Smartphone app-based interventions on physical activity behaviors and psychological correlates in healthy young adults: A systematic review.

BACKGROUND: The issue of low physical activity (PA) levels among the youth is a longstanding concern. Smartphone applications offer a promising avenue for delivering interventions that are both accessible and engaging. Up to now, there appears to be a gap in the literature, with no systematic reviews assessing the efficacy of smartphone apps in encouraging increased physical activity among healthy young adults. OBJECTIVE: To synthesize the effects of a smartphone app-based intervention on PA and PA-related psychological correlates in healthy young adults (18-35 years old). METHODS: A search was conducted on eighteen databases: PubMed, Medline, Web of Science, SPORTDiscus, Scopus, Academic Search Premier, Communication and Mass Media Complete, Article First, Biomed Central, BioOne, EBSCOHost, JSTOR, ProQuest, SAGE Reference Online, ScienceDirect, SpringerLink, Taylor&Francis, and Wiley Online. The search covered the period up until December 2023. This research included all randomized controlled trials (RCTs) that evaluated the effectiveness of smartphone app-based interventions on PA and PA related psychological outcomes in healthy young adults. The overall impact was determined by vote counting based on the direction of effect and aggregating p values. The quality of the evidence was evaluated using an 8-item scale. This study has been registered in the PROSPERO database with the identification number CRD42023390033. RESULTS: A total of 8403 articles were retrieved, and based on the predefined inclusion and exclusion criteria, seven articles were selected for inclusion. Among these articles, four high-quality RCTs were identified, and the results of vote counting and combining p values methods suggested that smartphone-based app interventions did not demonstrate significant effectiveness in improving PA and PA-related psychological outcomes. However, some improvements were observed. The analysis results, which were categorized into fitness apps and health apps based on the characteristics of the interventions, also failed to demonstrate significant intervention effects. CONCLUSION: The findings indicate that, currently, there are no significant effects of smartphone app interventions on improving PA and PA-related psychological outcomes in healthy young adults aged 18-35 years. It is important to note that these findings should be interpreted with caution due to the limited number of included studies. Future research should focus on employing high-quality study designs to determine the true effects of interventions and analyze various smartphone app interventions. These analyses should encompass different app characteristics (e.g., fitness app and health app), various combinations (e.g., fitness app alone and fitness app in combination with other interventions), diverse intervention goals (e.g., PA and PA along with other outcomes), and multiple intervention characteristics (e.g., frequency and duration).

Isotemporal substitution effect of 24-hour movement behavior on the mental health of Chinese preschool children.

The 24-h movement behavior of preschoolers comprises a spectrum of activities, including moderate-to-vigorous intensity physical activity (MVPA), light-intensity physical activity (LPA), screen-based sedentary behavior (SCSB), non-screen-based sedentary behavior (NSCSB), and sleep. While previous research has shed light on the link between movement behaviors and children's mental health, the specific impacts on the unique demographic of Chinese preschoolers remain underexplored. This study significantly contributes to the literature by exploring how 24-h movement behavior affects the mental health of preschoolers in a Chinese context. The study involved205 Chinese preschool children (117 boys and 88 girls) between the ages of 3 and 6 years wore accelerometers to measure their LPA, MVPA, and sedentary behavior (SB), while their parents reported the time spent on sleep and SCSB. The parents also completed the Strength and Difficulties Questionnaire to assess their children's mental health. The study used compositional regression and isotemporal substitution models to examine the relationship between the various components of 24-h movement behavior and mental health. The results showed that greater NCSSB compared to MVPA, LPA, sleep, and SCSB was associated with good prosocial behavior and lower scores on externalizing problems. This highlights the potential of NSCSB as a beneficial component in the daily routine of preschoolers for fostering mental well-being. Replacing 15 min of sleep and SCSB with 15 min of NSCSB was associated with a decrease of 0.24 and 0.15 units, respectively, in externalizing problems. Reallocating 15 min of sleep to NSCSB was linked to an increase of 0.11 units in prosocial behavior. There were no significant substitution effects between LPA and MVPA time with any other movement behavior on prosocial behavior and externalizing problems. Given the positive associations observed, further longitudinal studies are necessary to explore the link between 24-h movement behavior and mental health in preschool children.

Acute effects of exergaming on young adults' energy expenditure, enjoyment, and self-efficacy.

This study investigated the effects of a dance-based exergaming on Chinese college students' energy expenditure, self-efficacy, and enjoyment in comparison with the traditional aerobic dance exercise. Forty young adults (33 females; Mage = 21.55 years, SD = 2.06) completed two separate 20 min exercise sessions with 10 min intervals on the same day: (1) Xbox 360 Kinect Just Dance exergaming session; and (2) a traditional instructor-led aerobic dance exercise session. Participants' energy expenditure (Kcal/session) was measured by the ActiGraph GT9X Link accelerometers, and their perceived self-efficacy and enjoyment were assessed via validated surveys following each session. Dependent t-test indicated significant differences in participants' enjoyment (t = -1.83, p = 0.04). Specifically, participants in the dance-based exergaming session reported a higher level of enjoyment (M = 3.96, SD = 0.65) as compared to the aerobic dance session (M = 3.61, SD = 0.54). However, there was no significant difference in energy expenditure and self-efficacy between the two sessions. Findings suggest that college students had comparable energy expenditure as the traditional aerobic dance session while experiencing more fun and enjoyment. This suggests that exergaming can be a fun exercise alternative for promoting physical activity among young adults.

The Moderating Effects of Physical Activity on the Relationships between Child Maltreatment and Health Outcomes among Korean Adolescents: A Secondary Analysis of the 2020 Korean Children and Youth Rights Survey.

Adverse childhood events (ACEs) are associated with poor health outcomes and behaviors. Research has shown that physical activity (PA) can have a protective effect on the relationship between ACEs and health outcomes. This study aimed to explore the moderating effects of PA on the relationships between ACEs (physical and emotional abuse) and physical and psychological health (depression and self-esteem) among South Korean middle school students. The data used in this study were from the 2020 Korean Children and Youth Rights Survey (KCYRS), which had 2640 participants. The results indicated that PA could lessen the negative effects of emotional abuse on physical health and self-esteem. However, there was no significant moderating effect of PA in the relationship between physical abuse and health outcomes. The findings suggest that, while PA might be a protective factor for individuals exposed to emotional abuse, the effects of abuse on engaging in PA and the benefits of PA can be complex. Further research is needed to understand how different types of ACEs affect individuals and how PA can mitigate negative impacts. Health professionals, educators, and stakeholders should provide more opportunities for PA to support healthy behaviors and prevent negative health outcomes in adulthood for youth exposed to ACEs.

Effects of personalized exercise prescriptions and social media delivered through mobile health on cancer survivors' physical activity and quality of life.

PURPOSE: This study aimed to examine the effects of a multi-component mobile health intervention (wearable, apps, and social media) on cancer survivors' (CS') physical activity (PA), quality of life, and PA determinants compared to exercise prescription only, social media only, and attention control conditions. METHODS: A total of 126 CS (age = 60.37 ± 7.41 years, mean ± SD) were recruited from the United States. The study duration was 6 months and participants were randomly placed into 4 groups. All participants received a Fitbit tracker and were instructed to install its companion app to monitor their daily PA. They (1) received previously established weekly personalized exercise prescriptions via email, (2) received weekly Facebook health education and interacted with one another, (3) received both Conditions 1 and 2, or (4) were part of the control condition, meaning they adopted usual care. CS PA daily steps, quality of life (i.e., physical health and mental health), and PA determinants (e.g., self-efficacy, social support) were measured at baseline, 3 months, and 6 months. RESULTS: The final sample size included 123 CS. The results revealed only the multi-component condition had greater improvements in PA daily steps than the control condition post-intervention (95% confidence interval (95%CI): 368-2951; p < 0.05). Similarly, those in the multi-component condition had significantly greater increased physical health than the control condition (95%CI: -0.41 to -0.01; p < 0.05) over time. In addition, the social media condition had significantly greater increased perceived social support than the control condition (95%CI: 0.01-0.93; p < 0.05). No other significant differences on outcomes were identified. CONCLUSION: The study findings suggest that the implementation of a multi-component mobile health intervention had positive effects on CS PA steps and physical health. Also, offering social media intervention has the potential to improve CS perceived social support.

Effects of Long-Term Endurance Exercise on Cardiac Morphology, Function, and Injury Indicators among Amateur Marathon Runners.

The purpose of this study was to investigate the effects of long-term endurance exercise on cardiac morphology and function, as well as injury indicators, among amateur marathon runners. We recruited 33 amateur runners who participated in a marathon. Participants were divided into experimental and control groups according to their National Athletic Grade. The experimental group included participants with a National Athletic Grade of 2 or better, and the control group included participants who did not have a National Athletic Grade. Cardiac morphology, function, and injury indicators were assessed before and after the participants' involvement in the Changsha International Marathon. All cardiac morphology and function indicators returned to pre-race levels at 24 h post-race, and left ventricular end-diastolic volume and left ventricular end-systolic volume indicators showed similar trends. Both stroke volume (SV) and percent fractional shortening (%FS) indicators showed similar trends in changes in the measurements before and after the race. SV showed no change between the pre-race and post-race periods. On the other hand, %FS showed a significant increase in the immediate post-race period, followed by restoration of its level at 24 h post-race. Among myocardial injury indicators, serum levels of cardiac troponin I, creatine kinase (CK), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and N-terminal pro-b-type natriuretic peptide (NT-proBNP) measured before the race, immediately after the race, and 24 h after the race displayed similar trends in changes among CK, CK-MB, LDH, and AST, while NT-proBNP levels did not change. We concluded that high-level amateur marathon runners had greater heart volumes, as well as wall and septal thicknesses, than low-level marathon runners, with differences in heart volume being the most pronounced. Long-term high-intensity endurance exercise caused some damage to the hearts of amateur runners. High-level runners showed better myocardial repair ability, and their levels of myocardial injury markers showed greater decreases at 24 h post-race, while low-level runners had poorer myocardial repair ability.

Breast cancer survivors' physical activity, psychosocial beliefs, daily trip behaviors, and subjective well-being: A descriptive study.

BACKGROUND: Physical inactivity has been a great public health concern among breast cancer survivors (BCS), especially during the COVID-19 pandemic, as it is closely related to a higher risk of cancer recurrence and mortality. The positive impacts of psychosocial beliefs in promoting physical activity (PA) have been well acknowledged. Therefore, this study aimed to explore the effects of psychosocial beliefs on PA in BCS to prevent physical inactivity. Furthermore, we examined the relationships between daily activities, trip behaviors, and associated subjective well-being. METHODS: This study used a cross-sectional, descriptive study design. Female BCS who were able to exercise regularly completed the battery of assessments in March 2021. Specifically, the international PA questionnaires and the adapted PA-related psychosocial beliefs questionnaires were used to assess BCS's PA and psychosocial beliefs, respectively. In addition, the smartphone-based Day Reconstruction Method was utilized to measure subjective well-being. Data were analyzed using descriptive statistics, Chi-squared test, analyses of variance, and correlation analysis. RESULTS: In the context of investigations during the COVID-19 pandemic, our study showed that 77.8% of BCS reported meeting PA guidelines. As the components of psychosocial beliefs, the change strategies, social support, and confidence were significantly associated with higher PA levels. Additionally, the protective effect of leisure/recreation activities among BCS on their emotional well-being was observed. CONCLUSIONS: Overall, this study demonstrated the importance of understanding the relationship between BCS's psychosocial beliefs and PA during the pandemic. Notably, this study is unique because it used an application-based method to assess BCS' subjective well-being objectively.

Effects of Tai Chi App and Facebook health education programs on breast cancer survivors' stress and quality of life in the Era of pandemic.

PURPOSE: This study investigated the effects of a mobile Tai Chi app and Facebook (FB) program on stress and quality of life (QoL) among breast cancer survivors (BCS). METHODS: This study was a remote, 12-week 2-arm parallel randomized controlled trial (RCT). BCS were randomly assigned into either the Tai Chi intervention condition (using an app to practice Tai Chi three times a day, at least five days/week and receiving FB health tips) or the comparison condition (receiving FB health tips only). The final sample comprised 35 female BCS (Mage = 56.17). The Perceived Stress Scale was utilized to measure stress and the Patient Reported Outcome Measurement Information System was adopted to assess QoL - mental health (anxiety and depression) and physical health. RESULTS: No significant time × group interaction effects emerged for stress and mental health (Wilk's lambda = 0.96, F (2, 32) = 0.74, p = 0.48, η2 = 0.04) and physical health (Wilk's lambda = 1.00, F (1,33) = 0.14, p = 0.71, η2 = 0.00). Yet, a significant time effect was observed for mental health, F (1,33) = 5.51, p = 0.02, η2 = 0.14; and physical health, F (1,33) = 5.59, p < 0.05, η2 = 0.14; but not for stress, F (1,33) = 1.70, p = 0.20, η2 = 0.05. Specifically, participants' physical health (1.57 vs. 1.41) and mental health (1.80 vs. 1.62) significantly improved over time across both groups. Also, a group effect for mental health approached the significant level, F (1,33) = 4.06, p = 0.05, η2 = 0.11. In detail, the Tai Chi participants had significantly better mental health at follow-up test (1.43 vs. 1.90) compared to the comparison participants (p < 0.05, 95%CI: 0.91 to -0.40). CONCLUSION: The study findings suggested that the implementation of the Tai Chi app combined FB health tips program had positive effects on BCS's mental health. Also, offering a health education program could be beneficial to BCS's physical health as well.

Investigating Relationships between Preschool Children's Perceived Competence, Motor Skills, and Physical Activity: A Cross-Lagged Panel Model.

BACKGROUND: Motor skill competence (MSC) and perceived competence (PC) are primary correlates that are linked with physical activity (PA) participation, yet there is limited evidence of the mutual longitudinal or temporal associations between these variables in preschoolers. Therefore, this study's purpose was to examine the bidirectional relationships between MSC and PA, MSC and PC, and PC and PA in preschoolers over time. METHODS: The final sample were 61 preschoolers (Mage = 4.45 years, ranging from 4 to 5) from two underserved schools. MSC was assessed using the Test of Gross Motor Development, Second Edition (TGMD-2). PC was assessed using the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children. PA was assessed using ActiGraph GT9X Link accelerometers during three consecutive school days. All assessments of MSC, PC, and PA were measured in identical conditions at schools at the baseline (T1) and the end of the eighth week (T2). We employed a cross-lagged model approach to understand the bidirectional relationships between MSC, PC, and PA. RESULTS: The results showed that T1 MSC significantly predicted T2 MSC (p < 0.01) and T1 MSC significantly predicted T2 PA only in girls (p = 0.03). Additionally, a cross-lagged effect of T1 MSC and T2 PC was only observed in boys (p = 0.03). Lastly, a significant association for T1 moderate-to-vigorous physical activity (MVPA) and T2 PC was only observed in girls (p = 0.04). CONCLUSIONS: Bidirectional relationships between the variables were not observed in preschoolers. However, significant gender differences were observed in each cross-lagged model.

Bidirectional Relationships among Children's Perceived Competence, Motor Skill Competence, Physical Activity, and Cardiorespiratory Fitness across One School Year.

PURPOSE: The bidirectional associations among children's motor skill competence (MSC), perceived competence (PC), physical activity (PA), and cardiorespiratory fitness (CRF) over time remain unanswered. This study is aimed at discerning the bidirectional relationships among elementary school children's MSC, PC, PA and, CRF over the course of one school year. METHODS: A total of 261 second and third grade children (127 boys, 134 girls; meanage = 8.27 years; BMI = 18.22 ± 3.71) were recruited from two Texas elementary schools. Approximately 73.56% of participants were White American. Children's baseline data were assessed in September/October in 2012 (Time1), and identical assessments were conducted in April/May in 2013 (Time2). MSC was assessed using product-oriented skill tests (e.g., throw, kick, and jump). PC was assessed via the Pictorial Scale of Perceived Competence for Children. Minutes spent in moderate-to-vigorous PA (MVPA) was assessed using ActiGraph GT3X+ accelerometers for five days, and CRF was assessed by the PACER test. Six age- and body mass index-adjusted cross-lagged panel models were used to test the relationships between the variables. RESULTS: We observed that T1 MSC significantly predicted T2 MSC (ß = 0.59; p < 0.01), T2 CRF (ß = 0.28; p < 0.01), and T2 MVPA (ß = 0.18; p < 0.01). Children's CRF was a positive predictor for T2 CRF (ß = 0.56; p < 0.01) and T2 MSC (ß = 0.13; p < 0.05) Additionally, T1 MVPA significantly predicted T2 MVPA (ß = 0.30; p < 0.01) and T2 PC (ß = -0.14; p < 0.05). CONCLUSION: Findings suggested a fully bidirectional relationship between elementary children's MSC and CRF. Other bidirectional relationships among the variables were only partially supported. Educators and health professionals need to emphasize the importance of developing both MSC and CRF to maintain physical health over time.