Comparative Effectiveness of Wearable Devices and Built-In Step Counters in Reducing Metabolic Syndrome Risk in South Korea: Population-Based Cohort Study
Bibliographic record
Abstract
Background: Mobile health technologies show promise in addressing metabolic syndrome, but their comparative effectiveness in large-scale public health interventions remains unclear. Objective: This study aims to compare the effectiveness of wearable devices (wearable activity trackers) and mobile app-based activity trackers (built-in step counters) in promoting walking practice, improving health behaviors, and reducing metabolic syndrome risk within a national mobile health care program operated by the Korea Health Promotion Institute. Methods: This retrospective cohort study analyzed data from 46,579 participants in South Korea's national mobile health care program (2020-2022). Participants used wearable devices for 12 weeks, after which some switched to built-in step counters. The study collected data on demographics, health behaviors, and metabolic syndrome risk factors at baseline, 12 weeks, and 24 weeks. Outcomes included changes in walking practice, health behaviors, and metabolic syndrome risk factors. Metabolic syndrome risk was assessed based on 5 factors: blood pressure, fasting glucose, waist circumference, triglycerides, and high-density lipoprotein cholesterol. Health behaviors included low-sodium diet preference, nutrition label reading, regular breakfast consumption, aerobic physical activity, and regular walking. To address potential selection bias, propensity score matching was performed, balancing the 2 groups on baseline characteristics including age, gender, education level, occupation, insurance type, smoking status, and alcohol consumption. Results: Both wearable activity tracker and built-in step counter groups exhibited significant improvements across all evaluated outcomes. The improvement rates for regular walking practice, health behavior changes, and metabolic syndrome risk reduction were high in both groups, with percentages ranging from 45.2% to 60.8%. After propensity score matching, both device types showed substantial improvements across all indicators. The built-in step counter group demonstrated greater reductions in metabolic syndrome risk compared to the wearable device group (odds ratio [OR] 1.20, 95% CI 1.05-1.36). No significant differences were found in overall health behavior improvements (OR 0.95, 95% CI 0.83-1.09) or walking practice (OR 0.84, 95% CI 0.70-1.01) between the 2 groups. Age-specific subgroup analyses revealed that the association between built-in step counters and metabolic syndrome risk reduction was more pronounced in young adults aged 19-39 years (OR 1.35, 95% CI 1.09-1.68). Among Android use subgroups, built-in step counters were associated with a higher reduction in health risk factors (OR 1.20, 95% CI 1.03-1.39). Conclusions: Both wearable devices and built-in step counters effectively reduced metabolic syndrome risk in a large-scale public health intervention, with built-in step counters showing a slight advantage. The findings suggest that personalized device recommendations based on individual characteristics, such as age and specific health risk factors, may enhance the effectiveness of mobile health interventions. Future research should explore the mechanisms behind these differences and their long-term impacts on health outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".