Content uploaded by André Henriksen
Author content
All content in this area was uploaded by André Henriksen on Jun 21, 2018
Content may be subject to copyright.
A preview of the PDF is not available
Motivational Factors for User Engagement with mHealth Apps
Abstract
The widespread adoption of smartphones creates an enormous potential to improve healthcare services. Numerous apps, sensors, and devices are developed for health self-management purposes. However, adoption rates remain low and long-term user engagement is a major issue. The goal of this study is to identify major motivational factors that can facilitate prolonged use of mobile health systems. To this end, we conducted 16 interviews with representatives of various cultural backgrounds, disease history, age, and gender. Participants' experiences indicated that existing systems were unable to answer their self-management needs properly. People with a disease history favored learning from data, as well as from others via social media integration. People without chronic disease felt more reserved about social media integration. In conclusion, systems that collect and share personal data should have a clear opt-in or opt-out option to motivate usage. Additionally, researchers and mobile health system developers could achieve long-term adoption by giving clear answers to privacy and trust issues, while offering people strong added value according to their individual needs.
... According to the findings, multiple stakeholders in the field of cardiovascular prevention and rehabilitation may derive the most benefit from a personalized eHealth platform that integrates a number of evidence-based interventions. (Woldaregay et al., 2018) conducted sixteen interviews with individuals from diverse cultural contexts, disease histories, ages, and genders. Individuals with a disease history favored learning from data and others via social media integration, according to the findings. ...
... Other than that, the combined application of 'Social Media' platforms also allows individuals to disseminate their progression, accomplishments, and obstacles throughout their connections with others, thereby fostering a communal atmosphere and encouraging responsibility (Woldaregay et al., 2018). Last but not least, the incorporation of 'Push Notifications' perform as a constant reminder by providing custom-tailored and accurate messages to end users, prompting themselves to engage frequently with the application, furthermore, there are several different approaches for these enactments, which also could be substantiated by empirical evidence, and also consistently displayed the capability to enhance participation from users upon health care applications (Bidargaddi & others, 2018). ...
Mobile health (mHealth) applications have become an integral part of our existence, offering multiple functions and a new level of user engagement. However, the competitive market presents difficulties for development teams attempting to attract and retain customers. User engagement is crucial to the success of mHealth applications, as it promotes interaction, adherence, and behavior modification. This paper presents a systematic literature review in order to investigate methods for enhancing user engagement in mHealth applications. The review identifies successful strategies from existing research and seeks to provide developers with guidance for creating engaging mobile applications. The selected studies are subjected to systematic searching, screening, data extraction, and quality evaluation, followed by narrative synthesis and thematic analysis. The findings emphasize the importance of gamification, design, personalization, social media integration, and push notifications in boosting user engagement. The review also emphasizes the need for experimental research to evaluate the efficacy of different user engagement strategies to achieve more accurate and reliable results. By addressing gaps and employing effective engagement strategies, mHealth applications can increase user satisfaction, encourage continued use, and improve health outcomes. The study lays the groundwork for future research and makes suggestions for designing strategies to increase user engagement in mHealth applications
... Furthermore, economic cost is a significant factor affecting the older adults' use of mobile healthcare services (Wilson et al., 2021). While many applications offer basic services for free, older adults may opt out due to additional service fees (Woldaregay et al., 2018). Moreover, data privacy and security issues remain major challenges for mobile healthcare applications, significantly impacting users' trust (Baig et al., 2015;Newaz et al., 2021). ...
With the acceleration of the aging process in China, chronic diseases have become one of the main health threats for older adults, creating significant pressure on society and the healthcare system. As information technology and artificial intelligence advance rapidly, smart health services have become readily accessible. However, utilization rates among the older adults, especially those with chronic illnesses, remain low, preventing them from fully benefiting from these advanced technologies. The value of mobile health (mHealth) services can only be realized through sustained use. Therefore, this study empirically investigates the continuous use intention of mHealth services from the perspective of older adults with chronic illnesses, integrating the Technology Acceptance Model (TAM) and Value-Based Adoption Model (VAM). A total of 372 questionnaires were collected from various cities in China, and data were analyzed using SPSS 24.0 and Partial Least Squares Structural Equation Modeling (PLS-SEM). Results indicate that perceived ease of use (β = 0.155, p = 0.004; β = 0.116, p = 0.027) and perceived usefulness (β = 0.175, p = 0.001; β = 0.151, p = 0.004) have a significant positive impact on attitude and perceived value. Perceived enjoyment significantly influences attitude (β = 0.147, p = 0.010), while perceived risk (β = −0.189, p < 0.001; β = −0.281, p < 0.001) and perceived cost (β = −0.155, p = 0.003; β = −0.130, p = 0.022) have a significant negative impact on attitude and perceived value. Both attitude (β = 0.357, p < 0.001) and perceived value (β = 0.314, p < 0.001) positively impact continuous intention. In total, only one of the twelve hypotheses was not supported. This study not only provides strong evidence for the effectiveness of the integrated TAM and VAM model in the mHealth field but also offers theoretical insights and practical recommendations for product optimization and promotion to mHealth service providers and designers.
... O uso de dispositivos móveis naárea da saúde visa auxiliar no controle e monitoramento de doenças e condições clínicas, por meio das aplicações de saúde móvel. Conhecidas como mHealth (mobile Health), essa classe de aplicações oferece uma variedade de Estudos destacam a importância da motivação do paciente para o autocuidado em saúde, relacionadaàs ações realizadas para promover e melhorar o bem-estar [Riegel et al. 2021, Woldaregay et al. 2018. O avanço tecnológico naárea da saúde impulsiona essa prática, especialmente com a crescente adoção de dispositivos móveis por pessoas de todas as idades . ...
O uso de dispositivos móveis na saúde visa auxiliar no controle e monitoramento de doenças e condições clínicas, colaborando com o autocuidado das pessoas. Nesse contexto, o IUProst destaca-se como uma aplicação mHealth que auxilia pacientes durante o tratamento da incontinência urinária, uma comorbidade decorrente da cirurgia de retirada de próstata em pacientes que enfrentaram o câncer. Apesar do potencial das aplicações mHealth, como o IUProst, para auxiliar no tratamento da incontinência urinária, a baixa adesão dos usuários destaca a urgência de implementar mecanismos de engajamento eficazes. O objetivo deste artigo é relatar uma pesquisa que utiliza a metodologia CRISP-DM para identificar padrões, tendências e percepções nos dados do IUProst, visando levantar demandas para subsidiar os próximos ciclos de evolução e o aprimoramento da aplicação. Análises dos resultados obtidos nas fases de compreensão do negócio e compreensão dos dados, revelaram um número significativo de usuários e exercícios realizados, porém com baixa participação no tratamento cognitivo comportamental proposto.
... Using data from a social media platform such as Reddit to identify the most asked questions along with the most prevalent concerns and experiences following a TBI can provide unique insights into what people may prefer learning from peers with similar experiences (Woldaregay et al., 2018). These insights allow for more personalized and client-centered care. ...
Purpose
Given the limited availability of topic-specific resources, many people turn to anonymous social media platforms such as Reddit to seek information and connect to others with similar experiences and needs. Mining of such data can therefore identify unmet needs within the community and allow speech-language pathologists to incorporate clients' real-life insights into clinical practices.
Method
A mixed-method analysis was performed on 3,648 traumatic brain injury (TBI) subreddit posts created between 2013 and 2021. Sentiment analysis was used to determine the sentiment expressed in each post; topic modeling and qualitative content analysis were used to uncover the main topics discussed across posts. Subgroup analyses were conducted based on injury severity, chronicity, and whether the post was authored by a person with TBI or a close other.
Results
There was no significant difference between the number of posts with positive sentiment and the number of posts with negative sentiment. Comparisons between subgroups showed significantly higher positive sentiment in posts by or about people with moderate-to-severe TBI (compared to mild TBI) and who were more than 1 month postinjury (compared to less than 1 month). Posts by close others had significantly higher positive sentiment than posts by people with TBI. Topic modeling identified three meta-themes: Recovery, Symptoms, and Medical Care. Qualitative content analysis further revealed that returning to productivity and life as well as sharing recovery tips were the primary focus under the Recovery theme. Symptom-related posts often discussed symptom management and validation of experiences. The Medical Care theme encompassed concerns regarding diagnosis, medication, and treatment.
Conclusions
Concerns and needs shift over time following TBI, and they extend beyond health and functioning to participation in meaningful daily activities. The findings can inform the development of tailored educational resources and rehabilitative approaches, facilitating recovery and community building for individuals with TBI.
Supplemental Material
https://doi.org/10.23641/asha.24881340
... While mHealth apps have great potential, some people may be hesitant to use them due to various reasons. These include concerns about the privacy and security of personal information [4,78], a lack of trust in the accuracy of the information provided by the app, and concerns about the cost of the app [74]. ...
Mobile health (mHealth) applications have become increasingly valuable in preventive healthcare and in reducing the burden on healthcare organizations. The aim of this paper is to investigate the factors that influence user acceptance of mHealth apps and identify the underlying structure that shapes users’ behavioral intention. An online study that employed factorial survey design with vignettes was conducted, and a total of 1,669 participants from eight countries across four continents were included in the study. Structural equation modeling was employed to quantitatively assess how various factors collectively contribute to users’ willingness to use mHealth apps. The results indicate that users’ digital literacy has the strongest impact on their willingness to use them, followed by their online habit of sharing personal information. Users’ concerns about personal privacy only had a weak impact. Furthermore, users’ demographic background, such as their country of residence, age, ethnicity, and education, has a significant moderating effect. Our findings have implications for app designers, healthcare practitioners, and policymakers. Efforts are needed to regulate data collection and sharing and promote digital literacy among the general population to facilitate the widespread adoption of mHealth apps.
... Two additional interview guides were created targeting individuals with diabetes (n=2) and individuals with no chronic disease (n=4). Combined results from all three interviews were published by Woldaregay et al. [2]. Through author discussion, the findings from these interviews were used to construct the final questionnaire and the themes. ...
We created and carried out a cross-sectional anonymous structured questionnaire on what motivates users of mobile health applications and wearables to share their collected health related data. The questionnaire was distributed online in English, French, and Norwegian. In addition, a flyer with information of where to locate the online questionnaire was distributed during a Swiss health conference. We used snowball sampling and encouraged participants to forward the questionnaires to friends, family, and others. Data were collected between October 2018 and March 2020. 58.1 % (n = 473) responded to the English survey, 34.3 % (n = 279) responded to the French survey, and 7.6 % (n = 62) responded to the Norwegian survey.
The questionnaire contained 38 questions divided into seven themes: Background and health goals, Wearables and sensors, Mobile applications, Logging of health data, Data sharing- and integration, Social media and entertainment, and Demographics (age, gender, country of origin, chronic disease status, and chronic disease caretaker status). Answer options were single answer, multiple-choice, open-ended, or on a 4-point Likert scale.
Questions were defined based on 16 in-person interviews with people without any chronic disorder, people with diabetes, and people with sickle cell disease. All questions were optional. Data were collected from 814 participants. All answers to the open-ended questions have been translated into English.
This dataset is especially interesting for researchers interesting in what motivates people with and without chronic disease across countries to use mHealth tools and share their collected health data. Only a subset of variables has been analyzed so far and new research questions on motivation can potentially be answered using this dataset.
Purpose
From an active ageing perspective, investigating how adults use apps and wearables for health purposes might improve well-being strategies supported by widely adopted technologies. This study investigated adults’ perceptions of using apps and wearables for health purposes.
Methods
A qualitative interview study was conducted. Adults (+18) using an app/wearable to monitor at least one health variable (e.g. physical activity and diet) were eligible. Transcriptions were analysed using the Reflexive Thematic Analysis.
Results
Nineteen participants (34.3 ± 14.5 years; men/women: 8/11) joined the study and from their transcriptions 5 themes were created: 1) Easy and accurate monitoring of health: balancing users’ needs and technological challenges; 2) Self-improvement and motivation: usefulness of rewarding behaviours and gamification towards achievements; 3) Requiring personalized apps and wearables: aesthetics and wearability; 4) Beyond simple monitoring: prevention and care throughout daily life; 5) Awareness of potentially dangerous digital data world: from distress to fixation.
Conclusions
Apps and wearables were highly valued by our participants for effectively managing and enhancing their health and sports performance while ensuring education, motivation, ease of use, safety, and prevention. However, issues such as privacy concerns, wearability, and lack of integration need to be addressed to improve adoption, enhance usability and support active ageing initiatives.
Amaç: Bu çalışmanın amacı prekonsepsiyonel bakımda kullanılan mobil aplikasyonların etkinliğini incelemektir. Yöntem: Bu sistematik derleme çalışması için Google Scholar, PubMed, Cochrane, Science Direct, ProQuest Central ve Web of Science elektronik veri tabanları, makaleler için herhangi bir tarih sınırlaması yapılmadan İngilizce dilinde 07 Haziran-10 Temmuz 2022 tarih aralığında taranmıştır. Taramalar, “mobile”, “mobile intervention”, “mobile health”, “mHealth”, “mobile application” “preconception” anahtar kelimeleri kullanılarak yapılmıştır. Çalışma PRISMA-P kontrol listesine göre raporlandırılmıştır. Bulgular: Sistematik derlemeye 3’ü randomize kontrollü, 1’i yarı deneysel ve 2’si karma yöntem olmak üzere toplam 6 çalışma dahil edilmiştir. Çalışmaların örneklem grubunu 16-49 yaş aralığındaki toplam 1017 kadın ve 36 erkek birey oluşturmuştur. Dahil edilen çalışmalarda DeDi torRi, PADI, MAMA-EMPOWER ve üç çalışmada Smarter Pregnancy isimli mobil aplikasyon geliştirilerek prekonsepsiyonel bakıma yönelik etkinliği değerlendirilmiştir. Çalışmalarda prekonsepsiyonel bakıma ilişkin geliştirilen mobil aplikasyonların bireylerde sağlıklı yaşam tarzı değişiklikleri oluşturduğu ve anne adaylarının gebeliğe yönelik bilgi düzeylerini artırdığı görülmüştür. Dahil edilen çalışmalarda geliştirilen mobil aplikasyonlar ile, sağlıksız beslenmenin, sigara içme alışkanlıklarının, düşük riskinin, perinatal ve neonatal bakımın tıbbi maliyetlerinin azaldığı görülmüştür. Sonuç: Genel olarak mobil aplikasyonlar gebeliğe uyumu artırmış, maliyeti düşürmüş, düşük riskini azaltmıştır. Bu olumlu sonuçların yanında mobil aplikasyonların küçük örneklem gruplarında çalışılmış olması sonuçların genellenebilirliğini etkilemektedir. Mobil aplikasyonların daha büyük örneklem grupları ile üreme çağındaki hem kadın hem erkek bireyler üzerinde değerlendirilmesi önerilebilir.
The aim of the research is to explore the theoretical background and experiences of using lifestyle (LS) applications from a user perspective. The objective is to identify the reasons for non-usage. To accomplish these research goals, four focus group interviews were conducted with students studying recreation management in the autumn of 2022. The focus group research findings indicated that sports and fitness apps were the participants' most favoured. The evaluation of LS applications identified usefulness, features, accessibility, and accuracy as the most significant factors. More students reported positive effects on their physical and mental health; however, they viewed the applications and smart devices as auxiliary tools. The main reasons for non-use included personal, technical, and usability issues, as discovered by the authors. This chapter provides an in-depth insight into alterations in health practices, incentives and encounters with mobile devices and LS apps, contributing to the field of service literature.
Objectives:
The Dutch government implemented the apps 'CoronaMelder' and 'CoronaCheck' to prevent the transmission of SARS-CoV-2. They faced many questions on how to responsibly implement such technologies. Here, we aim to develop an assessment framework to support the Dutch national government with the responsible design and implementation of technologies for the prevention of future infectious diseases.
Study design:
Three-stage web-based Delphi process.
Methods:
The assessment framework was developed through two research phases. During the Initial Design phase, a conceptual version of the assessment framework was developed through a scoping review and semistructured interviews with a scientific board. The Consensus phase involved a three-stage web-based Delphi process with an expert community.
Results:
The final assessment framework consists of five development phases, 10 values, and a total of 152 questions.
Conclusions:
Technology assessment frameworks help policymakers to make informed decisions and contribute to the responsible implementation of technologies in society. The framework is now available for the Dutch government and other stakeholders to use in future pandemics. We discuss the possibilities of using the framework transnationally.
Background
Tobacco smoking is the leading cause of preventable death in the United States, and the annual economic burden attributable to smoking exceeds US $300 billion. Obstacles to smoking cessation include limited access and adherence to effective cessation interventions. Technology can help overcome these obstacles; many smartphone apps have been developed to aid smoking cessation, but few that conform to the US clinical practice guideline (USCPG) have been rigorously tested and reported in the literature. Clickotine is a novel smartphone app for smoking cessation, designed to deliver the essential features of the USCPG and engineered to engage smokers by personalizing intervention components.
Objective
Our objective was to assess the engagement, efficacy, and safety of Clickotine in an initial, single-arm study. Outcomes measured were indicators of engagement with the smartphone app (number of app opens, number of interactions with the Clickotine program, and weeks active with Clickotine), cessation outcomes of 7- and 30-day self-reported abstinence from smoking, and negative health events.
Methods
We recruited US residents between 18 and 65 years of age who owned an iPhone and smoked 5 or more cigarettes daily for the study via online advertising. Respondents were prescreened for eligibility by telephone and, if appropriate, directed to a Web portal to provide informed consent, confirm eligibility, and download the Clickotine app. Participants completed study assessments via the online portal at baseline and after 8 weeks. Data were collected in Amazon S3 with no manual data entry, and access to all data was maximally restrictive, logged, and auditable.
Results
A total of 416 participants downloaded the app and constituted the intention-to-treat (ITT) sample. On average, participants opened the Clickotine app 100.6 times during the 8-week study (median 69), logged 214.4 interactions with the Clickotine program (median 178), and remained engaged with Clickotine for 5.3 weeks (median 5). Among the ITT sample, 45.2% (188/416) reported 7-day abstinence and 26.2% (109/416) reported 30-day abstinence from smoking after 8 weeks. Completer analysis focused on 365 (87.7%) of the 416 enrolled participants who completed the 8-week questionnaire revealed that 51.5% (188/365) of completers reported 7-day abstinence and 29.9% (109/365) reported 30-day abstinence. Few adverse events, mostly consistent with nicotine withdrawal symptoms, were reported and overall no safety signal was detected.
Conclusions
In this initial single-arm trial, Clickotine users appeared to demonstrate encouraging indicators of engagement in terms of the number of app opens, number of program interactions, and continued engagement over time. Clickotine users reported encouraging quit rates while reporting few adverse events. Future research is warranted to assess Clickotine’s efficacy in a randomized controlled trial.
Trial Registration
Clinicaltrials.gov NCT02656745; https://clinicaltrials.gov/ct2/show/NCT02656745 (Archived by WebCite at http://www.webcitation.org/6peTT4x60)
Background
Chronic conditions are an increasing challenge for individuals and the health care system. Smartphones and health apps are potentially promising tools to change health-related behaviors and manage chronic conditions.
Objective
The aim of this study was to explore (1) the extent of smartphone and health app use, (2) sociodemographic, medical, and behavioral correlates of smartphone and health app use, and (3) associations of the use of apps and app characteristics with actual health behaviors.
Methods
A population-based survey (N=4144) among Germans, aged 35 years and older, was conducted. Sociodemographics, presence of chronic conditions, health behaviors, quality of life, and health literacy, as well as the use of the Internet, smartphone, and health apps were assessed by questionnaire at home visit. Binary logistic regression models were applied.
Results
It was found that 61.25% (2538/4144) of participants used a smartphone. Compared with nonusers, smartphone users were younger, did more research on the Internet, were more likely to work full-time and more likely to have a university degree, engaged more in physical activity, and less in low fat diet, and had a higher health-related quality of life and health literacy. Among smartphone users, 20.53% (521/2538) used health apps. App users were younger, less likely to be native German speakers, did more research on the Internet, were more likely to report chronic conditions, engaged more in physical activity, and low fat diet, and were more health literate compared with nonusers who had a smartphone. Health apps focused on smoking cessation (232/521, 44.5%), healthy diet (201/521, 38.6%), and weight loss (121/521, 23.2%). The most common app characteristics were planning (264/521, 50.7%), reminding (188/521, 36.1%), prompting motivation (179/521 34.4%), and the provision of information (175/521, 33.6%). Significant associations were found between planning and the health behavior physical activity, between feedback or monitoring and physical activity, and between feedback or monitoring and adherence to doctor’s advice.
Conclusions
Although there were many smartphone and health app users, a substantial proportion of the population was not engaged. Findings suggest age-related, socioeconomic-related, literacy-related, and health-related disparities in the use of mobile technologies. Health app use may reflect a user’s motivation to change or maintain health behaviors. App developers and researchers should take account of the needs of older people, people with low health literacy, and chronic conditions.
Objectives
To examine the prevalence of the willingness of patients with diabetes to use a self-management tool based on information and communication technology (ICT) such as personal computers, smartphones, and mobile phones; and to examine the patient characteristics associated with that willingness.
Research design and methods
We conducted a cross-sectional interview survey of 312 adults with diabetes at a university hospital in an urban area in Japan. Participants were classified into 2 groups: those who were willing to use an ICT-based self-management tool and those who were unwilling. Multiple logistic regression analysis was used to identify factors associated with the willingness, including clinical and social factors, current use of ICT, self-management practices, self-efficacy, and diabetes-related emotional distress.
Results
The mean age of the 312 participants was 66.3 years (SD=11.5) and 198 (63%) were male. Most of the participants (93%) had type 2 diabetes. Although only 51 (16%) currently used ICT-based self-management tools, a total of 157 (50%) expressed the willingness to use such a tool. Factors associated with the willingness included: not having nephropathy (OR=2.02, 95% CI 1.14 to 3.58); outpatient visits once a month or more (vs less than once a month, OR=2.13, 95% CI 1.13 to 3.99); current use of personal computers and/or smartphones (OR=4.91, 95% CI 2.69 to 8.98); and having greater diabetes-related emotional distress (OR=1.10, 95% CI 1.01 to 1.20).
Conclusions
Approximately half of the patients showed interest in using an ICT-based self-management tool. Willing patients may expect ICT-based self-management tools to complement outpatient visits and to make self-management easier. Starting with patients who display the willingness factors might optimize programs based on such tools.
Background:
Finding novel ways to engage patients in chronic disease management has led to increased interest in the potential of mobile health technologies for the management of diabetes. There is currently a wealth of smartphone apps for diabetes management that are available for free download or purchase. However, the usability and desirability of these apps has not been extensively studied. These are important considerations, as these apps must be accepted by the patient population at a practical level if they are to be utilized.
Objective:
The purpose of this study was to gain insight into patient experiences related to the use of smartphone apps for the management of type 1 diabetes.
Methods:
Adults with type 1 diabetes who had previously (or currently) used apps to manage their diabetes were eligible to participate. Participants (n=12) completed a questionnaire in which they were required to list the names of preferred apps and indicate which app functions they had used. Participants were given the opportunity to comment on app functions that they perceived to be missing from the current technology. Participants were also asked whether they had previously paid for an app and whether they would be willing to do so.
Results:
MyFitnessPal and iBGStar were the apps most commonly listed as the best available on the market. Blood glucose tracking, carbohydrate counting, and activity tracking were the most commonly used features. Ten participants fulfilled all eligibility criteria, and indicated that they had not encountered any one app that included all of the functions that they had used. The ability to synchronize an app with a glucometer or insulin pump was the most common function that participants stated was missing from current app technology. One participant had previously paid for a diabetes-related app and the other 9 participants indicated that they would be willing to pay.
Conclusions:
Despite dissatisfaction with the currently available apps, there is interest in using these tools for diabetes management. Adapting existing technology to better meet the needs of this patient population may allow these apps to become more widely utilized.
Objective:
Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps.
Materials and methods:
'Health app' was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively.
Results:
Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26-35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers' data.
Conclusions:
The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring.
Control theory and other frameworks for understanding self-regulation suggest that monitoring goal
progress is a crucial process that intervenes between setting and attaining a goal, and helps to ensure that
goals are translated into action. However, the impact of progress monitoring interventions on rates of
behavioral performance and goal attainment has yet to be quantified. A systematic literature search
identified 138 studies (N �= 19,951) that randomly allocated participants to an intervention designed to
promote monitoring of goal progress versus a control condition. All studies reported the effects of the
treatment on (a) the frequency of progress monitoring and (b) subsequent goal attainment. A random
effects model revealed that, on average, interventions were successful at increasing the frequency of
monitoring goal progress (d� �= 1.98, 95% CI [1.71, 2.24]) and promoted goal attainment (d� �= 0.40,
95% CI [0.32, 0.48]). Furthermore, changes in the frequency of progress monitoring mediated the effect
of the interventions on goal attainment. Moderation tests revealed that progress monitoring had larger
effects on goal attainment when the outcomes were reported or made public, and when the information
was physically recorded. Taken together, the findings suggest that monitoring goal progress is an
effective self-regulation strategy, and that interventions that increase the frequency of progress monitoring
are likely to promote behavior change.
Background
Mobile phone health apps may now seem to be ubiquitous, yet much remains unknown with regard to their usage. Information is limited with regard to important metrics, including the percentage of the population that uses health apps, reasons for adoption/nonadoption, and reasons for noncontinuance of use.
Objective
The purpose of this study was to examine health app use among mobile phone owners in the United States.
Methods
We conducted a cross-sectional survey of 1604 mobile phone users throughout the United States. The 36-item survey assessed sociodemographic characteristics, history of and reasons for health app use/nonuse, perceived effectiveness of health apps, reasons for stopping use, and general health status.
ResultsA little over half (934/1604, 58.23%) of mobile phone users had downloaded a health-related mobile app. Fitness and nutrition were the most common categories of health apps used, with most respondents using them at least daily. Common reasons for not having downloaded apps were lack of interest, cost, and concern about apps collecting their data. Individuals more likely to use health apps tended to be younger, have higher incomes, be more educated, be Latino/Hispanic, and have a body mass index (BMI) in the obese range (all P
Background:
This meta-analysis of randomized controlled trials (RCTs) examines the efficacy of physical exercise as treatment for unipolar depression, both as an independent intervention and as an adjunct intervention to antidepressant medication.
Methods:
We searched PsycINFO, EMBASE, MEDLINE, CENTRAL, and Sports Discus for articles published until November 2014. Effect sizes were computed with random effects models. The main outcome was reduction in depressive symptoms or remission.
Results:
A total of 23 RCTs and 977 participants were included. Physical exercise had a moderate to large significant effect on depression compared to control conditions (g=-0.68), but the effect was small and not significant at follow-up (g=-0.22). Exercise compared to no intervention yielded a large and significant effect size (g=-1.24), and exercise had a moderate and significant effect compared to usual care (g=-0.48). The effects of exercise when compared to psychological treatments or antidepressant medication were small and not significant (g=-0.22 and g=-0.08, respectively). Exercise as an adjunct to antidepressant medication yielded a moderate effect (g=-0.50) that trended toward significance.
Limitations:
Use of the arms with the largest clinical effect instead of largest dose may have overestimated the effect of exercise.
Conclusions:
Physical exercise is an effective intervention for depression. It also could be a viable adjunct treatment in combination with antidepressants.