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Digital health has grown from a collection of provocative ideas into a multibillion-dollar industry in just over a decade in part because of the promise of this technology for improving physical activity monitoring and promotion strategies. Systematic reviews and meta-analyses of evidence for this technology are beginning to accumulate.1 2 In this commentary, we offer some important considerations as the field moves towards creating personalised strategies for promoting physical activity.
First, apps and wearable trackers are often portrayed as tools for promoting physical activity, but, by themselves, they are not treatments. They are simply vehicles for delivering the psychologically active ingredients of behaviour change, akin to the capsule that encloses pharmacologically active agents in medication. Physicians do not prescribe medication based on the delivery vehicle alone; they consider the mechanism of dysfunction to target, active ingredients in the drug and dosing to inform treatments. It is inappropriate to conclude that digital tools promote positive changes in activity; poorly designed interventions deployed via digital modes are no more than a digital placebo—they lack a defined target or active ingredient but are delivered in a shiny new capsule.
Second, between-group differences in treatment and control groups are …
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Contributors All authors contributed to the conceptualisation of this editorial. DEC wrote the original draft. All authors contributed to the revision and approval of the final draft.
Funding DEC and CML were supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number R01HL142732, and the National Science Foundation under Award Number ECCS1808266.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of either the National Institutes of Health or the National Science Foundation.
Competing interests GGB holds equity in Coeus Health and serves on the scientific advisory boards of WW, Gelesis and Naturally Slim. KYW holds equity in Coeus Health. These organisations had no writing this editorial, or in the decision to submit the article for publication.
Provenance and peer review Not commissioned; externally peer reviewed.