In addition, eHealth and mHealth studies focus on a general target group and often do not research subgroups (ie, low-SEP groups). With regard to including people with a low-SEP background in research, studies identified challenges in reaching the target group and engaging them in research and in the digital health intervention. ĭespite the promise of digital or mHealth interventions in promoting PA, a common challenge is to engage users in the long term or effectively. This suggests that approaching youth with low SEP via apps (eg, screen and games) can be useful and beneficial, yet other ingredients (eg, tailoring) are needed to reach them effectively in mHealth apps. In contrast to mHealth apps, youth from low-SEP families engage in more screen time and are more involved on the web and active gaming. Apps are primarily designed for people with high SEP, and people with low SEP are often reported as being difficult to reach. People with high SEP compared with people with low SEP report foremost positive health effects of the same digital intervention. Earlier systematic reviews indicated that currently, foremost, adults are included in mHealth effectiveness studies, and limited research has been conducted among youth. Appropriate content may refer to different forms of app use that might not necessarily increase current screen time use, as the design of the mHealth intervention may have considered a limited use time frame, only stimulating sporadic screen time (eg, integration to the direct physical environment to stimulate children to go outside and be physically active instead of the requirement of using the digital tool when being physically active) or stimulating the co-use of young children and guardians. Families of young children, especially those with a low-SEP background, indicate concern about inappropriate content, which might suggest that appropriate content might rather be supported by guardians. Mobile devices and apps have gained popularity in the daily life of increasingly younger age groups of youth, starting at the age of 3 or 4 years already. mHealth interventions are preferred by youth over traditional in-person approaches and are in line with preferences of youth, with regard to multimedia formats (ie, text, sound, and video). Mobile health (mHealth) tools such as smartphone apps can be cost-effective in changing total PA and daily steps. SEP is often measured in terms of education (attainment), income, and occupation status, which are often interrelated and related to the social and economic resources available. Therefore, effective and socially acceptable PA interventions are needed, especially among youth of families with a low SEP. Also, the youth of families with a low socioeconomic position (SEP) are less likely to meet the recommended PA guidelines. Moreover, PA in youth is reported to track into adulthood, underlying the importance of promoting PA in the youth. In Europe, only 19% of adolescents comply with the MVPA guidelines, and higher family affluence is associated with higher levels of MVPA. Despite the health benefits, 81% of youth (ie, those in childhood and adolescence) globally do not meet the PA guidelines of daily 60 minutes of moderate- to vigorous-intensity physical activity (MVPA) and vigorous activities 3 days per week. Physical activity (PA) in youth is associated with a variety of health benefits, including physical and mental health benefits.
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