Digital physical activity and/or sedentary behavior interventions for community-living adults:An umbrella review (Preprint)

BACKGROUND Digital interventions hold significant potential for improving physical activity (PA) and reducing sedentary behavior (SB) in adults. Despite increasing interest, there remain surprising gaps in the current knowledge of how best to deliver these interventions, including incorporating appropriate theoretical frameworks and behavior change techniques (BCTs). Following numerous systematic reviews there is now significant potential for umbrella reviews to provide an overview of the current evidence. OBJECTIVE To conduct a review of systematic reviews (umbrella review) exploring digital PA and SB interventions for community-living adults across; effectiveness, key components, and methodological quality. METHODS The Joanna Briggs institute framework for umbrella reviews was followed. Key search terms were developed iteratively based on ‘physical’ and ‘sedentary’ activity alongside ‘digital’ interventions. We searched seven online databases (Web of Science Core Collection, CINAHL, APA PsychINFO, INSPEC, the Cochrane Library, MEDLINE (Ovid), PROSPERO) alongside grey literature databases. For each included article, information was extracted and tabulated from included interventions around effectiveness, key components and content acknowledging both the digital and human elements, and study quality was appraised using AMSTAR-2. The Corrected Covered Area (CCA) was used to assess the overlap of primary studies included in the systematic reviews. All relevant research findings were extracted and reported. RESULTS Search terms identified 330 articles of which 5 met inclusion criteria. The most common PA outcomes identified were steps, moderate-to-vigorous physical activity (MVPA), total PA, and PA change. Reviews with meta-analysis reported digital interventions improved multiple PA outcomes (daily steps, MVPA time, and total PA time). However, findings from the remaining systematic reviews were mixed. Similarly, findings for SB were contrasting. In terms of components used, monitor/sensor-only intervention delivery methods were most frequently implemented. Eleven different theoretical frameworks were identified, with social cognitive theory being the most prominent theory used to guide interventions. Twenty-eight different BCTs were reported, with goal setting, self-monitoring, feedback, and social support being the most frequently used. All 5 systematic reviews were of low or critically low quality, each incorporating unique primary studies (CCA= 0%). CONCLUSIONS This umbrella review highlights the potential of digital interventions to increase PA and reduce SB among community-living adults. The disparate nature of current academic knowledge means that potentially efficacious research may not realistically translate to real work impacts. Namely, our umbrella review identifies a lack of consensus around outcomes and components at both an individual (e.g. difficult to collate and compare findings) and multiple study (poor reported quality of systematic reviews through use of AMSTAR-2) level. Collective, concerted action is required to standardize outcomes and improve systematic review reporting in order to optimize future learning around digital interventions to support increasing PA and reducing SB in community-living adults, including traditionally overlooked populations such as informal carers. CLINICALTRIAL PROSPERO registration number: CRD42023450773