A Systematic Review of Application and Effectiveness of mHealth Interventions for Obesity and Diabetes Treatment and Self-Management

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ABSTRACT

The use of mobile and wireless technologies and wearable devices for improving health care processes and outcomes (mHealth) is promising for health promotion among patients with chronic diseases such as obesity and diabetes. This study comprehensively examined published mHealth intervention studies for obesity and diabetes treatment and management to assess their effectiveness and provide recommendations for future research. We systematically searched PubMed for mHealth-related studies on diabetes and obesity treatment and management published during 2000–2016. Relevant information was extracted and analyzed. Twenty-four studies met inclusion criteria and varied in terms of sample size, ethnicity, gender, and age of the participating patients and length of follow-up. The mHealth interventions were categorized into 3 types: mobile phone text messaging, wearable or portable monitoring devices, and applications running on smartphones. Primary outcomes included weight loss (an average loss ranging from −1.97 kg in 16 wk to −7.1 kg in 5 wk) or maintenance and blood glucose reduction (an average decrease of glycated hemoglobin ranging from −0.4% in 10 mo to −1.9% in 12 mo); main secondary outcomes included behavior changes and patient perceptions such as self-efficacy and acceptability of the intervention programs. More than 50% of studies reported positive effects of interventions based on primary outcomes. The duration or length of intervention ranged from 1 wk to 24 mo. However, most studies included small samples and short intervention periods and did not use rigorous data collection or analytic approaches. Although some studies suggest that mHealth interventions are effective and promising, most are pilot studies or have limitations in their study designs. There is an essential need for future studies that use larger study samples, longer intervention (≥ 6 mo) and follow-up periods (≥ 6 mo), and integrative and personalized innovative mobile technologies to provide comprehensive and sustainable support for patients and health service providers.

mHealth
intervention
obesity
overweight
diabetes

Abbreviations

APP
application run on a smartphone
HbA1c
glycated hemoglobin
mHealth
use of mobile and wireless technologies and wearable devices for improving the health care processes and outcomes
MPTM
mobile phone text messaging
PA
physical activity
RCT
randomized control trial
T2D
type 2 diabetes
WPMD
wearable or portable monitoring device

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Supported by research grants from the NIH (1R01HD064685-01A1, R01DK81335-01A1, U54 HD070725, and 2R42CA168107-02). The U54 project (U54 HD070725) is funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the Office of the Director, NIH.

The content of the article is solely the responsibility of the authors and does not necessarily represent the official views of the funders.

Author disclosures: H Xue, Y Huang, L Huang, and D Zhang, no conflicts of interest. Y Wang is the principal investigator of the first 3 projects listed above in the grant support from the NIH.