Effectiveness of step-count monitoring interventions in increasing physical activity among children and adolescents: A systematic review and meta-analysis.

Objective: This study aimed to evaluate the effect of step-count monitoring interventions on objectively measured physical activity-related outcomes in children and adolescents.

Methods: This review was designed and conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The following five electronic databases were searched to identify relevant studies: PubMed, Web of Science, SCOPUS, SPORTDiscus, and Cochrane Library. The search was performed from the date of database inception to December 7, 2024. Meta-analyses were conducted to evaluate the pooled effects of the interventions on daily steps, accelerometer-measured moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), and sedentary behavior (SB).

Results: Thirty-four studies were selected for this meta-analysis. Step-count monitoring interventions could significantly increase daily steps (MD 1588.83 steps/day; 95% CI 1033.94 to 2143.72; P < 0.01) and tended to significantly reduce SB (MD -3.42 min/day; 95% CI -6.83 to -0.01; P = 0.05). However, they had no significant effects on MVPA (MD 0.59 min/day; 95% CI -3.46 to 4.64; P = 0.78) and LPA (MD 1.29 min/day; 95% CI -1.44 to 4.03; P = 0.35). Subgroup analyses indicated that step-count monitoring interventions offered greater benefits for increasing MVPA in children (MD 6.09 min/day; P < 0.01) than in adolescents (MD -3.79 min/day; P = 0.13). Pedometer-based interventions (MD 1757.58 steps/day; P < 0.01) were more effective at increasing daily steps than those involving other emerging step-count monitoring devices (MD 406.12 steps/day; P = 0.37).

Conclusions: Step-count monitoring interventions may be appropriate and effective for increasing total physical activity and reducing SB in children and adolescents. Moreover, these interventions may serve as an optional approach for increasing MVPA in children. We recommend a "less is more" strategy with regard to step-count monitoring interventions for increasing physical activity in children and adolescents.