A Contactless App-Based Intervention to Improve Health Behaviors in Airline Pilots: A Randomized Trial

Introduction: There is a need for enhanced preventive health care among airline pilots to mitigate the prevalence of cardiometabolic health risk factors.Study design: A randomized, waitlist-controlled trial was utilized to evaluate the effectiveness of a smartphone-based app intervention for improving health behaviors and cardiometabolic health parameters.Setting/participants: A total of 186 airline pilots (aged 43.2 +/- 9.1 years; male, 64%) were recruited and participated in the trial during 2022. Intervention: This intervention was a personalized, 16-week smartphone-based app multicompo-nent physical activity, healthy eating, and sleep hygiene intervention.Main outcome measures: Outcome measures of objective health (Cooper's 12-minute exercise test, resting heart rate, push ups, plank isometric hold, body mass), subjective health (self-rated health, perceived psychological stress and fatigue), and health behaviors (weekly physical activity, sleep quality and duration, fruit and vegetable intake) were collected at baseline and after interven-tion. The waitlist control completed the same measures.Results: Significant interactions for time X group from baseline to 16 weeks were found for all out-come measures (p<0.001). Significant between-group differences for positive health changes in favor of the intervention group were found after intervention for all outcome measures (p<0.05, d=0.4-1.0) except for self-rated health, body mass, and Pittsburgh Sleep Quality Index score.Conclusions: Study findings show that an app-based health behavior intervention can elicit posi-tive cardiometabolic health changes among airline pilots over 16 weeks, associated with trivial to large effect sizes.Trial registration: The trial protocol was prospectively registered at The Australian New Zealand Clinical Trials Registry (ACTRN12622000288729). Am J Prev Med 2023;64(5):666-676. (c) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Automated summary

There is a need for enhanced preventive health care among airline pilots, and a smartphone-based app intervention has been shown to be effective in improving health behaviors and cardiometabolic health parameters. In a randomized trial, 186 airline pilots participated in a personalized 16-week app intervention, resulting in significant positive health changes in objective health, subjective health, and health behaviors. This study highlights the potential of app-based interventions to improve cardiometabolic health among airline pilots.