How APPropriate are physical activity apps for pregnant women appropriate: A systematic search and content analysis of evidence-based content, features of exercise instruction, and expert involvement (Preprint)

BACKGROUND Guidelines on physical activity/exercise during pregnancy recommend all women without contraindications engage in regular physical activity to improve both their own health and the health of their baby. Many women are uncertain how to safely engage in physical activity/exercise during this life-stage and are increasingly using mobile applications (apps) to access health-related information. However, the extent to which apps provide physical activity/exercise advice aligns with current evidence-based pregnancy recommendations is currently unclear. OBJECTIVE The aim of this study was to conduct a systematic search and content analysis of apps that promote physical activity/exercise in pregnancy to examine: (1) alignment of the content with current evidence-based recommendations; (2) delivery, format and features of physical activity/exercise instruction; and (3) credentials of app developers. METHODS Systematic searches were conducted in the Australian AppStore and GooglePlay stores in October 2020. Apps were identified using combinations of search terms relevant to pregnancy and physical activity/exercise and screened for inclusion (primary focus on physical activity/exercise during pregnancy, free to download or did not require immediate paid subscription and an average user rating of 4+ out of 5). Each app was then independently reviewed using an author-designed extraction tool. Data were exported, collated, and reported using descriptive statistics. RESULTS Twenty-seven apps were included in this review (GooglePlay: n=16 and AppStore: n=11). All were exercise-based apps that predominately recommended structured and purposeful activity. Two-thirds (n=17) provided some information relating to each of the FITT principles (frequency, intensity, time, type) of exercise; however, only three provided this information in-line with current evidence-based guidelines. Just over one-third of apps (n=10) provided information about contraindications to exercise during pregnancy and referenced the supporting evidence. No apps actively engaged in screening for potential contraindications. Only four apps collected information about the user’s current exercise behaviours, three apps allowed users to personalise features relating to their exercise preferences, and just over one-third (n=10) provided information about developer credentials. CONCLUSIONS Our findings showed that few exercise apps designed for pregnancy aligned with current evidence-based physical activity guidelines. No apps screened users for contraindications to physical activity/exercise during pregnancy and most lacked appropriate personalisation features to account for individual characteristics. Few involved qualified experts during the development of the app. As such, there is a need to improve the quality of apps that promote exercise in pregnancy, to ensure women are appropriately supported to engage in exercise, and the potential risk of injury, complications and/or adverse pregnancy outcomes for both mother and child is minimised. This could be done by providing expert guidance that aligns with current recommendations, introducing screening measures and features that enable personalisation and tailoring to individual users, or by developing a recognised system for regulating apps. CLINICALTRIAL Not required

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German Recommendations for Physical Activity and Physical Activity Promotion in Adults with Noncommunicable Diseases

10.1101/19008953 ◽

2019 ◽

Cited By ~ 2

Author(s):

Wolfgang Geidl ◽

Karim Abu-Omar ◽

Mayra Weege ◽

Sven Messing ◽

Klaus Pfeifer

Keyword(s):

Physical Activity ◽

Content Analysis ◽

Chronic Conditions ◽

Phase 1 ◽

Quality Criteria ◽

Noncommunicable Diseases ◽

Moderate Intensity ◽

Chronic Obstructive ◽

Evidence Based ◽

Activity Promotion

ABSTRACTBackgroundThe objective of this study was to develop evidence-based recommendations for physical activity (PA) and PA promotion for German adults (18–65 years) with noncommunicable diseases (NCDs).MethodsThe PA recommendations were developed based on existing PA recommendations and using a three-phased process. In phase 1, systematic literature searches were conducted for current PA recommendations for seven chronic conditions (osteoarthrosis of the hip and knee, chronic obstructive pulmonary disease, stable ischemic heart disease, stroke, clinical depression, and chronic non-specific back pain). In phase 2, the PA recommendations were evaluated on the basis of 28 quality criteria. High-quality recommendations were identified, and a content analysis was conducted on these recommendations. In phase 3, the findings of the content analysis were summarised, and PA recommendations for seven chronic conditions were deducted. The seven recommendations were then synthesised to generate generic German PA recommendations for adults with noncommunicable diseases (NCDs). In relation to the recommendations for PA promotion, a systematic literature review was conducted on papers that reviewed the efficacy/effectiveness of interventions for PA promotion in adults with NCDs.ResultsThe German Recommendations for Physical Activity state that adults with NCDs should, over the course of a week, should do at least 150 minutes of moderate-intensity aerobic PA, or 75 minutes of vigorous-intensity aerobic PA, or a combination of both. Furthermore, muscle-strengthening activities should be performed at least twice a week. The promotion of PA among adults with NCDs should be theory-based, specifically target PA behaviour, and be tailored to the respective target group. In this context, and as an intervention method, exercise referral schemes are one of the more promising methods of promoting PA in adults with NCDs.ConclusionThe development of evidence-based recommendations for PA and PA promotion is an important step in terms of the initiation and implementation of actions for PA-related health promotion in Germany. The German Recommendations for PA and PA promotion inform adults affected by NCDs and health professionals on how much PA would be optimal for adults with NCDs. Additionally, the recommendations provide professionals entrusted in PA promotion the best strategies and interventions to raise low PA levels in adults with NCDs. The formulation of specific PA recommendations for adults with NCDs and their combination with recommendations on PA promotion is a unique characteristic of the German recommendations.

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Evidence-based risk assessment and recommendations for physical activity clearance: pregnancy1This paper is one of a selection of papers published in this Special Issue, entitled Evidence-based risk assessment and recommendations for physical activity clearance, and has undergone the Journal’s usual peer review process.

Applied Physiology Nutrition and Metabolism ◽

10.1139/h11-061 ◽

2011 ◽

Vol 36 (S1) ◽

pp. S33-S48 ◽

Cited By ~ 14

Author(s):

Sarah Charlesworth ◽

Heather J.A. Foulds ◽

Jamie F. Burr ◽

Shannon S.D. Bredin

Keyword(s):

Physical Activity ◽

Risk Assessment ◽

Adverse Event ◽

Pregnant Women ◽

Event Rate ◽

Scientific Information ◽

Well Being ◽

Adverse Event Rate ◽

Evidence Based ◽

Exercise During Pregnancy

Recommendations for physical activity during pregnancy have progressed significantly in the last 30 years and continue to evolve as an increasing body of scientific evidence becomes available. In addition, there is an increasing number of women who wish to either maintain physical fitness levels during the prenatal period or initiate exercise for a healthier lifestyle during pregnancy. As such, consistent evaluation of the risks associated with exercise during pregnancy is warranted for maternal and fetal well-being. The primary purpose of this systematic review was to evaluate the scientific information available regarding maternal and fetal responses as it relates to the occurrence of adverse exercise-related events in pregnant women without contraindications to exercise. A systematic and evidence-based approach was used to analyze critically the level of evidence for risks associated with acute and chronic exercise during pregnancy in healthy pregnant women. All articles were screened according to standardized evaluation criteria developed by a panel of experts. A total of 74 investigations that involved 3766 pregnant women were included in the analysis. Of the 74 studies, only 35 studies documented the presence or absence of adverse events. The serious adverse event rate for these studies was 1.4 per 10 000 h of exercise. The adverse event rate increased to 6.8 per 10 000 h of exercise when including the occurrence of more mild events and exercise-related fetal bradycardia and tachycardia. Previously inactive or active women (without contraindications) are at a low risk for adverse fetal or maternal events if they participate in routine physical activity during pregnancy.

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Smartphone Apps Targeting Alcohol and Illicit Substance Use: Systematic Search in in Commercial App Stores and Critical Content Analysis (Preprint)

10.2196/preprints.11831 ◽

2018 ◽

Author(s):

Babak Tofighi ◽

Chemi Chemi ◽

Jose Ruiz-Valcarcel ◽

Paul Hein ◽

Lu Hu

Keyword(s):

Substance Use ◽

Content Analysis ◽

Substance Use Disorders ◽

Low Cost ◽

Descriptive Analysis ◽

Systematic Search ◽

Evidence Based ◽

Smartphone Apps ◽

Illicit Substance Use ◽

Critical Content

BACKGROUND Smartphone apps promise to enhance the reach of evidence-based interventions (cognitive behavior therapy, contingency management and therapeutic education system) for populations with substance use disorders, with minimal disruption to health systems. However, further studies are needed to systematically evaluate smartphone apps targeting alcohol and illicit substances. OBJECTIVE The aim of this study was to evaluate the functionality, aesthetics, and quality of information of free or low-cost apps claiming to target alcohol, benzodiazepine, cocaine, crack/cocaine, crystal methamphetamine, and heroin use using the validated Mobile App Rating Scale (MARS) and critical content analysis. METHODS A systematic search of iTunes and Google Play app stores for free or low-cost apps facilitating recovery was conducted in March 2018 and yielded 904 apps using the keywords described in previous studies (eg, recovery, sobriety, sober, alcohol, and heroin). An interdisciplinary team of clinicians, behavioral informatics, and public health reviewers trained in substance use disorders conducted a descriptive analysis of 74 apps categorized as reducing use. In addition to the MARS scale, a descriptive analysis of relevant apps was conducted by the study team to assess for quality indicators emphasized by expert guidelines and review articles. RESULTS Most apps (n=74) claimed to reduce use or promote abstinence and yielded an overall low median MARS score of 2.82 (0.55) and a wide range of scores (1.64, 4.20). Ratings were also low for engagement (2.75 (0.72)), functionality (3.64 (0.78)), aesthetics (3.03 (0.87)), information (2.82 (0.62)), and satisfaction (1.76 (0.67)) subdomains. Innovative design and content features elicited in the review included initial assessments of substance use following app download, tracking substance use, and related consequences (eg, cost or calorie intake), remote and proximate peer support per geospatial positioning, and allowing users and family members of individuals with substance use disorders to locate 12-step meetings, treatment programs, and mental health services. Few apps integrated evidence-based psychotherapeutic (eg, cognitive behavioral therapy [CBT] or motivational interviewing) and pharmacologic interventions (eg, naloxone or buprenorphine). CONCLUSIONS Few commercially available apps yielded in our search integrated evidence-based interventions (eg, extended-release naltrexone, buprenorphine, naloxone, Self-Management and Recovery Training recovery, or CBT), and a concerning number of apps promoted harmful drinking and illicit substance use.

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