Living Labs for a Mobile App-Based Health Program: Effectiveness of a 24-Week Walking Intervention for Cardiovascular Disease Risk Reduction Among Female Korean-Chinese Migrant Workers: Randomized Controlled Trial (Preprint)

Abstract

Cardiovascular disease (CVD) accounts for one-third of the causes of death in women, and migrants are relatively more likely to be exposed to CVD risk owing to social and environmental factors.

This study aimed to examine the effectiveness of a 24-week app-based walking program, using Fitbit, for CVD risk reduction among female Korean-Chinese middle-aged workers.

Participants were recruited between April 11 and July 11, 2018 through distributing posters and flyers. They were randomly assigned to either the standard treatment (ST; n = 22) or enhanced treatment (ET; n = 28) group. All participants were provided with a mobile app linked to Fitbit Alta for 24 weeks and instructed to walk for more than 30 minutes five times a week and moderate intensity physical activity. During the 12-week adaptation period, the ET group also received a mobile app-based health program applying socio-cognitive strategies to increase walking adherence. All participants were guided to voluntary physical activity without researchers' intervention during the 12-week maintenance period. Data were analyzed by the Mann Whitney U-test and a generalized estimating equation.

There were significant between-group differences regarding the number of steps (B = 1.295, P < .001).and moderate physical activity time (OR = 6.396, P = .030) at week 12. ET group had significant changes in high-density lipoprotein cholesterol (B = 10.522, P = .007), low-density lipoprotein cholesterol ( B = -16.178, P = .024), total cholesterol (B = -20.325, P = .039), fasting blood sugar (B = -8.138, P = -.046) over 12 weeks compared to the ST group. In addition, there was a significant reduction CVD risk for the ET group over 12 weeks compared to the ST group (B = -0.521, P <. 001).

The app-based walking intervention was effective in reducing CVD risk among female Korean-Chinese migrant workers during the 12-week period. In future studies, long-term studies are needed to reduce the risk of cardiovascular disease in large-scale migrant workers, and it is necessary to confirm the direct and indirect effects of various socio-cognitive factors on health outcomes.