Evidence map›Paper›PMID 34753490›Full record

SynthesisThe international journal of behavioral nutrition and physical activity2021

The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis.

Max J Western, Miranda E G Armstrong, Ishrat Islam, Kelly Morgan, Una F Jones, Mark J Kelson

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of behavioral nutrition and physical activity, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 108 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
108citing papers in PubMed, 17 pooled it
47.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

108 citing papers in PubMed, 17 syntheses or guidelines pooled it, 225 citations in OpenAlex.

  1. Inequalities in Exclusively Mobile Interventions Targeting Weight-Related Behaviors: Systematic Review of Observational Studies.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
    Pooled it
  2. Identifying Social Media-Based Interactions That Help Adults to Adhere to Weight Loss Goals: A Systematic Review.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2026
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  9. Interventions on Barriers to the Participation of Adolescents in Physical Activity: A Systematic Review.International journal of environmental research and public health · 2025
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  15. Digital behaviour change interventions to increase vegetable intake in adults: a systematic review.The international journal of behavioral nutrition and physical activity · 2023
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  17. A systematic review examining socioeconomic factors in trials of interventions for men that report weight as an outcome.Obesity reviews : an official journal of the International Association for the Study of Obesity · 2022
    Pooled it
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48 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Max J WesternCentre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Claverton Down, Bath, BA2 7AY, UK.
Miranda E G ArmstrongCentre for Exercise, Nutrition and Health Science, School for Policy Studies, University of Bristol, 8 Priory Road, Bristol, BS8 1TZ, UK.
Ishrat IslamPRIME Centre Wales, School of Medicine, Cardiff University, Cardiff, CF14 4YS, UK.
Kelly MorganCentre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), School of Social Sciences, Cardiff University, Cardiff, CF10 3BD, UK.
Una F JonesSchool of Healthcare Sciences, College of Biomedical and Life Sciences, Cardiff University, Cardiff, CF14 4XN, UK.
Mark J KelsonDepartment of Mathematics/Institute of Data Science and Artificial Intelligence, University of Exeter, Laver Building, Exeter, EX4 4QE, UK. M.J.Kelson@exeter.ac.uk.ORCID 0000-0001-7744-3780
Cardiff University · GBUniversity of Bath · GBUniversity of Bristol · GBUniversity of Exeter · GB

Funding

HCRW_ HF-16-1164Marie Curie MCCC-FCO-11-CMedical Research Council MR/K023233/1
6 · The paper itself

Abstract

backgroundDigital technologies such as wearables, websites and mobile applications are increasingly used in interventions targeting physical activity (PA). Increasing access to such technologies makes an attractive prospect for helping individuals of low socioeconomic status (SES) in becoming more active and healthier. However, little is known about their effectiveness in such populations. The aim of this systematic review was to explore whether digital interventions were effective in promoting PA in low SES populations, whether interventions are of equal benefit to higher SES individuals and whether the number or type of behaviour change techniques (BCTs) used in digital PA interventions was associated with intervention effects.

methodsA systematic search strategy was used to identify eligible studies from MEDLINE, Embase, PsycINFO, Web of Science, Scopus and The Cochrane Library, published between January 1990 and March 2020. Randomised controlled trials, using digital technology as the primary intervention tool, and a control group that did not receive any digital technology-based intervention were included, provided they had a measure of PA as an outcome. Lastly, studies that did not have any measure of SES were excluded from the review. Risk of Bias was assessed using the Cochrane Risk of Bias tool version 2.

resultsOf the 14,589 records initially identified, 19 studies were included in the final meta-analysis. Using random-effects models, in low SES there was a standardised mean difference (SMD (95%CI)) in PA between intervention and control groups of 0.06 (- 0.08,0.20). In high SES the SMD was 0.34 (0.22,0.45). Heterogeneity was modest in both low (I DISCUSSION: Digital interventions targeting PA do not show equivalent efficacy for people of low and high SES. For people of low SES, there is no evidence that digital PA interventions are effective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate effectiveness. To reduce inequalities and improve effectiveness, future development of digital interventions aimed at improving PA must make more effort to meet the needs of low SES people within the target population.

Indexed as

ExerciseMobile ApplicationsBehavior TherapyChronic DiseaseHumansSocial ClassBehaviour changeDigital healthDigital interventioneHealthHealth inequalitiesPhysical activityRCTSocioeconomic status

Identifiers

PMID34753490
PMCPMC8576797
OpenAlexW3210923803

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.