University of Exeter: Tech-based health and exercise programmes less beneficial for users with low socio-economic status, study shows

Technology-based health and exercise programmes and apps, designed to offer a convenient and accessible way to boost physical activity, are dramatically less beneficial for users with low socio-economic status, a study has shown.

A team of experts, including Professor Mark Kelson from the University of Exeter, have conducted a major study to determine whether digital health programmes are equally beneficial to users from all socio-economic backgrounds.

The researchers, from the GW4 Alliance, found that health and exercise apps helped users from middle and higher socio-economic status achieve a higher level of physical activity.

However, those participants with lower socio-economic status experienced no clear benefit from using digital health programmes and apps.

The team suggest that, rather than providing an easy and available healthy lifestyle for everyone, the apps could in fact be exacerbating health inequalities.

The research is published in the International Journal of Behavioural Nutrition and Physical Activity.

Professor Kelson, an Associate Professor of Statistics for Health at the University of Exeter said: “This finding is really quite striking. Across multiple sensitivity analyses we are seeing the same result: the apps work for those from higher socio-economic backgrounds and they don’t for those with lower socio-economic status”

For the study, the researchers screened more than 14,000 studies, published over a 30-year period, selecting 19 randomised controlled trials that evaluated the effectiveness of digital technology – such as mobile apps, websites and wearable health technology such as smart watches – on people’s physical activity.

They found that, while people with higher socio-economic status displayed significant and long-term benefits from using such technology, those of lower socioeconomic status displayed no discernible benefits at all.

This finding was true irrespective of the behaviour change techniques used in these studies.

Dr Ishrat Islam, co-author from Cardiff University explains that “no association was found with the number or type of techniques these digital interventions used and the resulting change in physical activity behaviour of either low or high socio economic group”.

Dr Max Western, lead author and behavioural scientist at the University of Bath proposes that “these findings suggest that access to technologies is not the issue, but more likely the way in which people interact with and have the capability and opportunity to act upon the advice of digital health tools.”

Dr Una Jones, co-author and senior lecturer at Cardiff University, further explains that “these findings are of importance to all providers of healthcare and health promotion to ensure a person-centred approach using appropriate management strategies as we accelerate towards a digital health landscape”

Co-author, Dr Morgan added “It is important that future work around such digital interventions considers both measurement of and strategies to reduce any widening of further health inequalities”

The team suggest that future providers of digital health interventions targeting physical activity and other behaviours should account for the needs of users with lower socio-economic status to ensure they don’t, inadvertently, widen socio-economic inequalities.

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