An mHealth-based lifestyle intervention for metabolic syndrome management: evaluation of the Seoul Metabolic Challenge app

ISRCTN	ISRCTN10351636
DOI	https://doi.org/10.1186/ISRCTN10351636
Sponsor	Seoul Metropolitan Government
Funder	Seoul Metropolitan Government

Submission date: 01/06/2026
Registration date: 02/06/2026
Last edited: 09/09/2026

Recruitment status: Recruiting
Overall study status: Ongoing
Condition category: Nutritional, Metabolic, Endocrine

Prospectively registered

Protocol

Statistical analysis plan

Results

Individual participant data

Record updated in last year

Plain English summary of protocol

Background and study aims
Metabolic syndrome is a group of health risk factors, including abdominal obesity, high blood pressure, high blood sugar, high triglycerides, and low high-density lipoprotein cholesterol. People with metabolic syndrome have a higher risk of cardiovascular disease and diabetes. Improving daily health behaviors, such as physical activity, healthy eating, weight control, and self-management, can help reduce these risks.
The Seoul Metabolic Challenge App is a mobile health lifestyle program developed to support the prevention and management of metabolic syndrome. It is provided through the Seoul "Wrist Doctor 9988" application. This study aims to find out whether using the Seoul Metabolic Challenge App in addition to standard public health center metabolic syndrome management is more effective than standard management alone in reducing metabolic syndrome risk and improving heart-healthy lifestyle behaviors and motivation.

Who can participate?
Adults aged 20 to 69 years who are participating in a metabolic syndrome management program at a public health center in Seoul and who have one or more metabolic syndrome risk factors.

What does the study involve?
Participants will be randomly allocated to one of two groups.
Participants in the control group will receive the standard metabolic syndrome management program provided by the public health center for 12 weeks. This includes health counselling, explanation of health examination results, lifestyle education, and general health management information.
Participants in the intervention group will receive the same standard metabolic syndrome management program and will also use the Seoul Metabolic Challenge App for 12 weeks. The app provides personalized health missions, health information, self-monitoring, and support for improving physical activity, dietary habits, and other lifestyle behaviors.
All participants will complete surveys and health examinations before the program starts and after 12 weeks. The health examination includes measurements of height, weight, waist circumference, blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol. Participants in the intervention group will also complete an app user evaluation after the program. After the 12-week program, approximately 12 intervention group participants will be invited to take part in an audio-recorded focus group interview lasting about 90 minutes.

What are the possible benefits and risks of participating?
Participants may benefit from learning more about their health status and metabolic syndrome risk factors. Both groups will receive standard metabolic syndrome management from the public health center. Participants in the intervention group may additionally benefit from using the mobile app to support daily lifestyle management.
There are no expected serious risks from taking part in this study. Some participants may feel inconvenience from the time required to complete surveys and health examinations. Fingerprick blood testing may cause mild and temporary discomfort; however, the procedure will be performed according to standard protocols to minimize potential risks. The pre-test and post-test are expected to take about 30 minutes each. Participants in the focus group interviews may feel uncomfortable about being audio-recorded; recordings will be anonymized and used only for research purposes.

Where is the study run from?
The study is run from Korea University College of Nursing, in collaboration with a public health center metabolic syndrome management center in Seoul (South Korea)

When is the study starting and how long is it expected to run for?
August 2026 to May 2027

Who is funding the study?
Seoul Metropolitan Government (South Korea)

Who is the main contact?
Prof. Jina Choo, jinachoo@korea.ac.kr

Contact information

Prof Jina Choo
Public, Scientific, Principal investigator

College of Nursing, Korea University
145 Anam-ro
Seongbuk-gu
Seoul
02841
Korea, South

ORCID ID	0000-0001-9271-3689
Phone	+82 (0)2 3290 4925
Email	jinachoo@korea.ac.kr

Study information

Primary study design	Interventional
Allocation	Randomized controlled trial
Masking	Blinded (masking used)
Control	Active
Assignment	Parallel
Purpose	Health services research, Prevention
Scientific title	Effects of the Seoul Metabolic Challenge app among adults with metabolic syndrome risk: a randomized controlled trial
Study objectives	Current study objective as of 08/09/2026: The objective of this study is to evaluate whether the Seoul Metabolic Challenge mobile health application, when added to standard public health center metabolic syndrome management, is more effective than standard public health center metabolic syndrome management alone in reducing metabolic syndrome risk and improving heart-healthy lifestyle indicators among community-dwelling adults aged 20 to 69 years with one or more metabolic syndrome risk factors. Previous study objective: The objective of this study is to evaluate whether the Seoul Metabolic Challenge mobile health application, when added to standard public health center metabolic syndrome management, is more effective than standard public health center metabolic syndrome management alone in reducing metabolic syndrome prevalence and improving heart-healthy lifestyle indicators among community-dwelling adults aged 50 to 64 years with metabolic syndrome.
Ethics approval(s)	1. Approved 29/05/2026, Korea University Institutional Review Board (Korea University Research Center, Anam-dong, Seongbuk-gu, Seoul, 02841, Korea, South; +82 (0)2 3290 1137; kuirb@korea.ac.kr), ref: KUIRB-2026-0292-01 2. Approved 07/09/2026, Korea University Institutional Review Board (Korea University Research Center, Anam-dong, Seongbuk-gu, Seoul, 02841, Korea, South; +82 (0)2 3290 1137; kuirb@korea.ac.kr), ref: KUIRB-2026-0292-02
Health condition(s) or problem(s) studied	Metabolic syndrome and cardiovascular disease risk factors
Intervention	Current interventions as of 08/09/2026: Participants will be randomly allocated in a 1:1 ratio to either the control group or the intervention group. Randomization will be performed using a computer-generated block randomization schedule stratified by sex and medication use, with allocation sequences generated in advance using R (version 4.5.3; R Foundation for Statistical Computing, Vienna, Austria). The control group will receive standard public health center metabolic syndrome management for 12 weeks, including counselling on metabolic syndrome risk factors, explanation of health examination results, lifestyle education, and general health management information. The intervention group will receive the same standard public health center metabolic syndrome management plus the Seoul Metabolic Challenge mobile health application for 12 weeks. The application is provided through the Seoul “Wrist Doctor 9988” platform and includes personalized health missions, health information, self-monitoring, prompts for health behavior practice, and support for improving physical activity and dietary habits. Outcomes will be measured at baseline and after the 12-week intervention. After completion of the 12-week intervention, approximately 12 intervention group participants will take part in audio-recorded focus group interviews to explore their experience of the program. Previous interventions: Participants will be randomly allocated in a 1:1 ratio to either the control group or the intervention group. Randomization will be performed using a computer-generated block randomization schedule stratified by sex and medication use, with allocation sequences generated in advance using R (version 4.5.3; R Foundation for Statistical Computing, Vienna, Austria). The control group will receive standard public health center metabolic syndrome management for 12 weeks, including counselling on metabolic syndrome risk factors, explanation of health examination results, lifestyle education, and general health management information. The intervention group will receive the same standard public health center metabolic syndrome management plus the Seoul Metabolic Challenge mobile health application for 12 weeks. The application is provided through the Seoul “Wrist Doctor 9988” platform and includes personalized health missions, health information, self-monitoring, prompts for health behavior practice, and support for improving physical activity and dietary habits. Outcomes will be measured at baseline and after the 12-week intervention.
Intervention type	Behavioural
Primary outcome measure(s)	Metabolic syndrome risk measured using (1) metabolic syndrome prevalence, measured as the proportion of participants meeting three or more of the five risk-factor criteria (waist circumference ≥90 cm in men / ≥85 cm in women; blood pressure ≥130/85 mmHg or antihypertensive medication; fasting blood glucose ≥100 mg/dL or antidiabetic medication; triglycerides ≥150 mg/dL or lipid-lowering medication; high-density lipoprotein cholesterol <40 mg/dL in men / <50 mg/dL in women or lipid-lowering medication); (2) number of risk factors, measured as the count of criteria met by each participant (range 0–5); and (3) individual risk-factor values, measured as waist circumference (cm), systolic and diastolic blood pressure (mmHg), fasting blood glucose (mg/dL), triglycerides (mg/dL), and high-density lipoprotein cholesterol (mg/dL) at baseline and after 12 weeks Previous primary outcome: Metabolic syndrome prevalence measured using the proportion of participants meeting three or more of the five metabolic syndrome risk-factor criteria: waist circumference, blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol at baseline and after 12 weeks
Key secondary outcome measure(s)	Added 08/09/2026: 1. Heart-healthy behavior measured using the Self-Care for a Heart-Healthy Lifestyle scale (SC-HeartLife) at baseline and after 12 weeks 2. Heart-healthy motivation measured using the Intrinsic Motivation Inventory for Heart-Healthy Lifestyle (IMI-HeartLife) at baseline and after 12 weeks
Completion date	28/05/2027

Eligibility

Participant type(s)
Age group	Mixed
Lower age limit	20 Years
Upper age limit	69 Years
Sex	All
Target sample size at registration	132
Key inclusion criteria	Current inclusion criteria as of 08/09/2026: 1. Adults aged 20 to 69 years 2. Participants in a metabolic syndrome management program at a public health center in S district, Seoul 3. Participants with one or more of the five metabolic syndrome risk factors: waist circumference, blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol Previous inclusion criteria: 1. Adults aged 50 to 64 years 2. Participants in a metabolic syndrome management program at a public health center in S district, Seoul 3. Participants with three or more of the five metabolic syndrome risk factors: waist circumference, blood pressure, fasting blood sugar, triglycerides, and high-density lipoprotein cholesterol
Key exclusion criteria	1. Having physical limitations that make participation in physical activity difficult 2. Having cognitive impairment or other difficulties that make study participation or survey completion difficult 3. Unable to complete online or offline surveys 4. Unable to use a mobile application
Date of first enrolment	03/08/2026
Date of final enrolment	30/11/2026

Locations

Countries of recruitment

Korea, South

Study participating centres

Results and Publications

Individual participant data (IPD) Intention to share	No

Editorial Notes

09/09/2026: The following changes were made to the study record:
1. The completion date was changed from 30/11/2026 to 25/05/2027.
2. The plain English summary was updated to reflect these changes.
08/09/2026: The following changes were made to the study record:
1. The scientific title was changed from 'Effects of the Seoul Metabolic Challenge app among middle-aged adults with metabolic syndrome: a randomized controlled trial' to 'Effects of the Seoul Metabolic Challenge app among adults with metabolic syndrome risk: a randomized controlled trial'.
2. The study objectives, ethics approval, interventions, primary/secondary outcomes and inclusion criteria were updated.
3. The date of first enrolment was changed from 01/07/2026 to 03/08/2026.
4. The date of final enrolment was changed from 31/10/2026 to 30/11/2026.
01/06/2026: Study's existence confirmed by the Korea University Institutional Review Board.