Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)

BackgroundInformation and communication technologies are currently among the supporting elements that may contribute to improving health and changing lifestyles. ObjectiveThe aim of this study was to evaluate the long-term effectiveness of adding an app to standardized counseling in orde...

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Main Authors: Garcia-Ortiz, Luis, Recio-Rodriguez, Jose Ignacio, Agudo-Conde, Cristina, Patino-Alonso, María Carmen, Maderuelo-Fernandez, Jose-Angel, Repiso Gento, Irene, Puigdomenech Puig, Elisa, Gonzalez-Viejo, Natividad, Arietaleanizbeaskoa, Maria Soledad, Schmolling-Guinovart, Yolanda, Gomez-Marcos, Manuel Angel, Rodriguez-Sanchez, Emiliano
Format: Article
Language:English
Published: JMIR Publications 2018-04-01
Series:JMIR mHealth and uHealth
Online Access:http://mhealth.jmir.org/2018/4/e107/
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author Garcia-Ortiz, Luis
Recio-Rodriguez, Jose Ignacio
Agudo-Conde, Cristina
Patino-Alonso, María Carmen
Maderuelo-Fernandez, Jose-Angel
Repiso Gento, Irene
Puigdomenech Puig, Elisa
Gonzalez-Viejo, Natividad
Arietaleanizbeaskoa, Maria Soledad
Schmolling-Guinovart, Yolanda
Gomez-Marcos, Manuel Angel
Rodriguez-Sanchez, Emiliano
author_facet Garcia-Ortiz, Luis
Recio-Rodriguez, Jose Ignacio
Agudo-Conde, Cristina
Patino-Alonso, María Carmen
Maderuelo-Fernandez, Jose-Angel
Repiso Gento, Irene
Puigdomenech Puig, Elisa
Gonzalez-Viejo, Natividad
Arietaleanizbeaskoa, Maria Soledad
Schmolling-Guinovart, Yolanda
Gomez-Marcos, Manuel Angel
Rodriguez-Sanchez, Emiliano
author_sort Garcia-Ortiz, Luis
collection DOAJ
description BackgroundInformation and communication technologies are currently among the supporting elements that may contribute to improving health and changing lifestyles. ObjectiveThe aim of this study was to evaluate the long-term effectiveness of adding an app to standardized counseling in order to increase physical activity (PA) and adherence to the Mediterranean diet and to analyze the effects of app adherence in lifestyle changes. MethodsA randomized, multicenter clinical trial with a 12 month-follow up was conducted, involving 833 participants recruited by random sampling in 6 primary Spanish care centers (415 vs 418). Counseling on PA and the Mediterranean diet was given to both groups by a research nurse; however, the counseling + app group (intervention group) received additional training in the use of an app that was designed to promote the Mediterranean diet and PA over a 3-month period. Main outcomes and measures included PA by accelerometer and the 7-day Physical Activity Recall (PAR) questionnaire and adherence to the Mediterranean diet by an adherence screener questionnaire. We considered adherence to the app to be high when it was used for more than 60 days. ResultsThe mean age was 51 years (SD 12) in the intervention group and 52.3 years (SD 12.0) in the counseling-only group; females predominated in both groups (60.0%, 249/415 and 64.1%, 268/418, respectively). PA by accelerometer declined in both groups at 12 months (P value for tendency in moderate to vigorous PA, [MVPA]=.15). The intervention subgroup with high app adherence had better behavior than the low adherence subgroup (P value for tendency in MVPA=.001). PA analyzed by 7-day PAR did not show changes at 12 months in any of the groups (P value for tendency=.25). In the Mediterranean diet, an increase in adherence was observed in both groups at 12 months with no differences between them (P value for tendency=.46). In these two cases, the group with high app adherence also had better behavior, although without reaching significance for the tendency (P>.05). ConclusionsThe participants with strongest app adherence showed better outcomes in terms of maintenance of healthy lifestyles at 12 months than those with weaker adherence. Overall, however, we found no differences between intervention group and counseling-only group in PA increase and adherence to the Mediterranean diet in the long term. Trial RegistrationClinicaltrials.gov NCT02016014; https://clinicaltrials.gov/ct2/show/NCT02016014 (Archived by WebCite at http://www.webcitation.org/6ymEXH6W4)
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spelling doaj.art-ddf11f761ee44eb3ade392241c496ddb2022-12-21T19:58:51ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222018-04-0164e10710.2196/mhealth.9218Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)Garcia-Ortiz, LuisRecio-Rodriguez, Jose IgnacioAgudo-Conde, CristinaPatino-Alonso, María CarmenMaderuelo-Fernandez, Jose-AngelRepiso Gento, IrenePuigdomenech Puig, ElisaGonzalez-Viejo, NatividadArietaleanizbeaskoa, Maria SoledadSchmolling-Guinovart, YolandaGomez-Marcos, Manuel AngelRodriguez-Sanchez, EmilianoBackgroundInformation and communication technologies are currently among the supporting elements that may contribute to improving health and changing lifestyles. ObjectiveThe aim of this study was to evaluate the long-term effectiveness of adding an app to standardized counseling in order to increase physical activity (PA) and adherence to the Mediterranean diet and to analyze the effects of app adherence in lifestyle changes. MethodsA randomized, multicenter clinical trial with a 12 month-follow up was conducted, involving 833 participants recruited by random sampling in 6 primary Spanish care centers (415 vs 418). Counseling on PA and the Mediterranean diet was given to both groups by a research nurse; however, the counseling + app group (intervention group) received additional training in the use of an app that was designed to promote the Mediterranean diet and PA over a 3-month period. Main outcomes and measures included PA by accelerometer and the 7-day Physical Activity Recall (PAR) questionnaire and adherence to the Mediterranean diet by an adherence screener questionnaire. We considered adherence to the app to be high when it was used for more than 60 days. ResultsThe mean age was 51 years (SD 12) in the intervention group and 52.3 years (SD 12.0) in the counseling-only group; females predominated in both groups (60.0%, 249/415 and 64.1%, 268/418, respectively). PA by accelerometer declined in both groups at 12 months (P value for tendency in moderate to vigorous PA, [MVPA]=.15). The intervention subgroup with high app adherence had better behavior than the low adherence subgroup (P value for tendency in MVPA=.001). PA analyzed by 7-day PAR did not show changes at 12 months in any of the groups (P value for tendency=.25). In the Mediterranean diet, an increase in adherence was observed in both groups at 12 months with no differences between them (P value for tendency=.46). In these two cases, the group with high app adherence also had better behavior, although without reaching significance for the tendency (P>.05). ConclusionsThe participants with strongest app adherence showed better outcomes in terms of maintenance of healthy lifestyles at 12 months than those with weaker adherence. Overall, however, we found no differences between intervention group and counseling-only group in PA increase and adherence to the Mediterranean diet in the long term. Trial RegistrationClinicaltrials.gov NCT02016014; https://clinicaltrials.gov/ct2/show/NCT02016014 (Archived by WebCite at http://www.webcitation.org/6ymEXH6W4)http://mhealth.jmir.org/2018/4/e107/
spellingShingle Garcia-Ortiz, Luis
Recio-Rodriguez, Jose Ignacio
Agudo-Conde, Cristina
Patino-Alonso, María Carmen
Maderuelo-Fernandez, Jose-Angel
Repiso Gento, Irene
Puigdomenech Puig, Elisa
Gonzalez-Viejo, Natividad
Arietaleanizbeaskoa, Maria Soledad
Schmolling-Guinovart, Yolanda
Gomez-Marcos, Manuel Angel
Rodriguez-Sanchez, Emiliano
Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
JMIR mHealth and uHealth
title Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
title_full Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
title_fullStr Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
title_full_unstemmed Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
title_short Long-Term Effectiveness of a Smartphone App for Improving Healthy Lifestyles in General Population in Primary Care: Randomized Controlled Trial (Evident II Study)
title_sort long term effectiveness of a smartphone app for improving healthy lifestyles in general population in primary care randomized controlled trial evident ii study
url http://mhealth.jmir.org/2018/4/e107/
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