Digital tools like wearables, apps and other technologies that aim to increase physical activity may not be effective for people in low socioeconomic status groups, according to a systematic review of studies published in the International Journal of Behavioral Nutrition and Physical Activity.

“Digital interventions targeting PA [physical activity] do not show equivalent efficacy for people of low and high SES [socioeconomic status]. For people of low SES, there is no evidence that digital PA interventions are effective, irrespective of the behaviour change techniques used. In contrast, the same interventions in high SES participants do indicate effectiveness,” the review’s authors wrote. 


Researchers included 19 studies in their analysis. In low socioeconomic status groups, they found a standardized mean difference in physical activity between intervention and control groups of 0.06.

In groups with high socioeconomic status, researchers found a standardized mean difference of 0.34. 

“The studies used a range of digital technologies and BCTs [behaviour change techniques] in their interventions, but the main findings were consistent across all of the subgroup analyses (digital interventions with a PA only focus, country, chronic disease and duration of intervention), and there was no association with the number or type of BCTs,” the authors wrote.


Researchers conducted a systematic search to find eligible randomized controlled trials published between January 1990 and March 2020.

The studies included use digital technologies as an intervention with physical activity as a goal, have a control group that doesn’t receive the digital tools, and have data on socioeconomic status.


The Centers for Disease Control and Prevention reports only one in four U.S. adults gets the recommended amount of physical activity. Lack of physical activity can lead to conditions like heart disease, Type 2 diabetes and some types of cancers.

Meanwhile the benefits of adequate physical activity include improved musculoskeletal health, better sleep and improved cognitive abilities.


The analysis’ authors said there is more research to be done on the topic, as in studying which behavior-change techniques could serve these populations and whether engagement is different between groups differing in socioeconomic status.

They also recommend researching if lower digital health literacy could impact physical activity and how digital tools could make health recommendations based on the larger context of a person’s life.

“Increasing access to information communication and wearable technology amongst even the most vulnerable people has led to digital interventions being championed as a tool for reducing inequalities in health promotion,” the authors wrote. 

“This study suggests that in a PA context the opposite is true, that is, people who would benefit the most from these interventions are being left behind. We recommend that future development of digital interventions aimed at improving PA must make more effort to meet the needs of low SES people within the target population.”

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