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Table 1 Summary of included studies

From: The effectiveness of digital interventions for increasing physical activity in individuals of low socioeconomic status: a systematic review and meta-analysis

Author, date, setting, location, study design Population/health condition, age, gender SES High/low and % per group Intervention: type of tech, duration, frequency, follow-up, additional support/incentives Number of behavioural change techniques used Outcome measure and measuring tool.
Aittasalo 2012 [45]
Office-based occupational health units, Southern Finland, RCT.
Insufficiently physically active healthy participants.
I: n = 123, 44.1 yrs.
87% female
C: n = 118, 45.3 yrs.
78% female
Education:
High: University, polytechnic
I = 94%, C = 91%.
Low: basic
I = 6%, C = 9%.
I: One-hour preliminary meeting including benefits of PA and walking, self-monitoring of PA with a pedometer (Omron, Walking Style II) and logbooks, monthly email message.
C: No intervention.
Duration: 12 months.
7 Walking minutes/week (to work, for transport, for leisure, stairs), sedentary time. (SR)
Alley 2016 [46]
Australian metropolitan and regional cities, RCT.
Adults not meeting physical activity recommendations.
I1: n = 53; 55.3 yrs.
67% female
I2: n = 56; 52.2 yrs.
75% female
C: n = 45; 55.2 yrs.
84% female
Income/year:
High
>AUD$52 K
I1 = 68%, I2 = 62%, C = 69%.
Low
<AUD$52 K
I1 = 32%, I2 = 38%, C = 31%
I1: ‘My Activity Coach’ web-based intervention delivered 1 module of computer-tailored advice every 2 weeks. Biweekly web-based video coaching. (Alley 2.0 in analysis)
I2: ‘My Activity Coach’ web-based intervention delivered 1 module of computer-tailored advice every 2 weeks. Biweekly email reminder. (Alley 1.0 in analysis)
C: No intervention, waiting list.
Duration: 8 weeks, follow up 6 months.
The incentive to those who complete all surveys: entry into the draw for a pedometer, Fitbit, heart rate monitor.
10 PA minutes/week via Active Australia Survey. (SR)
Ashton 2017 [47]
Hunter region, New South Wales, Australia, RCT.
Men aged 18–25 not meeting physical activity recommendations.I: n = 26, 22.4 yrs.
C: n = 24, 21.9 yrs
Income/week:
High > $1 K
I = 15%, C = 4%
Low < $1 K
I = 85%, C = 96%
I: A website with resource library, Jawbone PA tracker with an associated mobile phone app, One-hour weekly face to face group sessions, personalised food and nutrient report, private Facebook discussion group, Gymstick resistance band, TEMPlate guide for meal portions.
C: No intervention, waiting list.
Duration: 3 months.
9 Steps/day measured by Yamax digiwalker SW200 pedometers.
Minutes/week MVPA using Godin leisure-time exercise questionnaire. (SR)
Creel 2016 [48]
Midwestern US city, RCT.
People undergoing bariatric surgery.
I1: n = 52, 41.8 yrs. 84.6% female
I2: n = 48, 43.6 yrs. 83.3%female C: n = 50, 44.2 yrs.
84% female
Years of Education:
High > 14 yrs.;
I1 = 37%,
I2 = 36%,
C = 36%
Low ≤14 yrs.
I1 = 63%,
I2 = 64%,
C = 64%
I1: Omron HJ-113 pedometer, data recorded by participants daily, written advice on how to increase PA, Educational booklet.
I2: Omron HJ-113 pedometer, data recorded by participants daily, education manual, exercise counselling at clinic visits, Educational booklet.
C: Educational booklet.
Interventions were delivered before and for 6 months after bariatric surgery
Duration: 6 months
Incentive: Study completers received $50 gift card.
3 Steps/day, MVPA bouts, sedentary time, and light physical activity measured by GT3X accelerometer.
Duncan 2014 [49]
Queensland, Australia, RCT
Males aged 35–54 years
I: n = 205, 44.2 yrs.
C: n = 96, 73.8 yrs
Education:
High: Higher/further education
I = 78.1%, C = 79.1%;
Low: Secondary school or less I = 22%, C = 20.8%
I: IT-based ManUp challenges on PA and healthy eating
C: Print-based ManUp challenges on PA and healthy eating
Duration: 9 months.
11 PA minutes/week via Active Australia Questionnaire. (SR)
Fjeldsoe 2016 [50]
New South Wales, Australia, RCT.
Healthy adult participants.
I: n = 114, 55.5 yrs. 64.9% Female C: n = 114, 51.2 yrs. 68.4% female
Deprivation:
High: SEIFA > lowest 2 quintiles
I = 75%, C = 68%
Low: SEIFA = lowest 2 quintiles
I = 25%, C = 32%
I: Get Healthy, Stay healthy initiative - tailored text messages ranging from 4/fortnight to 1/fortnight.
C: No intervention, written feedback from each assessment point.
Duration: 6 months.
12 MVPA via Actigraph GT1M.
Walking > 30 min (frequency), MVPA> 30 min (frequency) from 3Q-PA. (SR)
Golsteijn 2018 [51]
Hospital oncology departments throughout The Netherlands, RCT.
Patients and survivors of prostate and colorectal cancer.
I: n = 249, 66.6 yrs. 14.9% Female C: n = 229, 66.4 yrs. 10.9% Female
Education:
High I = 56%, C = 50%;
Low I = 44%, C = 50.0%
I: OncoActive intervention. Tailored PA advice at baseline, after 2 months, after 3 months delivered online and in paper; provision of pedometer and access to interactive online PA resources.
C: Usual care.
Duration: 3 months, follow-up at 6 months
9 MVPA minutes/week via Actigraph.
MVPA days > 30 min of PA via Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) (SR)
Greaney 2017 [52]
Rural North Carolina, USA, RCT.
Overweight black females.
I: n = 60, 36.6 yrs.
C: n = 61, 35.6 yrs
Federal Poverty Level (FPL):
High: Above FPL I = 38.9%, C = 35.6%;
Low: At or below FPL I = 61.1, C = 64.4
I: Shape intervention - tailored behaviour change goals, printed skills training materials, weekly interactive voice responses telephone calls, monthly telephone coaching, a no-cost membership to YMCA facility. For the first 8 weeks, participants were assigned 3 goals, and then 4 goals for each 8-week interval.
C: semi-annual newsletters on general wellbeing and not including PA, nutrition, and weight.
Duration: 12 months.
10 MVPA minutes via Actical accelerometer.
Gutierrez-Martinez 2018 [53]
Bogota, Columbia, Cluster RCT.
Schoolchildren
I1: n = 57, 10.4 yrs. 57.9% female I2: n = 60, 10.4 yrs. 60.0% female C: n = 67, 10.6 yrs. 53.7% female
Socioeconomic group:
High: Group 3
I1 = 35.1%, I2 = 3.3%, C = 6.0%;
Low: Groups 1 and 2
I1 = 64.9%, I2 = 96.7%, C = 94.0%
I1: MARA+SMS MARA = Standardised recess activities 20 min, 3/week SMS = daily SMS sent to parents/children. Parents were asked to show children every SMS.
I2: MARA.
C: No intervention
Duration: 10 weeks.
2 MVPA minutes/day and minutes/week, via Actigraph GT3X+.
Hawkins 2019 [54]
8 local authorities in Wales, UK, RCT.
Adults referred to a National Exercise Referral Scheme.
I: n = 88, 55.1 yrs.
60% female
C: n = 68, 58.5 yrs.
74% female
Income/year:
High > £31 K
I = 24%, C = 19%
Low ≤£31 K
I = 76%, C = 81%
I: Enhanced exercise referral programme inc. usual care plus an accelerometer-based activity monitor (MyWellnessKey) and MyWellnessCloud web portal. Usual care = 16-week structured exercise programme with consultations at start, 4 weeks, 16 weeks and 12 months.
C: Usual care.
Duration: 16 weeks, follow-up at 12 months
6 MVPA minutes, PA volume, sedentary behaviour via Actigraph GT3X.
This data was collected from a subset of 53/99 of the study sample.
Houle 2011 [55]
Regional hospital, Quebec, Canada, RCT.
Adults with Post-acute coronary syndrome
I: n = 32, 58 yrs.
18.8% female
C: n = 33, 59 yrs.
24.2% female
Family income:
High > $30 K
I = 75%,
C = 75%
Low ≤$30 K
I = 25%, C = 25%
I: Provision of a pedometer (Yamax Digiwalker SW-200), diary and information regarding exercise after acute coronary syndrome, using the pedometer, and recommended exercise goals by a clinical nurse specialist. One phone call within 2 weeks, face to face consultations at 3, 6, 9, and 12 months
C: Usual care.
Duration: 12 months.
9 Steps/day by Yamax Digiwalker NL-2000.
Laing 2014 [56]
Primary Care clinics, Los Angeles, USA, RCT.
Adults with BMI > 25.
I: n = 107, 43.2 yrs.
76% female
C: n = 105, 43.1 yrs. 70% female
Annual income:
High: > $75 K I = 41%, C = 33%
Low ≤$75 K I = 59%, C = 67%
I: Usual care plus Mobile Fitness project app.
C: Usual care.
Duration: 6 months.
Incentive: $20 gift card for attending each follow-up visit.
6 PA days/week (SR)
Muller 2016 [57]
Urban Malaysia, RCT.
Older adults.
I: n = 22, 63.6 yrs.
73% female C: n = 21, 62.9 yrs.
76% female
Education:
High: Post-secondary
I = 73%, C = 81%
Low: Secondary
I = 27%, C = 19%
I: Booklet with information on benefits of exercise, safety, age-appropriate exercises. Daily text messages including instruction and praise.
C: Booklet with information on benefits of exercise, safety, age-appropriate exercises.
Duration: 12 weeks, follow up 24 weeks.
4 Exercise frequency (SR).
Weekly MET-Minutes and daily sitting hours via IPAQ short form (SR).
Phelan 2017 [58]
Women, Infants and Children clinics in California, USA, RCT.
Postpartum women with low-income.
I: n = 174, 27.5 yrs.
C: n = 196, 28.6 yrs
All sample are low SES. I: Standard care plus internet-based weight loss programme including goal setting for weight and physical activity, online resources, automated feedback, web diary, weight, and physical activity tracker, instructional and inspirational videos, and message board. Four weekly text messages re new material, motivation, support, and feedback. Monthly face to face group sessions.
C: Standard care plus newsletters every two months with information about weight control, exercise, nutrition, and wellness.
Duration:12 months.
9 MVPA, LPA sedentary time minutes per day, via GT3X+ Actigraph.
Taylor 2016 [59]
Four worksites, Texas, USA, Cluster RCT.
Desk-based working adults.
I1: n = 59, 44 yrs. I2: n = 69, 43 yrs.
C: n = 47, 42 yrs
Education:
High: more than high school
I1 = 97%,
I2 = 91%,
C = 85%
Low: High school diploma or less
I1 = 3%,
I2 = 9%,
C = 15%
I1: Computer prompts of 3-min breaks every hour over 5 h. Computer software Workrave v 1.10, Eyes relax v 0.87. Prompts encouraged getting up to walk hallways, stairs, outdoors.
I2: One daily break of 13–15 min. Group peer-led sessions of stretching, strengthening, aerobic movements, and meditation.
C: Usual breaks, no intervention. Typical patterns were 2 × 15-min breaks and 30–60 min for lunch.
Duration: 6 months.
Incentive: $25 for baseline and 6-month assessment, $50 for 12-month assessment.
2 Steps/week, steps/day via New Lifestyles DigiWalker SW200 pedometer.
Physical activity MET minute/week and sedentary time MET minute/week via IPAQ long-form. (SR)
Sedentary leisure time minute /day via Neighbourhood quality of life study. (SR)
Vallance 2007 [60]
Northern Alberta, Canada, RCT.
Adult women breast cancer survivors.
I1: n = 94, 58 yrs. I2: n = 93, 58 yrs.
I3: n = 94, 57 yrs.
C: n = 96, 57 yrs
Income:
High: >$59 K
I1 = 45.5%, I2 = 51.2%, I3 = 36.8%, C = 46.1%
Low: ≤$59 K
I1 = 54.5%, I2 = 48.8%, I3 = 63.2, C = 53.9%
I1: Pedometer (Digi-walker SW-200) and a 12-week step calendar.
I2: Pedometer and Printed materials - exercise for Health: An exercise guide for Breast Cancer Survivors.
I3: Printed materials - exercise for Health: An exercise guide for Breast Cancer Survivors.
C: No materials, recommended to maintain PA guideline.
Duration: 12 weeks.
2 Steps/day via Digi-walker pedometer.
MVPA, VPA total minutes, walking frequency, and duration via the leisure score index of the Godin Leisure time Exercise Questionnaire. (SR)
Valle 2017 [61]
Hospital clinics, local community North Carolina, USA, RCT.
Adult women African American breast cancer survivors with BMI 20–45.
I1: n = 11, 52.2 yrs.
I2: n = 13, 52.6 yrs.
C: n= 11, 54.4 yrs
Education:
High: College or higher I1 = 100%, I2 = 84.6%, C = 72.7%;
Low: High school or less I1 = 0%, I2 = 15.4%, C = 27.3%
I1: Activity tracker (Withings Pulse) plus 1 face to face education session, Weighing scales with a companion app, 24 weekly emailed tailored feedback on weight and physical activity.
I2: 1 face to face education session, Weighing scales and companion app, 24 weekly emailed tailored feedback on weight.
C: 1 face to face education session, weighing scales with a companion app.
Duration: 6 months.
Incentive: $40 for completing each data collection point.
10 PA minutes/5 days, minutes/week via Paffenbarger Activity Questionnaire. (SR)
Van der Weegen, 2015 [62]
Southern Netherlands, Cluster RCT.
People with Type 2 Diabetes and people with COPD who did not comply with Dutch norm for healthy exercise.
I1: n = 65, 57.5 yrs. 52.3% female I2: n = 66, 56.9 yrs. 47.0% female C: n = 68, 59.2 yrs. 54.4% female
Education:
High: I1 = 70.8%, I2 = 71.2%, C = 77.9%
Low I1 = 29.2%, I2 = 28.8%, C = 22.1%
I1: Self-management support programme (SSP) and monitoring and feedback tool. SSP = four individual consultations with the practice nurse in week 1, after 2–3 months, and after 4–6 months. Monitoring and feedback tool = activity monitors mobile phone app and web app.
I2: SSP only.
C: Usual care.
Duration: 6 months, follow-up 9 months.
5 PA minutes/day via Personal Activity Monitor AM 300.
Watson 2015 [63]
Belfast, Northern Ireland, RCT
Overweight and obese adults.
I: n = 32, 51.4 yrs.
50% female C: n = 33, 52.9 yrs.
61% female
Occupational class: (both groups)
High: Class 1 = 51%
Low: Class 2 & 3 = 49%
I: Imperative Health web-based programme (AXA PPP Healthcare Ltd) including monitoring, feedback.
C: Usual care.
Duration: 24 weeks, follow up 6 and 12 months.
12 MVPA minutes/day as measured by the Recent Physical Activity Questionnaire. (SR)
  1. RCT Randomised Control Trial, SR Self-reported, yrs. years, COPD Obstructive Pulmonary Disease, SEIFA Socio-Economic Indexes for Areas