J. Med. Internet Res. - Assessing the internal and external validity of mobile health physical activity promotion interventions: a systematic literature review using the RE-AIM framework.

Tópicos

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Resumo

CKGROUND: Mobile health (mHealth) interventions are effective in promoting physical activity (PA); however, the degree to which external validity indicators are reported is unclear.OBJECTIVE: The purpose of this systematic review was to use the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework to determine the extent to which mHealth intervention research for promoting PA reports on factors that inform generalizability across settings and populations and to provide recommendations for investigators planning to conduct this type of research.METHODS: Twenty articles reflecting 15 trials published between 2000 and 2012 were identified through a systematic review process (ie, queries of three online databases and reference lists of eligible articles) and met inclusion criteria (ie, implementation of mobile technologies, target physical activity, and provide original data). Two researchers coded each article using a validated RE-AIM data extraction tool (reach, efficacy/effectiveness, adoption, implementation, maintenance). Two members of the study team independently abstracted information from each article (inter-rater reliability >90%) and group meetings were used to gain consensus on discrepancies.RESULTS: The majority of studies were randomized controlled trials (n=14). The average reporting across RE-AIM indicators varied by dimension (reach=53.3%, 2.67/5; effectiveness/efficacy=60.0%, 2.4/4; adoption=11.1%, 0.7/6; implementation=24.4%, 0.7/3; maintenance=0%, 0/3). While most studies described changes in the primary outcome (effectiveness), few addressed the representativeness of participants (reach) or settings (adoption) and few reported on issues related to maintenance and degree of implementation fidelity.CONCLUSIONS: This review suggests that more focus is needed on research designs that highlight and report on both internal and external validity indicators. Specific recommendations are provided to encourage future mHealth interventionists and investigators to report on representativeness, settings, delivery agents for planned interventions, the extent to which protocol is delivered as intended, and maintenance of effects at the individual or organizational level.

Resumo Limpo

ckground mobil health mhealth intervent effect promot physic activ pa howev degre extern valid indic report unclearobject purpos systemat review use reaim reach effect adopt implement mainten framework determin extent mhealth intervent research promot pa report factor inform generaliz across set popul provid recommend investig plan conduct type researchmethod twenti articl reflect trial publish identifi systemat review process ie queri three onlin databas refer list elig articl met inclus criteria ie implement mobil technolog target physic activ provid origin data two research code articl use valid reaim data extract tool reach efficacyeffect adopt implement mainten two member studi team independ abstract inform articl interrat reliabl group meet use gain consensus discrepanciesresult major studi random control trial n averag report across reaim indic vari dimens reach effectivenessefficaci adopt implement mainten studi describ chang primari outcom effect address repres particip reach set adopt report issu relat mainten degre implement fidelityconclus review suggest focus need research design highlight report intern extern valid indic specif recommend provid encourag futur mhealth interventionist investig report repres set deliveri agent plan intervent extent protocol deliv intend mainten effect individu organiz level

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