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Physical Activity: Digital Health Interventions for Adults 55 Years and Older

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What the CPSTF Found

About The Systematic Review

The CPSTF uses recently published systematic reviews to conduct accelerated assessments of interventions that could provide program planners and decision makers with additional, effective options. The following published review was selected and evaluated by a team of specialists in systematic review methods, and in research, practice, and policy related to physical activity:

Muellmann S, Forberger S, Mollers T, Broring E, Zeeb H, Pischke CR. Effectiveness of eHealth interventions for the promotion of physical activity in older adults: a systematic review. Preventive Medicine 2018;108:93-110.

The published review included 20 studies (search period through March 2017). The CPSTF finding is based on results from the published review, additional analyses of data from included studies, and expert input from team members and the CPSTF.

Summary of Results

Detailed results from the systematic review are available in the CPSTF Finding and Rationale Statement.

The systematic review and meta-analysis included 20 studies.

  • Compared to interventions without a digital health intervention or to usual care, digital health interventions increased physical activity by 28% (17 studies).
    • Web-based interventions increased physical activity by a median of 28% (9 studies)
    • Telephone-based interventions increased physical activity by a median of 42% (5 studies)
    • Text message-based interventions increased physical activity by a median of 23% (3 studies)

Summary of Economic Evidence

A systematic review of economic evidence has not been conducted.

Applicability

Based on results from the review, findings should be applicable to recruited adults aged 55 years and older. Reporting of other participant characteristics including socioeconomic status, race, and ethnicity was limited.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • What are the longer-term effects of these interventions (i.e., 6-12 months following implementation)? Longer term studies would allow researchers to examine the effects of increased physical activity on clinical and health outcomes.
  • How do interventions affect rates of injuries, including falls? How do rates vary between active, inactive, and comparison group participants?
  • How does effectiveness vary by participant race, ethnicity, and socioeconomic status?
  • How are participation and effectiveness affected by the integration of enhanced technologies, such as smartphones, with monitoring functions?

Study Characteristics

  • Studies included 18 randomized controlled trials and two quasi-experimental designs.
  • Studies were conducted in the United States (11 studies), The Netherlands (3 studies), Belgium (2 studies), Australia (1 studies), New Zealand (1 study), Spain (1 study), and Malaysia (1 study).
  • Interventions used web or internet content (9 studies), telephone contact (6 studies), text messages (3 studies), and a mobile application (app; 1 study).
  • Interventions were provided for a median of 3 months.
  • The median age of study participants was 64 years. In four studies, the median age of recruited adults was 70 years or older, and results from this subset were similar to the overall findings.

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