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J Am Coll Cardiol. 2016 May 31;67(21):2453-63. doi: 10.1016/j.jacc.2016.03.472. Epub 2016 Apr 3.

International Mobile-Health Intervention on Physical Activity, Sitting, and Weight: The Stepathlon Cardiovascular Health Study.

Author information

1
School of Medicine, Flinders University of South Australia, Adelaide, Australia; Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia. Electronic address: anand.ganesan@flinders.edu.au.
2
Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia.
3
Health Systems Research, South Australian Health and Medical Research Institute, Adelaide, Australia.
4
Stepathlon Private Limited, Mumbai, India.
5
Centre for Heart Rhythm Disorders, University of Adelaide, Adelaide, Australia; Health Systems Research, South Australian Health and Medical Research Institute, Adelaide, Australia.
6
School of Medicine, Flinders University of South Australia, Adelaide, Australia; Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia.
7
School of Medicine, Flinders University of South Australia, Adelaide, Australia; Department of Cardiovascular Medicine, Flinders Medical Centre, Adelaide, Australia; Health Systems Research, South Australian Health and Medical Research Institute, Adelaide, Australia.

Abstract

BACKGROUND:

Although proof-of-concept for mobile health (mHealth) life-style programs targeting physical inactivity and overweight/obesity has been established in randomized trials, the feasibility and effect of a globally distributed, large-scale, mass-participation mHealth implementation has not been investigated.

OBJECTIVES:

The purpose of this study was to determine the effect of Stepathlon, an international, low-cost, mass-participation mHealth intervention, on physical activity, sitting, and weight.

METHODS:

We prospectively collected cohort data from participants completing Stepathlon, an annual 100-day global event in 2012, 2013, and 2014. Participants were organized in worksite-based teams, issued pedometers, and encouraged to increase daily steps and physical activity as part of the team-based race. The program was conducted via an interactive multiplatform application available on mobile devices and the Internet. Analysis was performed according to a pre-specified plan.

RESULTS:

A total of 69,219 subjects participated (481 employers, 1,481 cities, 64 countries, all populated continents, age 36 ± 9 years, 23.9% female, 8.0% high-income countries, and 92.0% lower-middle income countries). After Stepathlon completion, participants recorded improved step count (+3,519 steps/day; 95% confidence interval [CI]: 3,484 to 3,553 steps/day; p < 0.0001), exercise days (+0.89 days; 95% CI: 0.87 to 0.92 days; p < 0.0001), sitting duration (-0.74 h; 95% CI: -0.78 to -0.71 h; p < 0.0001) and weight (-1.45 kg; 95% CI: -1.53 to -1.38 kg; p < 0.0001). Improvements occurred in women and men, in all geographic regions, and in both high and lower-middle income countries, and the results were reproduced in 2012, 2013, and 2014 cohorts. Predictors of weight loss included step increase, sitting duration decrease, and increase in exercise days (all p < 0.0001).

CONCLUSIONS:

Distributed mHealth implementation of a low-cost life-style intervention is associated with short-term, reproducible, large-scale improvements in physical activity, sitting, and weight. (Effect of the Stepathlon Pedometer Program on Physical Activity, Weight and Well-Being; ACTRN12615001310550).

KEYWORDS:

mobile health; physical activity; prevention; sitting; weight loss

PMID:
27050185
DOI:
10.1016/j.jacc.2016.03.472
[Indexed for MEDLINE]
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