title: Using an electronic activity monitor system as an intervention modality: A systematic review.
abstract: BACKGROUND
  Obesity is a growing global health concern that may lead to cardiovascular disease, type II diabetes, and cancer. Several systematic reviews have shown that technology is successful in combating obesity through increased physical activity, but there is no known review on interventions that use an electronic activity monitor system (EAMS). 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. These devices improve upon standard pedometers because they have the ability to provide visual feedback on activity progression, verbal encouragement, and social comparison. This systematic review aimed to synthesize the efficacy and feasibility results of EAMSs within published physical activity interventions.
  
  
  METHODS
  Electronic databases and journal references were searched for relevant articles. Data sources included CINAHL, Cochrane CENTRAL, Medline Ovid, PsycINFO, and clinicaltrials.gov. Out of the 1,574 retrieved, 11 articles met the inclusion criteria. These articles were reviewed for quality and content based on a risk of bias tool and intervention components.
  
  
  RESULTS
  Most articles were determined to be of medium quality while two were of low quality, and one of high quality. Significant pre-post improvements in the EAMS group were found in five of nine studies for physical activity and in four of five studies for weight. One found a significant increase in physical activity and two studies found significant weight loss in the intervention group compared with the comparator group. The 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.
  
  
  CONCLUSIONS
  These studies provide preliminary evidence suggesting that EAMS can increase physical activity and decrease weight significantly, but their efficacy compared to other interventions has not yet been demonstrated. More high-quality randomized controlled trials are needed to evaluate the overall effect of EAMS, examine which EAMS features are most effective, and determine which populations are most receptive to an EAMS.
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch (UTMB), 301 University Blvd, Galveston, TX, USA. zalewisp@utmb.edu.|Department of Preventive Medicine & Community Health, UTMB, Galveston, TX, USA. zalewisp@utmb.edu.
authors.forename: Zakkoyya H
authors.initials: ZH
authors.lastname: Lewis
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch (UTMB), 301 University Blvd, Galveston, TX, USA. ellyons@utmb.edu.|Department of Nutrition and Metabolism, UTMB, Galveston, TX, USA. ellyons@utmb.edu.|Center for Interdisciplinary Research in Women's Health, UTMB, Galveston, TX, USA. ellyons@utmb.edu.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Lyons
authors.affiliation: Division of Rehabilitation Sciences, University of Texas Medical Branch (UTMB), 301 University Blvd, Galveston, TX, USA. jmjarvis@utmb.edu.|Department of Preventive Medicine & Community Health, UTMB, Galveston, TX, USA. jmjarvis@utmb.edu.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Jarvis
authors.affiliation: Department of Preventive Medicine & Community Health, UTMB, Galveston, TX, USA. jbaillar@utmb.edu.|Division of Epidemiology and Outcomes, Correctional Managed Care, UTMB, Galveston, TX, USA. jbaillar@utmb.edu.
authors.forename: Jacques
authors.initials: J
authors.lastname: Baillargeon
mesh_terms: D015374:Biosensing Techniques / Q000295:instrumentation*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000517:prevention & control*; D006293:Health Promotion / Q000379:methods*; D006304:Health Status; D006801:Humans; D008019:Life Style; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012648:Self Care / Q000379:methods