OBJECTIVE: To examine whether a fitness tracker (FT) intervention changes physical activity (PA) behavior compared to a control condition or compared to an alternative intervention. DATA SOURCE: Searches between January 1, 2010, and January 1, 2019, were conducted in PubMed, CINAHL, Cochrane CENTRAL, Embase, and PsycINFO. INCLUSION/EXCLUSION CRITERIA: Randomized clinical trials of adults using an FT to change PA behavior were included. Nonclinical trials, studies that included the delivery of structured exercise, and/or studies that only used the FT to assess PA were excluded. DATA EXTRACTION: Extracted features included characteristics of the study population, intervention components, PA outcomes, and results. DATA SYNTHESIS: Papers were pooled in a statistical meta-analysis using a fixed effects model. Where statistical pooling was not possible, standardized mean difference (SMD) and 95% confidence intervals (CI) were calculated. Findings were presented in a narrative form and tables. RESULTS: Of 2076 articles found, 21 were included in the review. A small yet significant positive effect (SMD 0.25, 95% CI 0.17 to 0.32; p < 0.01; I2 = 56.9%; p = 0.03) was found in step count for interventions compared to control. A small yet significant negative effect (SMD -0.11, 95% CI -0.20 to -0.02; p = 0.02; I2 = 58.2%; p = 0.03) was found in moderate-to-vigorous PA for interventions compared to an alternative intervention. CONCLUSION: Trackers may enhance PA interventions, as a general positive effect is found in step count compared to a control. However, there is no evidence of a positive effect when interventions are compared to an alternative intervention. It is unknown whether results are due to other intervention components and/or clinical heterogeneity.

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