Embase, Scopus, Web of Science, and PsycINFO). Studies were included if they targeted an entire population or population group, used mHealth, promoted at least one movement behavior, and reported RE-AIM-related outcomes (RE-AIM) either implicitly or explicitly. Study and intervention characteristics alongside RE-AIM-related indicators were extracted and synthesized narratively.

Results: From 9385 records, 43 studies reporting on 24 interventions were included. All were nonrandomized studies and targeted physical activity, with 21.0% also addressing sedentary behavior and 4.8% including sleep. Median reporting across RE-AIM indicators was 6.5 out of 14, with Reach most commonly reported (3 out of 4 indicators), followed by Implementation (2 out of 4), Maintenance (1 out of 2), Effectiveness (1 out of 2), and Adoption (0 out of 2). Representativeness was often assessed by age and sex, but rarely by socioeconomic status or ethnicity. Most interventions had positive effects on movement behavior, and 9.5% assessed cost-effectiveness.

Conclusions: While mHealth interventions show promise for promoting movement behaviors, gaps in evaluation and reporting persist, limiting our understanding of their real-world impact. Future research should prioritize rigorous evaluations and comprehensive reporting to strengthen the case for scalable, sustainable mHealth interventions.