Barriers to and Facilitators for Using Nutrition Apps: Systematic Review and Conceptual Framework

Abstract

Background Nutrition apps are effective in changing eating behavior and diet-related health risk factors. However, while they may curb growing overweight and obesity rates, widespread adoption is yet to be achieved. Hence, profound knowledge regarding factors motivating and hindering (long-term) nutrition app use is crucial for developing design guidelines aimed at supporting uptake and prolonged use of nutrition apps. Objective In this systematic review, we synthesized the literature on barriers to and facilitators for nutrition app use across disciplines including empirical qualitative and quantitative studies with current users, ex-users, and nonusers of nutrition apps. Methods A systematic literature search including 6 databases (PubMed, Web of Science, PsychINFO, PSYNDEX, PsycArticles, and SPORTDiscus) as well as backward and forward citation search was conducted. Search strategy, inclusion and exclusion criteria, and the planned data extraction process were preregistered. All empirical qualitative and quantitative studies published in German or English were eligible for inclusion if they examined adolescents (aged 13-18) or adults who were either current users, ex-users, and nonusers of nutrition apps. Based on qualitative content analysis, extracted individual barriers and facilitators were grouped into categories. Results A total of 28 publications were identified as eligible. A framework with a 3-level hierarchy was designed which grouped 328 individual barriers and facilitators into 23 subcategories, 12 categories, and 4 clusters that focus on either the individual user (goal setting and goal striving, motivation, routines, lack of awareness of knowledge), different aspects of the app and the smartphone (features, usability of the app or food database, technical issues, data security, accuracy/trustworthiness, costs), positive and negative outcomes of nutrition app use, or interactions between the user and their social environment. Conclusions The resulting conceptual framework underlines a pronounced diversity of reasons for (not) using nutrition apps, indicating that there is no “one-size-fits-all” approach for uptake and prolonged use of nutrition apps. Hence, tailoring nutrition apps to needs of specific user groups seems promising for increasing engagement.

User Engagement and Abandonment of mHealth: A Cross-Sectional Survey

“…The cost of apps was cited as a significant factor among respondents. Interestingly, in line with prior related literature [ 34 , 35 ], most participants advocated that mHealth should be accessible (free) or more affordable. Additionally, limiting of advertisements, more food or dieting options, and the need for more personalized and goal-oriented features were also considered desired features for inclusion in mHealth apps.…”

Usage of Mobile Applications or Mobile Health Technology to Improve Diet Quality in Adults

“…Some applications have merely provided dietary advice and improved the diet quality of participants; other applications monitor lapses and have the same effect on the user. Dietary applications that cause frustration to the user lead to complete disengagement, this can be in the form of draining the user's battery, poor data transfer or the app failing to work as detailed [64]. For the future of dietary applications, a focus on diet quality rather than goal-setting could have more significant long-term benefits.…”

mHealth Interventions for Self-management of Hypertension: Framework and Systematic Review on Engagement, Interactivity, and Tailoring

“…Along these lines, systematic reviews focusing on mHealth disease self-management interventions found that effective interventions integrated features of interactive communication [ 10 ] and tailored messages [ 22 ]. A systematic review of nutrition apps found that tailoring the apps to the needs of specific user groups can be beneficial in increasing engagement [ 23 ]. In addition, interventions can be more engaging if they are designed to be tailored to participants’ health beliefs and needs.…”