This systematic review evaluated the efficacy of electronic activity monitor systems (EAMS) interventions for increasing physical activity and decreasing weight. The review included 11 studies and 1272 total participants. Most studies found significant increases in physical activity or decreases in weight with EAMS interventions compared to control groups. However, the review was limited by heterogeneity between studies that prevented a meta-analysis. It concluded by calling for future research on EAMS interventions to be more rigorous by using stronger study designs, explicit theoretical frameworks, objective physical activity measures, and more diverse populations in order to better evaluate the effectiveness of these systems.

1. Future Work
• The EAMS interventions studied in this review demonstrated
ability to increase PA and decrease weight. Though
comparisons to other interventions produced equivocal results,
effect sizes suggest potentially clinically significant outcomes
• The limitations of this study include:
• A chance that not all relevant articles were captured
• This review does not reflect the current state of EAMS due to
quickly changing technology
• Could not conduct a meta-analysis due to heterogeneity
• First systematic review on EAMS research and outlines steps
for future research.
Methods
• Articles were
collected from
CINAHL, Cochrane
CENTRAL, Medline
Ovid, and
PsychINFO
databases, clinical
trial registry
(clinicaltrials.gov),
and reference
searching
• Two investigators
screening articles for
eligibility
Using an electronic activity monitor system as an intervention modality: A systematic review
Zakkoyya H. Lewis1,2
, Elizabeth J. Lyons1,3,4
, Jessica M. Jarvis1,2
, Jacques G. Baillargeon2,5
1
Division of Rehabilitation Sciences 2
Department of Preventative Medicine & Community Health 3
Department of Nutrition
and Metabolism 4
Center for Interdisciplinary Research in Women’s Health 5
UTMB, Division of Epidemiology and Outcomes,
Correctional Managed
ResultsBackground
• Technology is commonly used to combat obesity,
but an electronic activity monitor system (EAMS) is
not yet evaluated.
• EAMSs are defined as a wearable device that
objectively measures lifestyle physical activity and
can provide feedback, beyond the display of basic
activity count information, via the monitor display
or through a partnering application to elicit
continual self-monitoring of activity behavior.
• Study Aim: synthesize the efficacy results and
feasibility of an EAMS within a physical activity
intervention.
References
1
Barwais F, Cuddihy T, Tomson L: Physical activity, sedentary behavior and total wellness changes among sedentary adults: A 4-week randomized controlled trial. In Health and quality of life outcomes, vol. 11;
2013.2
Fitzsimons CF, Kirk A, Baker G, Michie F, Kane C, Mutrie N: Using an individualised consultation and activPAL feedback to reduce sedentary time in older Scottish adults: results of a feasibility and pilot
study. Preventive Medicine 2013, 57:718-720. 3
Hurling R, Catt M, Boni M, Fairley B, Hurst T, Murray P, Richardson A, Sodhi J: Using internet and mobile phone technology to deliver an automated physical activity program:
randomized controlled trial. In Journal of medical Internet research, vol. 9. pp. e7; 2007:e7. 4
Pellegrini CA, Verba SD, Otto AD, Helsel DL, Davis KK, Jakicic JM: The comparison of a technology-based system and an in-
person behavioral weight loss intervention. Obesity (Silver Spring) 2012, 20:356-363.5
Polzien KM, Jakicic JM, Tate DF, Otto AD: The efficacy of a technology-based system in a short-term behavioral weight loss
intervention. Obesity (Silver Spring) 2007, 15:825-830. 6
Reijonsaari K, Vehtari A, Kahilakoski O, Mechelen W, Aro T, Taimela S: The effectiveness of physical activity monitoring and distance counseling in an occupational
setting - results from a randomized controlled trial (CoAct). In BMC public health, vol. 12. pp. 344; 2012:344. 7
Shuger SL, Barry VW, Sui X, McClain A, Hand GA, Wilcox S, Meriwether RA, Hardin JW, Blair SN: Electronic
feedback in a diet- and physical activity-based lifestyle intervention for weight loss: a randomized controlled trial. Int J Behav Nutr Phys Act 2011, 8:41. 8
Slootmaker SM, Chinapaw MJ, Schuit AJ, Seidell JC, Van
Mechelen W: Feasibility and effectiveness of online physical activity advice based on a personal activity monitor: randomized controlled trial. Journal of Medical Internet Research 2009, 11:e27. 9
Tabak M, Op dAH,
Hermens H: Motivational cues as real-time feedback for changing daily activity behavior of patients with COPD. In Patient education and counseling, vol. 94. pp. 372-378; 2014:372-378. 10
Thompson WG, Kuhle CL, Koepp
GA, McCrady-Spitzer SK, Levine JA: "Go4Life" exercise counseling, accelerometer feedback, and activity levels in older people. Arch Gerontol Geriatr 2014, 58:314-319. 11
Thorndike AN: Be Fit in Residency: a
Randomized Controlled Trial of an Activity Device Among Medicine Residents. clinicaltrials.gov: Massachusetts General Hospital; 2012.
• The 11 studies included 1,272 participants with a mean age ranging from 27 to 79
years.
• Most of the studies were found to be of medium quality1,2,3,4,5,6,9,10
, two studies were
low quality8,11
, and one was of high quality7
.
• Gruve (Gruve Solution™ MUVE, Inc., USA)1
, activPAL (PAL Technologies Ltd.,
Glasgow, Scotland)2
, Bluetooth Actiwatch3
, Sense Wear armband (BodyMedia,
Pittsburgh PA)4,5,7
, PAM (model AM 200/model AM 101, PAM BV, the
Netherlands)6,8
, MTx-W sensor (Xsens Technologies, Enschese, The Netherlands)9
,
and Fitbit (Fitbit, San Francisco, CA)10,11
devices were used in the studies.
• 5 reported significant pre-post intervention differences1,2,3,4,5
, and 1 reported a
significant increase compared to the control group3
.
• 4 reported significant decreases over time4,5,7,10
, and 2 reported significant
differences between the EAMS group and another intervention or control group5,7
.
• EAMS interventions appear to be feasible with most studies reporting continual
wear of the device during waking hours and a higher retention rate of participants in
the EAMS groups.
EAMS examples
Screening Process
Funding for this project was provided by a beginning grant-in-aid from the
American Heart Association (13BGIA17110021). Dr. Lyons was additionally
supported by a research career development award (K12HD052023: Building
Interdisciplinary Research Careers in Women’s Health Program –BIRCWH)
from ORWH, OD, NIAID, and NICHD (National Institutes of Health) and a
Mentored Research Scholar Grant in Applied and Clinical Research, MRSG-
14-165-01-CPPB, from the American Cancer Society. This study was
conducted with the support of the Institute for Translational Sciences,
supported in part by a Clinical and Translational Science Award
(UL1TR000071) from the National Center for Advancing Translational
Sciences. The UTMB Claude D. Pepper Older Americans Independence
Center (P30AG024832) also provided support.
Conclusion
• There are several gaps within the literature. We suggest
several strategies to produce more rigorous research in order
to evaluate an EAMS’ effectiveness.
• Behavioral Change Techniques: EAMSs provide proven
behavioral change techniques and have the potential to
change behavior. The rationale for using these devices follow
different behavior change theories and different versions of
devices offer different techniques. Authors should explicitly
discuss EAMS version, theoretical rationale, and the
implemented behavioral change techniques.
• Theoretical Framework: There are several different
components within an EAMS that can make them effective. In
order to evaluate which components result in physical activity
change authors should maximize the potential of EAMSs by
using all their components and provide more in-depth process
evaluations
• Study Design: In order to aggregate data quantitatively and
move research forward, studies should:
• Be sufficiently powered
• Conduct follow-up assessments
• Objectively measure physical activity
• Include diverse populations
• Complete analyses of cost-effectiveness and public health
impact