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Cited by 226Physical Activity and HealthMobile Health and mHealth ApplicationsContext-Aware Activity Recognition Systems

Fitbit-based interventions for healthy lifestyle outcomes: systematic review and meta-analysis

Open access
Ringeval, Mickael, Wagner, Gerit, Denford, James, Paré, Guy, Kitsiou, Spyros·2020·Journal of Medical Internet Research
DOI 10.2196/23954PMC PMC7589007

Published version of a preprint

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Abstract

Background: Unhealthy behaviors, such as physical inactivity, sedentary lifestyle, and unhealthful eating, remain highly prevalent, posing formidable challenges in efforts to improve cardiovascular health. While traditional interventions to promote healthy lifestyles are both costly and effective, wearable trackers, especially Fitbit devices, can provide a low-cost alternative that may effectively help large numbers of individuals become more physically fit and thereby maintain a good health status. Objective: The objectives of this meta-analysis are (1) to assess the effectiveness of interventions that incorporate a Fitbit device for healthy lifestyle outcomes (eg, steps, moderate-to-vigorous physical activity, and weight) and (2) to identify which additional intervention components or study characteristics are the most effective at improving healthy lifestyle outcomes. Methods: A systematic review was conducted, searching the following databases from 2007 to 2019: MEDLINE, EMBASE, CINAHL, and CENTRAL (Cochrane). Studies were included if (1) they were randomized controlled trials, (2) the intervention involved the use of a Fitbit device, and (3) the reported outcomes were related to healthy lifestyles. The main outcome measures were related to physical activity, sedentary behavior, and weight. All the studies were assessed for risk of bias using Cochrane criteria. A random-effects meta-analysis was conducted to estimate the treatment effect of interventions that included a Fitbit device compared with a control group. We also conducted subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) to further disentangle the effects of intervention components. Results: Our final sample comprised 41 articles reporting the results of 37 studies. For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001) and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001), a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03), and a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively). In general, the included studies were at low risk for bias, except for performance bias. Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component. Conclusions: The use of Fitbit devices in interventions has the potential to promote healthy lifestyles in terms of physical activity and weight. Fitbit devices may be useful to health professionals for patient monitoring and support. Trial Registration: PROSPERO International Prospective Register of Systematic Reviews CRD42019145450; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019145450

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis of 41 articles reporting 37 RCTs found that Fitbit-based interventions significantly increased daily steps and moderate-to-vigorous physical activity (MVPA) and reduced weight, but did not significantly reduce sedentary behavior. Goal setting was the most important complementary intervention component in subgroup and fsQCA analyses.

Key findings

  • Daily step count increased significantly: mean difference (MD) 950.54, 95% CI 475.89-1425.18; P<.001; 16 studies in meta-analysis, with high heterogeneity (I2=51%).
  • MVPA increased significantly: MD 6.16 min/day, 95% CI 2.80-9.51; P<.001; I2=62%.
  • Weight decreased significantly: MD −1.48 kg, 95% CI −2.81 to −0.14; P=.03; I2=74%.
  • Sedentary behavior did not decrease significantly: objective MD −10.62 min/day, 95% CI −35.50 to 14.27; P=.40; self-reported standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56. Subgroup and fsQCA analyses indicated that setting activity goals was the most important intervention component; theory-based interventions had a significant impact on MVPA (P<.001), and subjects’ health condition had a significant impact on weight (P=.009).

Methods

  • Systematic review and random-effects meta-analysis following PRISMA, registered in PROSPERO (CRD42019145450); databases MEDLINE, EMBASE, CINAHL, and CENTRAL were searched on July 13, 2019, from 2007 to 2019.
  • Included randomized controlled trials involving a Fitbit device and reporting healthy lifestyle outcomes; final sample comprised 41 articles reporting 37 RCTs, with 3779 participants (mean 102 per study, median 68, range 16-800).
  • Meta-analyses used Review Manager for daily steps, MVPA, sedentary behavior, and weight; subgroup analysis and fuzzy-set qualitative comparative analysis (fsQCA) explored heterogeneity and intervention components; risk of bias assessed with Cochrane criteria.

Limitations

  • The paper states it could not assess the effectiveness of the interventions on all reported outcomes, limiting analyses to physical activity outcomes, sedentary behaviors, and weight; it also could not assess the Fitbit device itself because of intervention complexity and poor device description, and could not assess behavioral change techniques because of high heterogeneity and lack of information in included studies.
  • The paper states included studies involved very heterogeneous interventions, making assessments of Fitbit intervention effects more difficult, and notes the evidence is mostly representative for adults and older subjects, with a lack of studies in youth and adolescents.
  • Evident in the text: meta-analyses showed high heterogeneity for steps (I2=51%), MVPA (I2=62%), weight (I2=74%), and self-reported sedentary behavior (I2=69%); performance bias was high for all studies because blinding was not feasible, and the small number of sedentary-behavior studies precluded subgroup analysis.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/23954

Cites

118 of 118 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 44 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Fitbit-based interventions significantly increase moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001).

    “and moderate-to-vigorous physical activity (MD 6.16, 95% CI 2.80-9.51; P<.001)”
    Quote in the paperSubstantial claim
  • Findingown data

    Fitbit-based interventions have a nonsignificant decrease in self-reported sedentary behavior (SMD −0.11, 95% CI −0.48 to 0.26; P=.56).

    “a nonsignificant decrease in objectively assessed and self-reported sedentary behavior (MD −10.62, 95% CI −35.50 to 14.27; P=.40 and standardized MD −0.11, 95% CI −0.48 to 0.26; P=.56, respectively)”
    Quote in the paperNot a substantial claim
  • Findingown data

    Fitbit-based interventions significantly decrease weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03).

    “a significant decrease in weight (MD −1.48, 95% CI −2.81 to −0.14; P=.03)”
    Quote in the paperSubstantial claim
  • Findingown data

    Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component.

    “Subgroup analysis and fsQCA demonstrated that, in addition to the effects of the Fitbit devices, setting activity goals was the most important intervention component.”
    Quote in the paperSubstantial claim
  • Findingown data

    Fitbit-based interventions significantly increase daily step count (MD 950.54, 95% CI 475.89-1425.18; P<.001).

    “For Fitbit-based interventions, we found a statistically significant increase in daily step count (mean difference [MD] 950.54, 95% CI 475.89-1425.18; P<.001)”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 15
  • May combine two claims. 25

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    The final sample comprised 41 articles reporting the results of 37 studies.

    “Our final sample comprised 41 articles reporting the results of 37 studies.”
    • Also stated in: § Study Selection · plain
      “In total, 41 articles were included, reporting the results of 37 RCTs (Figure 1) [48,49,57,67-104].”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Virtually all studies focused on individuals over the age of 18 years (36/37, 97%).

    “Virtually all studies focused on individuals over the age of 18 years (36/37, 97%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Neither the presence nor the absence of goal setting improved PA; instead, the absence of messaging and/or absence of counselling were the most relevant conditions for improving PA.

    “Interestingly, neither the presence nor the absence of goal setting improved PA. Instead, the absence of messaging and/or absence of counselling were the most relevant conditions for improving PA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There are multiple paths to better outcomes for individuals with pre-existing conditions, but the most effective one centers on theory-based interventions with goal-setting but without messaging (H1A).

    “Thus, there are multiple paths to better outcomes for individuals with pre-existing conditions, but the most effective one (albeit for the short- or long-term interventions) centers on theory-based interventions with goal-setting but without messaging (H1A).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Table 2 suggests that there are more paths to success for people with pre-existing conditions and none for people without pre-existing conditions who receive long-term interventions.

    “Table 2 suggests that there are more paths to success for people with pre-existing conditions and none for people without pre-existing conditions who receive long-term interventions.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The configuration with all the intervention components (H3) is not the most effective, having the lowest raw coverage.

    “The configuration with all the intervention components (H3) is not the most effective (it has the lowest raw coverage).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    In addition to the wearable device, other intervention components included the use of an app or a website, goal setting and prescription, messaging, education, counseling and feedback, social support, financial incentives, and the provision of another device.

    “In addition to the wearable device, other intervention components included the use of an app or a website (sometimes different from the app provided by the device manufacturer), goal setting and prescription, messaging, education, counseling and feedback, social support, financial incentives, and the provision of another device (Multimedia Appendix 4).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    A total of 3779 participants were included, with a mean of 102 participants per study (median 68) and range from 16 to 800 participants per study.

    “A total of 3779 participants were included, with a mean of 102 participants per study (median 68) and range from 16 [98] to 800 participants [82] per study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The available evidence was primarily based on studies that reported PA outcomes, such as steps and MVPA, mostly measured with an actigraph.

    “To summarize, the available evidence was primarily based on studies that reported PA outcomes, such as steps and MVPA, mostly measured with an actigraph.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The follow-up duration ranged from 1 week to 1 year, with most studies lasting less than 5 months (20/37, 54%).

    “The follow-up duration ranged from 1 week [79] to 1 year [82,90,95,101], with most studies lasting less than 5 months (20/37, 54%).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingcitation

    Overall solution consistency for the fsQCA was 0.819, which is above the usually acceptable level of 0.80.

    “In our case, overall consistency was 0.819, which is above the usually acceptable level of 0.80 [106].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [106] Ragin, C, 2008, Redesigning Social Inquiry – Fuzzy Sets and Beyond source

      Not checked in the free run.

  • May combine two claims.

    Findingown data

    The studies in the sample rarely described the wearable and ignored its specific features.

    “Indeed, the studies in our sample rarely described the wearable and ignored its specific features.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Abstracts and full-text articles were examined independently by two authors, with disagreements resolved through discussion with a third author.

    “Second, all abstracts and full-text articles were examined independently by two authors (MR and GW). Any disagreements in the selection process were resolved through discussion with a third author (GP or SK).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The protocol for this review was registered in PROSPERO (CRD42019145450).

    “The protocol for this review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42019145450).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Two authors assessed each study for risk of bias using the Cochrane Collaboration seven domain-based criteria.

    “Two authors (MR and SK) assessed each study for risk of bias using the Cochrane Collaboration seven domain-based criteria as follows [53,54]:”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [53] RevMan 5Cochrane Community2020-10-02https://community.cochrane.org/help/tools-and-software/revman-5/revman-5-download

      Not checked in the free run.

    • cites [54] Higgins, J, 2019, Cochrane Handbook for Systematic Reviews of interventions source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    There is some evidence that theory-based interventions are more effective.

    “We considered these subgroup analyses because there is some evidence that theory-based interventions are more effective [60-62]”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [60] source

      Not checked in the free run.

    • cites [61] source

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    • cites [62] source

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  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Studies with multiple intervention groups were entered once in the meta-analysis to avoid double counting the control group.

    “Studies that included multiple intervention groups (eg, group A: Fitbit alone; group B: Fitbit + text messages) were entered once in the meta-analysis to avoid double counting the control group.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Fitbit devices may be useful to health professionals for patient monitoring and support.

    “Fitbit devices may be useful to health professionals for patient monitoring and support.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Objective and self-reported measures were analyzed separately because self-reported outcomes have a higher risk of over-estimation.

    “We analyzed objective and self-reported measures separately because self-reported outcomes have a higher risk of over-estimation [58,59].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [58] source

      Not checked in the free run.

    • cites [59] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Two authors independently extracted data from each included study, with discrepancies resolved through discussion and a third author.

    “Two authors (MR and GW) independently extracted data from each of the included studies. Discrepancies were resolved through discussion and meetings with a third author (SK).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The review was conducted and reported following PRISMA guidelines.

    “We conducted and reported this review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines [51,52].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [51] source

      Not checked in the free run.

    • cites [52] source

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  • May combine two claims.

    Study design and conductnone given

    The included studies were generally at low risk for bias, except for performance bias.

    “In general, the included studies were at low risk for bias, except for performance bias.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Among the 37 included studies, allocation concealment was assessed as low risk of bias in 20 (54.05%) and unclear in 17 (45.95%).

    “Allocation concealment was assessed as being at low risk of bias (20/37, 54.05%) or unclear (17/37, 45.95%) in the included studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Blinding of outcome assessment was assessed as high risk of bias in two studies because of subjective measures and because the authors clearly mentioned that it was an unblinded clinical trial.

    “This was assessed as being at high risk of bias in two studies because of the use of subjective measures [104] and because the authors clearly mentioned that it was an unblinded clinical trial [90].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [104] source

      Not checked in the free run.

    • cites [90] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Both theory- and nontheory-based interventions contributed, but this factor depends on specific conditions in order to lead to effective interventions.

    “We found that both theory- and nontheory-based interventions contributed, but it would appear that this factor depends on specific conditions in order to lead to effective interventions.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Given the small sample size, no subgroup analysis could be conducted for sedentary behaviors.

    “Given the small sample size, no subgroup analysis could be conducted.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    Two studies were assessed as high risk for other bias because of conflicts of interest and significant differences between groups at baseline.

    “Finally, two studies were assessed as having a high risk for other bias because of conflicts of interest declared by the authors [78] and significant differences between the groups at baseline [77].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [78] source

      Not checked in the free run.

    • cites [77] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    These results are in line with prior reviews on wearables that showed no change in sedentary behaviors and an improvement in PA outcomes and weight loss.

    “These results are in line with prior reviews on wearables that showed no change in sedentary behaviors [16], and an improvement in PA outcomes [16-18,28,30-32,35,36,107] and weight loss [28,32,35,108].”
    Quote in the paperNot a substantial claim0 of 10 sources checked
    • cites [16] source

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    • cites [17] source

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    • cites [18] source

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    • cites [28] source

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    • cites [30] source

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    • cites [31] source

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    • cites [32] source

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    • cites [35] source

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    • cites [36] source

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    • cites [107] source

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  • May combine two claims.

    Interpretationown data

    Goal setting was the most promising intervention component, whereas messaging seemed to be mostly ineffective in complex interventions.

    “Furthermore, we found that goal setting was the most promising intervention component, whereas messaging seemed to be mostly ineffective in complex interventions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    The length of an intervention does not appear to be relevant, because it was not significant in the subgroup analysis and the most dominant configuration (H1A) was not affected by this factor.

    “Finally, the length of an intervention does not appear to be relevant, because it was not significant in the subgroup analysis (P=.97 for steps, P=.28 for MVPA, and P=.26 for weight), and the most dominant configuration (H1A) was not affected by this factor.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationown data

    Although the findings were not significant in all the RCTs, short-term interventions utilizing a Fitbit device generally resulted in improvements in terms of a healthy lifestyle.

    “Although the findings were not significant in all the RCTs, short-term interventions utilizing a Fitbit device generally resulted in improvements in terms of a healthy lifestyle.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Only the social interaction and data management features of activity trackers help improve well-being outcomes.

    “This study suggests that only the social interaction and data management features of activity trackers help improve well-being outcomes.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [120] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Fitbit devices, included either as the primary component of an intervention or as part of a more comprehensive and complex intervention, have the potential to improve healthy lifestyle behaviors and, in particular, PA.

    “Fitbit devices, included either as the primary component of an intervention or as part of a more comprehensive and complex intervention, have the potential to improve healthy lifestyle behaviors and, in particular, PA.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The studies in our sample involved very heterogenous interventions, rendering assessments of the effects of Fitbit interventions more difficult.

    “Despite this, and much like other reviews, the studies in our sample involved very heterogenous interventions, rendering assessments of the effects of Fitbit interventions more difficult.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    James et al found that each set of features does not impact health outcomes equally.

    “Consideration of the features of these devices is also important because James et al [120] found that each set of features does not impact health outcomes equally.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [120] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    Using these two methodologies enabled the authors to provide a fine-grained picture of the effectiveness of Fitbit-based interventions.

    “Using these two methodologies enabled us to provide a fine-grained picture of the effectiveness of Fitbit-based interventions.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductnone given

    The authors could not assess the effectiveness of the interventions on each outcome; they limited their analyses to PA outcomes, sedentary behaviors, and weight.

    “First, even though we included a large range of outcomes, we could not assess the effectiveness of the interventions on each of them. Rather, we limited our analyses to PA outcomes, sedentary behaviors, and weight.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A thorough systematic and transparent methodology was followed.

    “However, a thorough systematic and transparent methodology was followed [115,116], and the use of meta-analysis tools and fsQCA allowed us to interpret the combined effects of Fitbit devices with the other interventional components and subject characteristics.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [115] source

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    • cites [116] source

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38 of 38

  • The authors state this as an assumption.

    The treatment effect was influenced by (1) a theoretically grounded treatment, (2) the duration of the treatment, and/or (3) the subject’s health condition.

    “We assumed that the treatment effect was influenced by (1) a theoretically grounded treatment, (2) the duration of the treatment, and/or (3) the subject’s health condition.”

  • The paper relies on this without support.

    The nature of the intervention and control conditions rendered blinding not feasible.

    “because the nature of the intervention and control conditions rendered blinding not feasible”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • For bodyweight, two meta-analyses of consumer activity-tracker interventions reported overall weight loss of -1.5 kg (95% CI -2.81 to -0.14) to -1.7 kg (-3.03 to -0.28), whereas two meta-analyses of pedometer interventions reported weight loss of -0.7 kg (95% CI -1.12 to -0.17) to -1.3 kg (-1.85 to -0.70).

    “For bodyweight, two meta-analyses 46,63 of consumer activitytracker interventions reported an overall weight loss of -1•5 kg (95% CI -2•81 to -0•14) to -1•7 kg (-3•03 to -0•28), whereas two meta-analyses 11,61 of pedometer interventions reported weight loss of -0•7 kg (95% CI -1•12 to -0•17) to -1•3 kg (-1•85 to -0•70; appendix p 37).”

    From Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. (2022) · cites this paper as [63]

  • For step count mean differences, Ringeval and colleagues of consumer activity-tracker-based interventions reported an increase of 951 daily steps (95% CI 476 to 1425), whereas two meta-analyses of pedometer-based interventions reported increases of 1822 (95% CI 751 to 2894) to 2491 (1098 to 3885) daily steps.

    “Three other metaanalyses provided mean-difference data for step count; the meta-analysis by Ringeval and colleagues 63 of consumer activity-tracker-based interventions reported an increase of 951 daily steps (95% CI 476 to 1425), whereas two meta-analyses of pedometer-based interventions reported increases of 1822 (95% CI 751 to 2894) 60 to 2491 (1098 to 3885) 10 daily steps (appendix p 35).”

    From Effectiveness of wearable activity trackers to increase physical activity and improve health: a systematic review of systematic reviews and meta-analyses. (2022) · cites this paper as [63]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Sedentary-behavior study count does not match its citations

    Minor

    The text says 10 studies reported sedentary-behavior outcomes, but the accompanying list contains only nine study references.

  • Sample-size summary conflicts with the reported range

    Minor

    The summary says the included studies had fewer than 100 subjects, but the reported range extends to 800 participants.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. Fitbit Reports $571M Q4’17 and $1.616B FY’17 RevenueFitbit20182020-10-02https://investor.fitbit.com/press/press-releases/press-release-details/2018/Fitbit-Reports-571M-Q417-and-1616B-FY17-Revenue/default.aspx
  2. Gartner Says Worldwide Wearable Device Sales to Grow 26 Percent in 2019Gartner20182020-10-02https://www.gartner.com/en/newsroom/press-releases/2018-11-29-gartner-says-worldwide-wearable-device-sales-to-grow-
  3. Christiansen, M, 2018, Arthritis Rheumatol, 70, 439

Cited by

Sorted by citations

Related

Authors
Ringeval, M., Wagner, G., Denford, J., Paré, G., & Kitsiou, S.
Affiliations
  • HEC Montréal (CA)
  • Royal Military College of Canada (CA)
  • University of Illinois Chicago (US)
Corresponding author
Paré, Guy
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2020-10-12
Volume
22
Issue
10
Pages
e23954
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/23954
PMC
PMC7589007
OpenAlex
W3088108321
Semantic Scholar
520125c6274cd347795bf0a5239c7704c465cdbd
Cited by
225
References
117
Citations by year
2026: 21 · 2025: 36 · 2024: 56 · 2023: 38 · 2022: 49 · 2021: 23 · 2020: 1
FWCI
3.54
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
  • Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
Keywords
Fitbit, wearable activity trackers, physical activity, sedentary behavior, weight change, step count, moderate-to-vigorous physical activity, healthy lifestyle intervention, intervention components, fuzzy-set qualitative comparative analysis, cardiovascular health, physical inactivity, self-monitoring, social support, goal setting, feedback, self-efficacy
MeSH terms
Healthy Lifestyle, Internet-Based Intervention, Humans, Prospective Studies, Sedentary Behavior

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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