Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis
IntroductionMental health conditions are highly prevalent among adolescents, affecting one in seven individuals and accounting for 15% of the global disease burden in this age group. The promotion of health behaviours including physical activity, nutrition, and sleep, and reduction of sedentary beha...
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2025-07-01
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| author | H. Baumann B. Singh A. E. Staiano C. Gough M. Ahmed J. Fiedler I. Timm K. Wunsch K. Wunsch A. Button Z. Yin M. F. Vasiloglou B. Sivakumar J. M. Petersen J. Dallinga C. Huong S. Schoeppe C. L. Kracht K. Spring C. Maher C. Maher C. Vandelanotte |
| author_facet | H. Baumann B. Singh A. E. Staiano C. Gough M. Ahmed J. Fiedler I. Timm K. Wunsch K. Wunsch A. Button Z. Yin M. F. Vasiloglou B. Sivakumar J. M. Petersen J. Dallinga C. Huong S. Schoeppe C. L. Kracht K. Spring C. Maher C. Maher C. Vandelanotte |
| author_sort | H. Baumann |
| collection | DOAJ |
| description | IntroductionMental health conditions are highly prevalent among adolescents, affecting one in seven individuals and accounting for 15% of the global disease burden in this age group. The promotion of health behaviours including physical activity, nutrition, and sleep, and reduction of sedentary behaviour, has been shown to significantly improve symptoms of mental health conditions in adolescents. However, addressing this public health challenge at a population level requires scalable interventions, such as mobile health (mHealth) interventions. However, the effectiveness of mHealth interventions in achieving clinically meaningful mental health improvements for adolescents with emotional, behavioural, or eating disorders remains unclear. Therefore, this systematic review and meta-analysis evaluated the effectiveness of mHealth behaviour change interventions aimed at improving physical activity (PA), sedentary behaviour (SB), nutrition, or sleep on outcomes related to emotional, behavioural, and eating disorders in adolescents.MethodsA systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPERO ID: CRD42024591285). Eight databases were searched for randomized controlled trials (RCTs) published up to September 2024. Eligible studies included participants in early (11–14 years), middle (15–17 years) and late (18–21 years) adolescence with clinical diagnosis or self-report of emotional, behavioural, or eating disorders, where interventions targeted physical activity, sedentary behaviour, nutrition, or sleep. The cochrane risk of bias 2.0 (ROB2) and cochrane grading of recommendations assessment, development and evaluation tool (GRADE) were applied. Pooled effect sizes were calculated as standardized mean differences (SMD) with 95% confidence intervals using random-effect models.ResultsNine RCTs involving 3,703 participants were analysed across emotional, behavioural, and eating disorders. The meta-analysis yielded a significant reduction in anxiety (6 Studies, 2086 participants, SMD [95% CI] = −0.19 [−0.37, −0.01], I2 = 71%, with positive effects for sleep focussed interventions as well as multimodal interventions (PA, SB, diet, sleep) and eating disorders (3 studies, 732 participants, SMD [95% CI] = −0.23 [−0.44, −0.02], I2 = 38%, with positive effects for diet and combined diet/PA interventions). In contrast, depressive (7 Studies, 1855 participants, SMD [95%CI] of −0.12 [−0.28, −0.04], I2 59%) and behavioural disorders symptoms (2 studies, 560 participants, SMD [95%CI] = −0.71 [1.77, 0.36], I2 = 95) showed no significant pooled effect. The cumulative evidence was weakened by high heterogeneity of trial design and low overall certainty of evidence as indicated by ROB2 and GRADE assessments. Across interventions, trials characterized by higher session frequency, greater intensity (e.g., more vigorous physical activity), longer duration, and hybrid delivery methods, including some face-to-face counselling were associated with larger effect sizes but reduced scalability.DiscussionThese findings suggest that mHealth interventions incorporating health behavior modifications may effectively reduce anxiety and eating disorder symptoms in adolescents. However, modest and mixed effects on depression and behavioural disorders, together with a low number of included studies, considerable heterogeneity and low certainty of evidence, underscore the need for further high-quality RCTs to evaluate long-term efficacy. Combining mHealth interventions with standard clinical care may enhance symptom improvements in adolescents.Systematic Review Registrationidentifier (CRD42024591285). |
| format | Article |
| id | doaj-art-207c0949b8d84194a09a54818059f27e |
| institution | Kabale University |
| issn | 2673-253X |
| language | English |
| publishDate | 2025-07-01 |
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| series | Frontiers in Digital Health |
| spelling | doaj-art-207c0949b8d84194a09a54818059f27e2025-08-20T03:28:13ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-07-01710.3389/fdgth.2025.15936771593677Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysisH. Baumann0B. Singh1A. E. Staiano2C. Gough3M. Ahmed4J. Fiedler5I. Timm6K. Wunsch7K. Wunsch8A. Button9Z. Yin10M. F. Vasiloglou11B. Sivakumar12J. M. Petersen13J. Dallinga14C. Huong15S. Schoeppe16C. L. Kracht17K. Spring18C. Maher19C. Maher20C. Vandelanotte21Movement-oriented Prevention and Rehabilitation, German Sport University Cologne, Cologne, North Rhine-Westphalia, GermanyAllied Health & Human Performance Academic Unit, University of South Australia, Adelaide, SA, AustraliaDepartment of Pediatric Obesity and Health Behavior, Pennington Biomedical Research Center, Baton Rouge, LA, United StatesCollege of Nursing and Health Sciences, Flinders University, Adelaide, SA, AustraliaDepartment of Nutritional Sciences and Joannah and Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, ON, CanadaInstitute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Karlsruhe, Baden-Württemberg, GermanyInstitute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Karlsruhe, Baden-Württemberg, GermanyInstitute of Sport and Sport Science, Karlsruhe Institute of Technology, Karlsruhe, Karlsruhe, Baden-Württemberg, GermanyDepartment of Health and Social Sciences, Hochschule Fresenius, Heidelberg, Baden-Württemberg, GermanyDepartment of Psychiatry, Virginia Commonwealth University, Richmond, VA, United StatesDepartment of Health and Kinesiology, University of Texas at San Antonio, San Antonio, TX, United States0Independent Researcher, Bern, Switzerland1Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, CanadaCollege of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia2Centre of Expertise Health Innovation, The Hague University of Applied Sciences, Den Haag, South Holland, NetherlandsDepartment of Health and Kinesiology, University of Texas at San Antonio, San Antonio, TX, United States3Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, QLD, Australia4Division of Physical Activity and Weight Management, Department of Internal Medicine, University of Kansas Medical Centre, Kansas City, KS, United StatesAllied Health & Human Performance Academic Unit, University of South Australia, Adelaide, SA, AustraliaAllied Health & Human Performance Academic Unit, University of South Australia, Adelaide, SA, Australia5School of Health and Medical Sciences, University of South Australia, Adelaide, SA, Australia3Physical Activity Research Group, Appleton Institute, Central Queensland University, Rockhampton, QLD, AustraliaIntroductionMental health conditions are highly prevalent among adolescents, affecting one in seven individuals and accounting for 15% of the global disease burden in this age group. The promotion of health behaviours including physical activity, nutrition, and sleep, and reduction of sedentary behaviour, has been shown to significantly improve symptoms of mental health conditions in adolescents. However, addressing this public health challenge at a population level requires scalable interventions, such as mobile health (mHealth) interventions. However, the effectiveness of mHealth interventions in achieving clinically meaningful mental health improvements for adolescents with emotional, behavioural, or eating disorders remains unclear. Therefore, this systematic review and meta-analysis evaluated the effectiveness of mHealth behaviour change interventions aimed at improving physical activity (PA), sedentary behaviour (SB), nutrition, or sleep on outcomes related to emotional, behavioural, and eating disorders in adolescents.MethodsA systematic review and meta-analysis were conducted in accordance with PRISMA guidelines (PROSPERO ID: CRD42024591285). Eight databases were searched for randomized controlled trials (RCTs) published up to September 2024. Eligible studies included participants in early (11–14 years), middle (15–17 years) and late (18–21 years) adolescence with clinical diagnosis or self-report of emotional, behavioural, or eating disorders, where interventions targeted physical activity, sedentary behaviour, nutrition, or sleep. The cochrane risk of bias 2.0 (ROB2) and cochrane grading of recommendations assessment, development and evaluation tool (GRADE) were applied. Pooled effect sizes were calculated as standardized mean differences (SMD) with 95% confidence intervals using random-effect models.ResultsNine RCTs involving 3,703 participants were analysed across emotional, behavioural, and eating disorders. The meta-analysis yielded a significant reduction in anxiety (6 Studies, 2086 participants, SMD [95% CI] = −0.19 [−0.37, −0.01], I2 = 71%, with positive effects for sleep focussed interventions as well as multimodal interventions (PA, SB, diet, sleep) and eating disorders (3 studies, 732 participants, SMD [95% CI] = −0.23 [−0.44, −0.02], I2 = 38%, with positive effects for diet and combined diet/PA interventions). In contrast, depressive (7 Studies, 1855 participants, SMD [95%CI] of −0.12 [−0.28, −0.04], I2 59%) and behavioural disorders symptoms (2 studies, 560 participants, SMD [95%CI] = −0.71 [1.77, 0.36], I2 = 95) showed no significant pooled effect. The cumulative evidence was weakened by high heterogeneity of trial design and low overall certainty of evidence as indicated by ROB2 and GRADE assessments. Across interventions, trials characterized by higher session frequency, greater intensity (e.g., more vigorous physical activity), longer duration, and hybrid delivery methods, including some face-to-face counselling were associated with larger effect sizes but reduced scalability.DiscussionThese findings suggest that mHealth interventions incorporating health behavior modifications may effectively reduce anxiety and eating disorder symptoms in adolescents. However, modest and mixed effects on depression and behavioural disorders, together with a low number of included studies, considerable heterogeneity and low certainty of evidence, underscore the need for further high-quality RCTs to evaluate long-term efficacy. Combining mHealth interventions with standard clinical care may enhance symptom improvements in adolescents.Systematic Review Registrationidentifier (CRD42024591285).https://www.frontiersin.org/articles/10.3389/fdgth.2025.1593677/fullmobile healthadolescent mental healthdigital interventionsphysical activitysedentary behaviornutrition |
| spellingShingle | H. Baumann B. Singh A. E. Staiano C. Gough M. Ahmed J. Fiedler I. Timm K. Wunsch K. Wunsch A. Button Z. Yin M. F. Vasiloglou B. Sivakumar J. M. Petersen J. Dallinga C. Huong S. Schoeppe C. L. Kracht K. Spring C. Maher C. Maher C. Vandelanotte Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis Frontiers in Digital Health mobile health adolescent mental health digital interventions physical activity sedentary behavior nutrition |
| title | Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis |
| title_full | Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis |
| title_fullStr | Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis |
| title_full_unstemmed | Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis |
| title_short | Effectiveness of mHealth interventions targeting physical activity, sedentary behaviour, sleep or nutrition on emotional, behavioural and eating disorders in adolescents: a systematic review and meta-analysis |
| title_sort | effectiveness of mhealth interventions targeting physical activity sedentary behaviour sleep or nutrition on emotional behavioural and eating disorders in adolescents a systematic review and meta analysis |
| topic | mobile health adolescent mental health digital interventions physical activity sedentary behavior nutrition |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2025.1593677/full |
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