Journal Reading 2f1v1c

Effectivity of a Smartphone Application to Promote Physical Activity in Primary Care: the SMART MOVE randomised controlled trial Anindya Herwidaputri Idri Nelvia Siska R. Pembimbing: dr. Oryzati Hilman Agrimon, M.Sc., CMFM, Ph.D

Physical inactivity is a major, potentially modifiable, risk factor for cardiovascular disease, cancer, and other chronic diseases. Effective, simple, and generalisable interventions that will increase physical activity in populations are needed. This research aim is to evaluate the effectiveness of a smartphone application (app) to increase physical activity in primary care.

PICO P : 90 patients were selected from primary Health care smartphone aged > 16 years who met the inclusion criteria I

: using SMART MOVE intervention shares the basic feature with software acupedo pro aplication pedometer and goals to reach 10.000 steps a day C : control group which told to walk 30 minutes a day

O : Post intervention of Use smartphone apps significantly increased physical activity. But There were not significant differences between control and intervention groups the systolic blood pressure, diastolic blood pressure, body weight, BMI, mental examples of health and quality of life.

Critical Apraissal Tools

Are the result valid? Were participant randomized? Yes, in page 384, in the last sentence of introduction part, it is stated “ This randomised controlled trial (RCT) aimed to evaluate the effectiveness of a smartphone app in increasing physical activity in primary care In page 385, in the first pharagraph of randomisation and intervention, it is also stated “Randomisation occurred using random permuted blocks to ensure there were similar numbers of participants in the intervention and control groups”

Were randomization concelaed?  Yes. In page 385, in the second pharagraph of randomisation and intervention, it’s stated “After the randomisation code was assigned, baseline screening was conducted blinded, during which relevant clinical, anthropometric, psychological, and mobile device data were collected.”  Yes. In page 385, in the third pharagraph of randomisation and intervention, it’s stated “the allocation sequence was concealed from all study investigators and participants until all codes were assigned and week 1 was completed.”

Cont…  Were participants analyzed in the groups to which they were randomized?  Yes. In page 385, in the third pharagraph of randomisation and intervention, it’s stated “Both intervention and control groups were then given similar physical activity goals and information on the benefits of exercise; however, only the intervention group was told how to use the app to help them achieve these goals.” Were participants in each group similar with regard to known prognostic variables? Yes, on page 389 Table 2 showed similarity between two groups

Cont…  Were participants aware of group allocation?

No, all participants didn’t know in which group they’re placed.

Were clinicians aware of group allocation?

 Yes, on page 385, it is stated “The same independent investigator was responsible for asg participants to the intervention and control groups after being called at a central site.”

Cont…  Were outcome assesors aware of group allocation ?  Yes. In page 386, it’s stated, “At the end of weeks 1, 2, and 8, allnparticipants were ed via SMS and asked to email their stepcount data to the research team using a ‘share data’ function of the app. All participants were invited back for follow-up testing within 1 week of finishing the trial.”

 Was follow up complete ?  Yes. In page 387, in the last sentence of results, it’s stated “ of the 90 participants randomised, 77 (86%) completed follow up; most loss to follow up occurred during baseline week [figure 1].”

What are the results?  How large was the treatment effect?  On page 388, Figure 2. It is stated the primary outcome, the mean change in step count from week 1 to week 8 was compared between the intervention and control groups.

 How precise was the estimate of the treatment effect?  Changes between baseline and followup for control and intervention groups for all primary and secondary outcomes are outlined in Table 2. After adjusting for possible explanatory variables, there was still evidence of a significant treatment effect (P = 0.009), where the difference in mean improvement in mean daily step count from week 1 to week 8 inclusive was 1029 (95% CI 214 to 1843) steps per day favouring the intervention.

How can I apply the results?  Were study participants similar to my own situation? Yes, Because in Indonesia the majority of the population is already using a smartphone, just have to the application and understand how to use it. Were all clinically-important outcomes (harms and benefits) considered?

Results on page 389 Table 2 shows significant differences smartphone app usage increase the number of steps in one week than the week 8, but for other variables the study did not show good results