People are more likely to adopt heart-healthy behaviors when guided by the Internet, their cellphones or other devices, according to 23 years of research reviewed in Journal of the American Heart Association.

“Both Internet-based and mobile-based programs can help people become more physically active, eat better and achieve modest weight loss over three to 12 months,” said Ashkan Afshin, M.D., M.P.H., Sc.D., lead study author and acting assistant professor of global health at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle.

Researchers reviewed 224 studies on generally healthy adults, published in 1990-2013. The studies evaluated the effect of using the Internet, mobile phones, personal sensors or stand-alone computer software tools to inspire behavioral changes, such as improving diet, increasing physical activity, losing weight and stopping/reducing tobacco or alcohol use.

Among the findings:

  • Participants in Internet interventions improved their diets, became more active, lost body weight/fat, reduced tobacco use and cut excessive alcohol use.
  • Participants in mobile device interventions (using smartphone apps or receiving text or voicemail messages) increased their physical activity and lost body weight/fat.

“Programs that have components such as goal-setting and self-monitoring and use multiple modes of communication with tailored messages tended to be more effective,” Afshin said. “We also found these programs were more effective if they included some interactions with healthcare providers.”

Clinicians, in particular in primary care settings, can use the programs to help people improve their lifestyle behaviors and reduce risk of chronic disease such as cardiovascular disease and diabetes, Afshin said.

Most studies lasted less than six months, providing little information on how effective and sustainable the behavioral changes will be over the long term.

“Our study highlights several important gaps in current evidence on Internet- and mobile-based interventions,” Afshin said. “We need to evaluate their long-term value, effectiveness in different populations (such as the elderly and people from developing countries) and how different strategies may increase adherence to the programs.”