Physical Activity: Interventions Including Activity Monitors for Adults with Overweight or Obesity

The Community Preventive Services Task Force (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 increasing physical activity.

de Vries HJ, Kooiman TJM, van Ittersum MW, van Brussel M, de Groot M. Do activity monitors increase physical activity in adults with overweight or obesity? A systematic review and meta-analysis. Obesity 2016;24(10):2076-91.

The review included 14 randomized controlled trials and a meta-analysis of 11 of these studies (search period through July 2015). The team examined each of the studies included in the systematic review and abstracted supplemental information about study, intervention, and population characteristics.

The CPSTF finding is based on results from the published review, additional information from the included studies, and expert input from team members and the CPSTF.

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

The systematic review included 14 randomized controlled trials and a meta-analysis of 11 of these studies.

• When compared with usual care or wait list controls, interventions reported statistically significant increases in steps per day and minutes spent engaging in moderate-to-vigorous physical activity per week (7 studies).
• Studies that reported the incremental benefit of adding an activity monitor to a behavioral intervention reported non-significant increases in minutes spent engaging in moderate-to-vigorous physical activity per week (7 studies).
  
  • A subset of these studies reported favorable but small effects on weight-related outcomes (5 studies).
• Only four studies ran longer than three months and outcomes were mixed, suggesting a need for additional research on longer-term effects.

A systematic review of economic evidence has not been conducted.

While additional research is warranted, the CPSTF finding is likely applicable to recruited adults in the United States with overweight or obesity.

Additional research and evaluation are needed to answer the following questions and fill existing gaps in the evidence base. (What are evidence gaps?)

• What is the longer-term effectiveness of these combined interventions (i.e., 6-12 months following intervention)?
• What are intervention effects on clinical and health outcomes?
• Are interventions effective with older adults?
• How does effectiveness vary by participants’ race, ethnicity, and socioeconomic status?
• How effective are interventions that use enhanced activity monitors, smartphones, or other newer technologies?
• What would be the effect of integrating enhanced content and interactivity (e.g., social support networks, prompts and reminders, rewards, behavioral self-monitoring) into these interventions?

• All 14 studies were randomized controlled trials.
• Studies were generally small; the median number of recruited participants was 69.
• Studies recruited substantially more women (80% women; 9 studies), although interventions were also effective in gender-restricted studies for men (3 studies) and women (1 study).
• The review did not include studies conducted on adults ages 60 years or older.
• Intervention and study periods were of short duration (median 12 weeks), and did not provide post-intervention follow-up.
• Studies added pedometers (10 studies) and accelerometers (4 studies) to behavioral interventions.
• Behavioral components included individual counseling (5 studies) and educational sessions (9 studies) on physical activity promotion or weight management.
• Activity monitor use was integrated within the behavioral intervention through specific step count goals (7 studies), participant activity logs (10 studies), and provider review and feedback (6 studies).
• Included studies were conducted in the United States (8 studies), Australia (4 studies), Canada (1 study), and Scotland (1 study).