Digital Tools' Effectiveness on Physical Activity Outcomes in Children and Adolescents: Umbrella Review

A substantial proportion of children and adolescents worldwide do not meet current physical activity (PA) guidelines. So digital tools interventions have been implemented worldwide. However, evidence regarding the effectiveness of these remains inconsistent, underscoring the need for a comprehensive synthesis of the available literature.

This umbrella review aimed to summarize and critically evaluate the characteristics and effectiveness of digital interventions designed to increase PA in children and adolescents.

An overview of systematic reviews (SRs) and meta-analyses of randomized controlled trials (RCTs) was conducted in accordance with the PRIOR (Preferred Reporting Items for Overviews of Reviews) and the PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Literature Search Extension) checklists. Reviews published between 2018 and 2025 were searched in SCOPUS, PubMed or MEDLINE, Web of Science, Cochrane Database of Systematic Reviews, and SPORTDiscus or EBSCO, using a combination of terms addressing the type of digital tool (eg, apps, wearables, etc) and device-based PA outcomes. Eligible SRs and meta-analyses focused on populations aged 6-17 years and evaluated digital interventions aimed at increasing PA. Methodological quality was assessed using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) for SRs and meta-analyses, and Risk of Bias 2 for RCTs. Intervention characteristics and effectiveness outcomes were summarized as frequencies, and chi-square tests were applied to explore differences in effectiveness across study features.

Forty-eight SRs or meta-analyses comprising 62 RCTs were included. The reviews' quality was moderate to poor, and 7/62 (11.3%) of RCTs were judged to have a high risk of bias. The mainly addressed PA outcomes were moderate-to-vigorous PA and step counts, commonly measured using accelerometers and pedometers. Overall, 45.2% of interventions demonstrated effectiveness for at least 1 PA outcome. Higher effectiveness rates were observed in RCTs that targeted PA as the sole primary outcome (19/32, 59.4%), used wearables as both the digital intervention component (7/11, 63.6%) and delivery device (8/12, 66.7%), and used pedometers for PA outcome measurement (13/16, 81.3%). Significant differences in effectiveness were found for the type of PA assessment device (P=.003) and for interventions targeting low-income populations, which showed lower effectiveness (P=.01). Additional trends were identified for geographic region (P=.06), intervention setting (P=.09), baseline activity level (P=.06), intervention focus (P=.09), and device brand (P=.09).

This novel umbrella review provides a comprehensive synthesis of digital PA interventions in youth, foreseeing potential factors that may influence their effectiveness, and highlighting methodological limitations. It offers evidence-based insights for practitioners, educators, and policymakers, helping to identify digital tools most likely to successfully increase PA in youth. Future research should prioritize stronger methodological rigor and more precise intervention designs. This has clear value for the public health practice to reduce long-term disease risk.