The American Heart Association has published a literature review spanning 23 years of research that suggests programs based on the internet or mobile devices can encourage heart-healthy behaviors and positive lifestyle changes. More specific details, like what program components appeared to be most effective, were also explored.
The researchers looked at 224 studies published between 1990 and 2013 that focused on healthy adults. Each study looked at the use of the internet, cell phones, computer software tools, and personal sensors in order to encourage certain heart-healthy behavior changes. Depending on the study in question, this could include reducing tobacco or alcohol use, making diet improvements, increasing physical activity, etc.
The review found that these programs were largely effective. Internet-based programs had the ability to improve diets, encourage more physical activity, get people to lose weight or reduce body fat, and could reduce the rate of alcohol and tobacco use. Programs based on mobile devices such as smartphone apps, texts, or voicemail messages, showed the ability to promote physical activity and the loss of body fat or weight.
When specific elements of the programs were inspected, it was found that plans which incorporated goal-setting, self-monitoring, multiple communication methods, or tailored messages had the greatest signs of success. Improvements were also seen when the program included interactions with a healthcare provider.
Limits of the Study
The scope of this review is impressive since it covers both the early days of the internet and pre-smartphone era to today’s highly connected world. It does, however, still suffer from some drawbacks. The main issue is that most of the studies lasted less than half a year, so little insight can be gained regarding how sustainable the programs’ gains were. Although not specifically a flaw in the research design, it is worth noting that studies with participants who had chronic problems like cardiovascular disease do not seem to have been included. While this doesn’t impact the meaning of the findings themselves, it would have been nice to know whether internet and mobile device-based programs had different effects on someone who already had a cardiovascular disease or suffered from diabetes.
The researchers conclude that, although their findings suggest mobile device and internet programs can encourage heart-healthy behavior and positive lifestyle changes, it also exposes gaps in existing literature. More work is advised for determining long-term effectiveness and improving adherence and sustainability.
“Internet, mobile devices can help make healthy lifestyle changes,” American Heart Association web site, August 31, 2016; http://news.heart.org/internet-mobile-devices-can-help-make-healthy-lifestyle-changes/, last accessed September 1, 2016.