Background: The effectiveness of digital health interventions is commonly assumed to be related to the level of user engagement with the digital health intervention, including measures of both digital health intervention use and users’ subjective experience. However, little is known about the relationships between the measures of digital health intervention engagement and physical activity or sedentary behavior. Objective: This study aims to describe the direction and strength of the association between engagement with digital health interventions and physical activity or sedentary behavior in adults and explore whether the direction of association of digital health intervention engagement with physical activity or sedentary behavior varies with the type of engagement with the digital health intervention (ie, subjective experience, activities completed, time, and logins). Methods: Four databases were searched from inception to December 2019. Grey literature and reference lists of key systematic reviews and journals were also searched. Studies were eligible for inclusion if they examined a quantitative association between a measure of engagement with a digital health intervention targeting physical activity and a measure of physical activity or sedentary behavior in adults (aged ≥18 years). Studies that purposely sampled or recruited individuals on the basis of pre-existing health-related conditions were excluded. In addition, studies were excluded if the individual engaging with the digital health intervention was not the target of the physical activity intervention, the study had a non–digital health intervention component, or the digital health interventions targeted multiple health behaviors. A random effects meta-analysis and direction of association vote counting (for studies not included in meta-analysis) were used to address objective 1. Objective 2 used vote counting on the direction of the association. Results: Overall, 10,653 unique citations were identified and 375 full texts were reviewed. Of these, 19 studies (26 associations) were included in the review, with no studies reporting a measure of sedentary behavior. A meta-analysis of 11 studies indicated a small statistically significant positive association between digital health engagement (based on all usage measures) and physical activity (0.08, 95% CI 0.01-0.14, SD 0.11). Heterogeneity was high, with 77% of the variation in the point estimates explained by the between-study heterogeneity. Vote counting indicated that the relationship between physical activity and digital health intervention engagement was consistently positive for three measures: subjective experience measures (2 of 3 associations), activities completed (5 of 8 associations), and logins (6 of 10 associations). However, the direction of associations between physical activity and time-based measures of usage (time spent using the intervention) were mixed (2 of 5 associations supported the hypothesis, 2 were inconclusive, and 1 rejected the hypothesis). Conclusions: The findings indicate a weak but consistent positive association between engagement with a physical activity digital health intervention and physical activity outcomes. No studies have targeted sedentary behavior outcomes. The findings were consistent across most constructs of engagement; however, the associations were weak.

This is the abstract only. Read the full article on the JMIR site. JMIR is the leading open access journal for eHealth and healthcare in the Internet age.

中文翻译：

---

数字健康干预参与，体育锻炼和久坐行为之间的关联：系统评价和荟萃分析

背景：数字健康干预措施的有效性通常被认为与用户对数字健康干预措施的参与程度有关，包括数字健康干预措施的使用和用户的主观体验。但是，关于数字健康干预参与度与身体活动或久坐行为之间的关系知之甚少。目的：本研究旨在描述成年人参与数字健康干预与身体活动或久坐行为之间联系的方向和强度，并探讨数字健康干预参与与身体活动或久坐行为之间联系的方向是否因类型而异参与数字健康干预的时间（即主观经验，活动完成，时间和登录）。方法：从成立到2019年12月，共检索了四个数据库。还检索了灰色文献以及关键系统评价和期刊的参考文献清单。如果研究检查了针对数字体育锻炼的针对身体活动的参与程度与成年人（≥18岁）身体活动或久坐行为的度量之间的定量关联，则有资格纳入研究。排除了根据已有的与健康相关的状况有针对性地对个体进行采样或招募的研究。此外，如果从事数字健康干预的个人不是身体活动干预的对象，则该研究被排除在外，该研究包含非数字健康干预组成部分，或针对多种健康行为的数字健康干预措施。随机效应荟萃分析和关联投票计数的方向（对于未纳入荟萃分析的研究）用于解决目标1。目标2使用关联方向的投票计数。结果：总体上，确定了10,653篇独特的引文，并审阅了375篇全文。其中，有19项研究（26个协会）被纳入评价，没有研究报告久坐行为的量度。对11项研究的荟萃分析表明，数字健康参与（基于所有使用方法）与身体活动（0.08，95％CI 0.01-0.14，SD 0.11）之间存在很小的统计学显着正相关。异质性很高，研究之间的异质性解释了点估计中77％的变化。投票计数表明，体育活动与数字健康干预参与之间的关系在以下三个方面一直呈正相关：主观体验指标（三个协会中的两个），已完成的活动（八个协会中的五个）和登录（十个协会中的六个）。但是，身体活动与基于时间的使用量度（使用干预所花费的时间）之间的关联方向是混杂的（5个关联中的2个支持该假设，2个没有定论，1个拒绝该假设）。结论：研究结果表明参与体育活动数字健康干预与体育活动结局之间存在微弱但一致的正相关性。没有研究针对久坐行为的结果。研究结果在大多数参与结构中都是一致的。然而，

这仅仅是抽象的。阅读JMIR网站上的全文。JMIR是互联网时代电子健康和医疗保健领域领先的开放获取期刊。