Application and Effect of Mobiletype-Bone Health Intervention in Korean Young Adult Women with Low Bone Mass: A Randomized Control Trial

Digital Health Technologies for Long-term Self-management of Osteoporosis: Systematic Review and Meta-analysis

Background

Osteoporosis is the fourth most common chronic disease worldwide. The adoption of preventative measures and effective self-management interventions can help improve bone health. Mobile health (mHealth) technologies can play a key role in the care and self-management of patients with osteoporosis.

Objective

This study presents a systematic review and meta-analysis of the currently available mHealth apps targeting osteoporosis self-management, aiming to determine the current status, gaps, and challenges that future research could address, as well as propose appropriate recommendations.

Methods

A systematic review of all English articles was conducted, in addition to a survey of all apps available in iOS and Android app stores as of May 2021. A comprehensive literature search (2010 to May 2021) of PubMed, Scopus, EBSCO, Web of Science, and IEEE Xplore was conducted. Articles were included if they described apps dedicated to or useful for osteoporosis (targeting self-management, nutrition, physical activity, and risk assessment) delivered on smartphone devices for adults aged ≥18 years. Of the 32 articles, a random effects meta-analysis was performed on 13 (41%) studies of randomized controlled trials, whereas the 19 (59%) remaining studies were only included in the narrative synthesis as they did not provide enough data.

Results

In total, 3906 unique articles were identified. Of these 3906 articles, 32 (0.81%) articles met the inclusion criteria and were reviewed in depth. The 32 studies comprised 14,235 participants, of whom, on average, 69.5% (n=9893) were female, with a mean age of 49.8 (SD 17.8) years. The app search identified 23 relevant apps for osteoporosis self-management. The meta-analysis revealed that mHealth-supported interventions resulted in a significant reduction in pain (Hedges g −1.09, 95% CI −1.68 to −0.45) and disability (Hedges g −0.77, 95% CI −1.59 to 0.05). The posttreatment effect of the digital intervention was significant for physical function (Hedges g 2.54, 95% CI −4.08 to 4.08) but nonsignificant for well-being (Hedges g 0.17, 95% CI −1.84 to 2.17), physical activity (Hedges g 0.09, 95% CI −0.59 to 0.50), anxiety (Hedges g −0.29, 95% CI −6.11 to 5.53), fatigue (Hedges g −0.34, 95% CI −5.84 to 5.16), calcium (Hedges g −0.05, 95% CI −0.59 to 0.50), vitamin D intake (Hedges g 0.10, 95% CI −4.05 to 4.26), and trabecular score (Hedges g 0.06, 95% CI −1.00 to 1.12).

Conclusions

Osteoporosis apps have the potential to support and improve the management of the disease and its symptoms; they also appear to be valuable tools for patients and health professionals. However, most of the apps that are currently available lack clinically validated evidence of their efficacy and focus on a limited number of symptoms. A more holistic and personalized approach within a cocreation design ecosystem is needed.

Trial Registration

PROSPERO 2021 CRD42021269399; https://tinyurl.com/2sw454a9

Effectiveness of Integrated Technology Apps for Supporting Healthy Food Purchasing and Consumption: A Systematic Review

A healthy diet is essential for good health and nutrition, though literature showed that there are various factors affecting the intention to purchase and consume healthy food. Technology integration is known to be useful in various aspects, but findings from studies on the efficacy of technology integration to improve healthy food consumption and purchase have largely been inconsistent. Therefore, we aimed to examine the efficacy of interventions that use technology apps to improve healthy food purchasing and consumption in adults. Relevant studies were identified through PubMed, Scopus, CINAHL, SportDiscuss and ACM Digital Library. Twenty studies were included in the systematic review. The majority of studies (n = 18) used a smartphone in the intervention, and only two studies used a personal digital assistant. The results showed that technology integration-based intervention favoured healthy changes in household food purchases, and increased consumption of healthy food and healthy eating outcomes - albeit to different extents. Overall, technology apps are convenient and user-friendly tools to encourage a change in healthy food purchase and consumption among people.

Mobile App-Based Health Promotion Programs: A Systematic Review of the Literature

This study investigated the features and usefulness of mobile app-based health promotion programs for the general population. A comprehensive bibliographic search of studies on health promotion programs using mobile apps in peer-reviewed journals published in English up to November 2017 was performed using the PubMed, Embase, and CINAHL databases. The inclusion criteria were (1) randomized control trial designs; (2) assessed mobile app-based interventions to promote adult health conditions; 12 studies were ultimately included. The most common topics were diet and physical activity (n = 8) and overall healthy lifestyle improvement (n = 4). The purpose of the apps included providing feedback on one’s health status (n = 9) and monitoring individual health status or behavior change (n = 9). Across all studies, health outcomes were shown to be better for mobile app users compared to non-users. Mobile app-based health interventions may be an effective strategy for improving health promotion behaviors in the general population without diseases. This study suggests that mobile app use is becoming commonplace for a variety of health-promoting behaviors in addition to physical activity and weight control. Future research should address the feasibility and effectiveness of using mobile apps for health promotion in developing countries.