BACKGROUND
Smartphone applications (apps) have shown potential in enhancing weight management in the Western population in the short to medium term. With a rapidly growing obesity burden in the Asian populations, researchers are turning to apps as a service delivery platform to reach a greater target audience to efficiently tackle the problem.
OBJECTIVE
This systematic review and meta-analysis aimed to determine the efficacy of interventions incorporating apps in facilitating weight loss and health behavior change in the Asian population.
METHODS
Six databases were searched in June 2020. Eligible studies were controlled trials utilizing an app in the intervention in participants aged 18 years or above and from an Asian ethnicity. A meta-analysis to test intervention efficacy, subgroup analyses and post-hoc analyses were conducted to determine the effects of adding app to usual care and study duration. The primary outcome was absolute or percentage weight change while secondary outcomes were changes to lifestyle behaviors.
RESULTS
A total of 21 studies were included in this review and 17 were selected for the meta-analysis. The pooled effect size across 14 randomized controlled trials for weight change was small to moderate (Hedges’ g = -0.28, 95% CI = -0.44 to -0.12) however, this was not representative of long-term studies (more than a year). Stand-alone app interventions were inefficacious for weight loss but supplementing multi-component usual care with an app led to statistically significant weight change (Hedges’ g = -0.25 95% CI = -0.43 to -0.07). Asian apps were largely culturally adapted and multi-functional, with the most common app features being communication with health professionals and self-monitoring of behaviors and outcomes.
CONCLUSIONS
More evidence is required to determine the efficacy of apps in the long term and address app non-usage to maximize the potential of the intervention. Future research should determine the efficacy of each component of the multi-component intervention to facilitate study designs that are most effective and cost-efficient for weight management.
CLINICALTRIAL
PROSPERO REGISTRATION: CRD42020165240.
Using the Internet to Promote Health Behavior Change: A Systematic Review and Meta-analysis of the Impact of Theoretical Basis, Use of Behavior Change Techniques, and Mode of Delivery on Efficacy
