The use of eHealth to promote physical activity in people with mental health conditions: a systematic review [version 3; peer review: 3 approved]

Abstract

Background: Achieving adequate amounts of physical activity (PA) confers important physical and mental health benefits. Despite this, people with mental health conditions often do not meet recommended levels of PA. eHealth, the delivery of health information through internet and mobile technologies, is an emerging concept in healthcare which presents opportunities to improve PA. The aim of this systematic review is to describe the use of eHealth to increase or monitor PA levels in people with mental health conditions. Methods: Databases searched included OVID Medline, EMBASE, PsychInfo and Web of Science using a combination of key-words and medical subject headings. Articles were included if they described an eHealth technology designed to improve or monitor PA in people with mental health conditions. Two reviewers screened articles. Articles included in the qualitative synthesis were screened for risk of bias using the Cochrane Risk of Bias Tool for experimental studies and Downs and Black Checklist for non-experimental studies. Results: Seven studies met the eligibility criteria. A variety of eHealth platforms designed to promote or monitor PA were described in these studies; web-based (n=4), web and mobile application (n=3) and e-mail-based (n=1), one study used both a web-based and mobile application. Three studies reported eHealth interventions significantly increased PA levels, however it is unclear if eHealth interventions are superior at promoting PA compared to conventional interventions. Four studies reported that higher levels of PA, measured using eHealth, were associated with better mental health profiles. Conclusion: eHealth interventions may be an innovative low-cost method to increase PA levels which may have knock-on effects on mental health outcomes. Although some of the included studies in this review demonstrated promising results, methodological restrictions and potential biases from using subjective measures of PA limit the interpretability of these results. Future research should evaluate this promising technology using well-designed trials.