Effects of mHealth model on health behavior and metabolic syndrome during COVID-19 epidemic: A case study of taxi drivers in Taiwan

Objectives: Taxi drivers are a high-risk population for metabolic syndrome. This study thus developed a mobile health-care model (mHealth) that integrates mobile phones with social media and various supporting strategies to promote healthy behaviors and address metabolic syndrome. Methods: A quasi-experimental design was adopted. Taxi drivers with at least one risk factor for metabolic syndrome or body mass index ≥ 25 were recruited and divided into an experimental group and a control group. A pretest comprising questionnaires and physiological value tests were conducted, and a posttest was conducted after 12 weeks of intervention. For 12 weeks, the experimental group used the mHealth model, which incorporated the predisposing factor, reinforcing factor, and enabling factor of the PRECEDE-PROCEED model. The model’s content included the components of Metabolic Syndrome Online Course, Self-Health Management, Line Online Consultation and Contact Tracing, and Reward Mechanism. Additionally, a pedometer was used for online exercise courses. Generalized estimating equations were primarily used for statistical analysis. Results: In total, 92 participants completed this study (48 experimental group participants and 44 control group participants). The intervention yielded significant improvements in healthy behavior (β = 0.22, 95% confidence interval [CI] = 0.07–0.38), self-efficacy (β = 0.18, 95% CI = 0.02–0.33) and physical activity (t = 2.648, 95% CI = 140.6–1042.3). Conclusions: For high-risk populations with metabolic syndrome, especially those profoundly affected by the COVID-19 pandemic, the mHealth model can not only reduce their risk of infection but also can be a way to improve metabolic syndrome.