Incorporating a Physical Activity mHealth Tool Into a Multidisciplinary Clinical Weight Management Service in England: Service Evaluation of Steps4Health

Background : Steps4Health, an mHealth tool for promoting physical activity and optimizing the 24-hour movement behaviors in long-term conditions, was implemented into a regional multidisciplinary clinical weight management service. This service evaluation reports uptake, usage, linkage with wearable devices, and impact on stepping behavior. Methods : Service users were adults living with severe obesity (body mass index ≥40 kg/m 2 or ≥35 kg/m 2 with a comorbidity) referred to a regional weight management service from November 2023 to August 2024. Those without physical activity contraindications were offered Steps4Health during their initial consultation. Steps4Health provides personalized goal-setting and feedback on stepping and other 24-hour behaviors alongside educational material and enables linkage to wearable activity devices incorporating baseline physical activity levels. Data extraction allowed for at least 6 weeks of follow-up, assessing uptake, demographic characteristics, usage patterns, and longitudinal stepping data. Results : Of 559 service users, 307 (54.9%) were eligible for Steps4Health. A total of 290 (94.5% of those eligible) individuals completed registration and logged into Steps4Health, an average of 28 times (8.3 min/login) over a 6-week period. The most popular features of Steps4Health were educational resources providing information on physical activity and chronic conditions. At baseline users averaged 4079 (95% confidence interval [CI], 2628 to 4531) steps/day. One hundred and thirty-nine (24.9%) logged at least 2 days of stepping data. Over the first 6 weeks, an average clinically meaningful increase of 974 (581, 1366; P < .001) steps/day was observed. Conclusions : Steps4Health, a bespoke digital tool promoting increased physical activity in inactive clinical populations, was used by half of all individuals within a regional weight management service with half again regularly self-monitoring daily physical activity with a clinically meaningful increase observed over the first 6 weeks. Steps4Health shows promise as part of a broader strategy to enhance physical activity engagement within clinical weight management services.