A systematic review assessing mobile health (mHealth) physical activity interventions in older adults with and without chronic health conditions.

Background: Engaging in regular physical activity is a key protective factor for reducing the risk of developing chronic health conditions associated with ageing. However, physical activity declines markedly with increasing age. The aim of this prospectively registered systematic review was to evaluate the effectiveness of mobile health (mHealth) physical activity interventions, and the behaviour change techniques (BCTs) they employ, in older adults. Methods: This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO), CRD42022342016. Eight databases (APA PsycINFO, ClinicalTrials.gov, Cochrane Library, Medline, PubMed, Scopus, SPORTDiscus, Web of Science) were searched up to February 2025. Eligible studies were randomised controlled trials (RCTs) evaluating mHealth interventions (e.g., smartphone apps, wearable devices) designed to increase physical activity in community-dwelling older adults (≥65 years) living with and without chronic health conditions. Primary outcomes included measures of physical activity (both objective and self-reported), functional fitness, and adverse effects. Secondary outcomes were physiological health, psychosocial wellbeing, and cognition. Risk of bias was assessed using the Cochrane Risk of Bias tool version 2, and certainty of the evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Nine RCTs were included, assessing mHealth interventions such as wearable devices, smartphone apps, or virtual coaching. Due to methodological heterogeneity across studies, meta-analyses were not possible. A narrative synthesis revealed limited or inconsistent findings for all primary and secondary outcomes. Interventions incorporated a limited number of the 93 available BCTs, with the most frequently used being self-monitoring of behaviour, information about antecedents, and feedback on behaviour. There was substantial variation in the number and combination of BCTs employed across studies, limiting the ability to evaluate their individual or combined effectiveness. Due to insufficient data, it was not possible to compare the effectiveness of mHealth interventions between healthy older adults and those living with chronic ill-health. Conclusions: The current review highlights that further research in this area is needed, as well as a requirement to optimise the design of mHealth physical activity interventions that incorporate suitable BCTs so that they can adequately address the complex needs of those living with and without chronic health conditions.