Effectiveness of Fitbit-Based Interventions in Improving 24-hour Movement Behaviors: A Systematic Review and Meta-Analysis

Introduction All activities performed by an individual over a 24-hour period can be classified into four categories—moderate-to-vigorous physical activity (MVPA), light physical activity (LPA), sedentary behavior (SB), and sleep—collectively referred to as 24-hour movement behaviors. Fitbit devices can not only monitor all components of 24-hour movement behaviors but are also cost-effective and reliable. The aim of this meta-analysis was to assess the impact of Fitbit-based interventions on 24-hour movement behaviors outcomes. Methods To identify studies that employed Fitbit devices as intervention tools to improve 24-hour movement behaviors, the following five electronic databases were searched: PubMed, Embase, SCOPUS, Cochrane Library, and Web of Science. Study quality was evaluated using the Cochrane Risk-of-Bias tool. Meta-analysis was performed using a random-effects model to assess the pooled effects of Fitbit-based interventions on MVPA, LPA, SB, and sleep. Results Forty-five studies involving 5234 participants were included in this meta-analysis. Fitbit-based interventions can significantly increase MVPA (MD 4.44 min/day; 95% CI 2.77 to 6.10; P <0.05) and reduce SB (MD –10.36 min/day; 95% CI –18.40 to –2.32; P <0.05). However, these interventions fail to significantly increase LPA (MD –0.55 min/day; 95% CI –4.47 to 3.37; P =0.78) and sleep (MD 19.64 min/day; 95% CI –1.64 to 40.93; P =0.07). Interestingly, subgroup analyses showed that Fitbit-based interventions were more effective at improving MVPA, SB, and LPA in adults than in children and adolescents. Moreover, programs targeting multiple behavior changes simultaneously appeared to be more effective at reducing SB than those targeting changes in a single behavior. Conclusions Fitbit-based interventions can motivate a shift from SB and LPA to MVPA and sleep. Further, Fitbit devices may be a feasible and effective tool for improving 24-hour movement behaviors in adults. Nevertheless, additional studies are needed to explore the effectiveness of Fitbit-based interventions in improving 24-hour movement behaviors among children and adolescents.