The use of technology to promote physical activity in Type 2 diabetes management: a systematic review

Abstract
With increasing evidence available on the importance of physical activity in the management of Type 2 diabetes, there has been an increase in technology-based interventions. This review provides a systematic and descriptive assessment of the effectiveness of technology to promote physical activity in people with Type 2 diabetes. For this review, technology included mobile phones and text messages, websites, CD-ROMs and computer-learning-based technology, and excluded telephone calls. A systematic literature search was conducted to retrieve articles from January 2001 to March 2013 using the following databases: the Cochrane Library, EMBASE, MEDLINE, PsycINFO and PubMed. Articles had to describe an intervention that used technology to promote physical activity in people with Type 2 diabetes. A methodological quality assessment of the studies was conducted and data synthesis was performed. In total, 15 articles were eligible for review: web-based (9), mobile phone (3), CD-ROM (2) and computer based (1). All studies found an increase in physical activity but only nine were significant. The use of a personal coach, logbooks and reinforcement strategies such as phone calls and email counselling were found to be effective components for behaviour change. No studies were ranked as low in terms of methodological quality. Technology-based interventions to promote physical activity are effective; using further methods to promote participant adherence is associated with greater benefit. Further research should look into strategies to enhance adherence and sustainability in order to increase the effectiveness of technology-based physical activity intervention in diabetes care.