Published on January 9, 2023 – Mobile health interventions are promising behavior change tools. However, there is a concern that they may benefit some populations less than others and thus widen inequalities in health. Therefore, together with researchers from Germany, the United Kingdom and Belgium, our vice-chair and secretary Eline Smit conducted a systematic review into this topic. This review investigated differences in uptake of, engagement with, and effectiveness of mobile interventions for weight-related behaviors (i.e., diet, physical activity, and sedentary behavior) based on a range of inequality indicators including age, gender, race/ethnicity, and socioeconomic status.
The protocol for this review was registered on PROSPERO (CRD42020192473). Six databases (CINAHL, EMBASE, ProQuest, PsycINFO, Pubmed, and Web of Science) were searched from inception to July 2021. Publications were eligible for inclusion if they reported the results of an exclusively mobile intervention and examined outcomes by at least one inequality indicator. Sixteen publications reporting on 13 studies were included with most reporting on multiple behaviors and inequality indicators. Uptake of mobile interventions was investigated in one study with no differences reported by the inequality indicators studied. Studies investigating engagement with mobile interventions (n = 7) reported differences by age (n = 1), gender (n = 3), ethnicity (n = 2), and education (n = 2), while those investigating effectiveness of mobile interventions (n = 9) reported differences by age (n = 3), gender (n = 5), education (n = 2), occupation (n = 1), and geographical location (n = 1). Given the limited number of studies and their inconsistent findings, evidence of the presence of a digital divide in mobile interventions targeting weight-related behaviors is inconclusive. Therefore, Eline and the other authors recommend that inequality indicators are specifically addressed, analyzed, and reported when evaluating mobile interventions in the future – it is with this evidence only, that conclusions can be drawn about the existence and nature of a digital divide when it concerns mobile health interventions.
The full paper can be found here (open access).