Publication date: 
August 31, 2016

Originally published by the American Heart Association on August 31, 2016.

DALLAS — People are more likely to adopt heart healthy behaviors when guided and encouraged via the Internet, their cell phones or other devices, according to 23 years of research reviewed in Journal of the American Heart Association, the Open Access Journal of the American Heart Association/American Stroke Association.

“Both Internet-based and mobile-based programs can help people become more physically active, eat better, and achieve modest weight loss over 3-12 months,” said Ashkan Afshin, MD, MPH, ScD, lead study author and acting assistant professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

Researchers reviewed 224 studies conducted on generally healthy adults, published between 1990 and 2013. The studies evaluated the effect of using Internet, mobile phones, personal sensors, or standalone computer software tools to inspire behavioral changes, such as improving diet, increasing physical activity, losing weight, and stopping/reducing tobacco or alcohol use.

Among the findings:

  • Participants in Internet interventions improved their diets, became more active, lost body weight/fat, reduced tobacco use, and cut excessive alcohol use.
  • Participants in mobile device interventions (using smartphone apps or receiving text or voicemail messages) increased their physical activity and lost body weight/fat.

“Programs that have components such as goal-setting and self-monitoring and use multiple modes of communication with tailored messages tended to be more effective. We also found these programs were more effective if they included some interactions with health,care providers.

Clinicians, in particular in primary care settings, can use such programs to help people improve their lifestyle behaviors and reduce the risk of chronic disease, such as cardiovascular disease and diabetes,” Afshin said.

The available research is limited because most studies lasted less than six months, providing little information on how effective and sustainable the behavioral changes will be over the long term. In addition, most studies were conducted in high-income countries with volunteers who were generally more highly educated and motivated than the general public.

“Our study highlights several important gaps in current evidence on Internet- and mobile-based interventions. We need to evaluate their long-term value, effectiveness in different populations (such as the elderly and people from developing countries) and how different strategies may increase adherence to the programs,” Afshin said.

Co-authors are Damilola Babalola, MD, MPH; Mireille Mclean, MA, MPH; Zhi Yu, MD, MSc; Wenjie Ma, MD, MSc; Cheng-Yu Chen, MD, PhD; Mandana Arabi, MD, PhD; and Dariush Mozaffarian, MD, DrPH. Author disclosures are on the manuscript.

The study was funded by the Sackler Institute for Nutrition Science at The New York Academy of Sciences, through a grant from the Robert Wood Johnson Foundation.

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