Date Presented 03/28/20
Being physically active is important for health and well-being; however, adults frequently do not engage in recommended levels of physical activity. This paper presents a systematic review and meta-ethnography of adults’ experiences using mobile health applications to support participation in physical activity. The findings will advance the ability of OTs to effectively use these novel interventions where service users aspire to increase their physical activity levels.
Primary Author and Speaker: Daniel Carter
Contributing Authors: Katie Robinson, John Forbes, Sara Hayes
PURPOSE: Physical activity is critical for the prevention and management of chronic conditions, including cardiovascular disease, cancer, and mental ill health (Powell et al., 2019). Despite this, adults in the United States frequently do not meet national physical activity guidelines (Kamil-Rosenberg, Greaney, Hochman, & Garber, 2019). To address this disparity, mobile health (mHealth) (i.e. the use of mobile devices, including smartphones and mobile applications, to improve health) is being incorporated into interventions to support participation in physical activity. Occupational therapists have a responsibility in promoting physical activity (Handcock & Tattersall, 2012) and mHealth presents as a novel tool at their disposal. Qualitative research is useful for understanding how technology can be used to support occupational therapists with prescribing and incorporating these tools into their intervention planning. The current systematic review aims to synthesize the experiences of adults using mHealth applications for the promotion of physical activity.
DESIGN/METHOD: A systematic search of five databases (CINAHL, Embase, ERIC, Medline and PsycINFO) was conducted in October 2017. Primary studies reporting qualitative research focused on the experiences of adults using mHealth applications for physical activity promotion were included. The quality of each study was appraised using the CASP Qualitative Checklist. Data were extracted to NVivo 12 and synthesized using Noblit and Hare’s approach to meta-ethnography.
RESULTS: The initial search produced 4,420 articles. Following screening, 15 articles met the inclusion criteria. No studies were excluded on the basis of quality. The general population and a variety of health statuses were represented, including those with diabetes, serious mental illness, and obesity. Overall, the experience of using mHealth applications for the promotion of physical activity was perceived positively. Experiences of personalization (e.g. feedback in the form of step count) were valued, particularly when paired with goal setting. Negative experiences were associated with poor design (e.g. excessive data entry) and technical issues (e.g. battery faults, inaccurate data). Overall, findings indicate that mHealth raises individuals’ awareness of their physical activity level, supporting them to identify ways of strategizing to incorporate physical activity into their routines.
CONCLUSION: The positive experiences of mHealth identified across the included studies paired with the ubiquity of smartphones suggests that mHealth applications can be an appropriate tool for occupational therapists working with clients who aspire to increase their participation in physical activity. The finding that negative experiences were not uncommon indicates that care must be taken when prescribing applications. This aligns with findings from a recently conducted survey of occupational therapists’ opinions on prescribing applications in the United States. The authors reported that a “one-size-fits-all” approach is typically not adopted by practitioners. Instead, they used applications with small portions of their caseload and targeted specific skills or supporting participation in everyday life activities (Seifert, Stotz, & Metz, 2017). Given the diverse populations included in the current study and the value placed on personalization, further research which explores the use of mHealth applications to support participation in physical activity for clients living with various health conditions is warranted.
References
Powell, K. E., King, A. C., Buchner, D. M., Campbell, W. W., DiPietro, L., Erickson, K. I., . . . Katzmarzyk, P. T. (2019). The scientific foundation for the Physical Activity Guidelines for Americans. Journal of Physical Activity and Health, 16(1), 1-11. doi:10.1123/jpah.2018-0618
Kamil-Rosenberg, S., Greaney, M. L., Hochman, T., & Garber, C. E. (2019). How Do Physical Activity and Health Vary Among Younger, Middle-Aged, and Older Adults With and Without Disability? Journal of aging and physical activity, 27(2), 234-241. doi:10.1123/japa.2017-0215
Handcock, P., & Tattersall, K. (2012). Occupational therapists beware: physical activity guidelines can mislead. British Journal of Occupational Therapy, 75(2), 111-113. doi:10.4276/030802212X13286281651270
Seifert, A. M., Stotz, N., & Metz, A. E. (2017). Apps in therapy: occupational therapists’ use and opinions. Disability and Rehabilitation: Assistive Technology, 12(8), 772-779. doi:10.1080/17483107.2016.1262912
