The Effectiveness of E-Health Interventions Promoting Physical Activity and Reducing Sedentary Behavior in College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Sanying Peng; Fang Yuan; Ahmad Tajuddin Othman; Xiaogang Zhou; Gang Shen; Jinghong Liang

doi:10.3390/ijerph20010318

The Effectiveness of E-Health Interventions Promoting Physical Activity and Reducing Sedentary Behavior in College Students: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Int J Environ Res Public Health. 2022 Dec 25;20(1):318. doi: 10.3390/ijerph20010318.

Authors

Sanying Peng^{1

2}, Fang Yuan³, Ahmad Tajuddin Othman², Xiaogang Zhou², Gang Shen⁴, Jinghong Liang⁵

Affiliations

¹ Physical Education Department, Hohai University, Nanjing 210024, China.
² School of Educational Studies, University Sains Malaysia, Penang 11800, Malaysia.
³ College of International Languages and Cultures, Hohai University, Nanjing 210024, China.
⁴ School of Physical Education, Changzhou University, Changzhou 213164, China.
⁵ Department of Maternal and Child Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.

Abstract

Insufficient physical activity (PA) and excessive sedentary behavior (SB) are detrimental to physical and mental health. This systematic review and meta-analysis aimed to identify whether e-health interventions are effective for improving PA and SB in college students. Five electronic databases, including Medline, Web of Science, Embase, Cochrane Library, and ProQuest, were searched to collect relevant randomized controlled trials up to 22 June 2022. In total, 22 trials (including 31 effects) with 8333 samples were included in this meta-analysis. The results showed that e-health interventions significantly improved PA at post-intervention (SMD = 0.32, 95% CI: 0.19, 0.45, p < 0.001) compared with the control group, especially for total PA (SMD = 0.34, 95% CI: 0.10, 0.58, p = 0.005), moderate to vigorous PA (SMD = 0.17, 95% CI: 0.01, 0.32, p = 0.036), and steps (SMD = 0.75, 95% CI: 0.23, 1.28, p < 0.001. There were no significant effects for both PA at follow-up (SMD = 0.24, 95% CI: − 0.01, 0.49, p = 0.057) and SB (MD = −29.11, 95% CI: −70.55, 12.32, p = 0.17). The findings of subgroup analyses indicated that compared to the control group, interventions in the group of general participants (SMD = 0.45, 95% CI: 0.27, 0.63, p < 0.001), smartphone apps (SMD = 0.46, 95% CI: 0.19, 0.73, p = 0.001), and online (SMD = 0.23, 95% CI: 0.04, 0.43, p < 0.001) can significantly improve PA at post-intervention. Moreover, the intervention effects were significant across all groups of theory, region, instrument, duration, and female ratio. At follow-up, interventions in groups of developing region (SMD = 1.17, 95% CI: 0.73, 1.62, p < 0.001), objective instrument (SMD = 0.83, 95% CI: 0.23, 1.42, p = 0.007), duration ≤ 3-month (SMD = 1.06, 95% CI: 0.72, 1.39, p < 0.001), and all female (SMD = 0.79, 95% CI: 0.02, 1.56, p = 0.044) can significantly improve PA. The evidence of this meta-analysis shows that e-health interventions can be taken as promising strategies for promoting PA. The maintenance of PA improvement and the effect of interventions in reducing SB remain to be further studied. Educators and health practitioners should focus on creating multiple e-health interventions with individualized components.

Keywords: college student; e-health; meta-analysis; physical activity; sedentary behavior.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

Exercise / psychology
Female
Humans
Randomized Controlled Trials as Topic
Sedentary Behavior*
Students
Telemedicine*

Grants and funding

This research was supported by the Fundamental Research Funds for the Central Universities (Hohai University, B200202203), the General Program of the National Social Science Funding (19BTY060), and the Key Project of Philosophy and Social Science Research in Colleges and Universities in Jiangsu Province (2018SJZDI196).