Development of a Weight Loss Mobile App Linked With an Accelerometer for Use in the Clinic: Usability, Acceptability, and Early Testing of its Impact on the Patient-Doctor Relationship

Abstract

BackgroundAlthough complications of obesity are well acknowledged and managed by clinicians, management of obesity itself is often difficult, which leads to its underdiagnosis and undertreatment in hospital settings. However, tools that could improve the management of obesity, including self-monitoring, engagement with a social network, and open channels of communication between the patient and doctor, are limited in a clinic-based setting.ObjectiveThe objective of our study was to evaluate the usability and acceptability of a newly developed mobile app linked with an accelerometer and its early effects on patient-doctor relationships.MethodsFrom September 2013 to February 2014, we developed a mobile app linked with an accelerometer as a supportive tool for a clinic-based weight loss program. The app used information from electronic health records and delivered tailored educational material. Personal goal setting, as well as monitoring of weight changes and physical activity combined with feedback, are key features of the app. We also incorporated an interactive message board for patients and doctors. During the period of March 2014 to May 2014, we tested our mobile app for 1 month in participants in a hospital clinic setting. We assessed the app’s usability and acceptability, as well as the patient-doctor relationship, via questionnaires and analysis of app usage data.ResultsWe recruited 30 individuals (18 male and 12 female) for the study. The median number of log-ins per day was 1.21, with the most frequently requested item being setting goals, followed by track physical activities and view personal health status. Scales of the depth of the patient-doctor relationship decreased from 27.6 (SD 4.8) to 25.1 (SD 4.5) by a Wilcoxon signed rank test (P=.02).ConclusionsA mobile phone app linked with an accelerometer for a clinic-based weight loss program is useful and acceptable for weight management but exhibited less favorable early effects on patient-doctor relationships.

Key Components in eHealth Interventions Combining Self-Tracking and Persuasive eCoaching to Promote a Healthier Lifestyle: A Scoping Review

“…In addition, 10 were categorized as high effective [ 32 , 39 , 41 , 45 , 48 , 49 , 51 , 60 , 61 , 63 ], 4 as low effective [ 32 , 37 , 44 , 57 ], and 3 as ineffective [ 35 , 43 , 52 ]. Additionally, 25 publications [ 32 - 36 , 38 - 43 , 46 - 51 , 54 - 59 , 62 , 63 ] included results on usability, 18 of which [ 32 , 33 , 35 , 36 , 38 - 43 , 48 , 49 , 51 , 54 , 56 , 57 , 62 , 63 ] were based on people’s experiences after having used the technology and 6 of which were based on expectations [ 34 , 46 , 50 , 55 , 58 , 59 ]. Only 1 study addressed usability results based on experiences as well as those based on expectations [ 47 ].…”

“…Out of those publications that described the design of an intervention, 17 were developed in a healthy lifestyle setting [ 32 , 33 , 35 , 37 , 39 , 42 - 45 , 49 , 51 , 52 , 57 , 58 , 61 - 63 ] and 10 in a chronic disease setting [ 38 , 40 , 41 , 47 , 48 , 53 - 56 , 60 ]. Furthermore, about half of the interventions described included the application of a certain theory in the design.…”

“…Furthermore, about half of the interventions described included the application of a certain theory in the design. The most frequently applied theories were social cognitive theory [ 33 , 35 , 38 , 49 , 52 ], transtheoretical theory [ 32 , 35 , 39 , 52 , 55 ], and self-regulation theory [ 38 , 47 , 63 ]. Additionally, 6 studies included descriptions of cocreation with end users [ 42 , 47 , 52 , 55 , 56 , 58 ].…”

Common Barriers to the Use of Patient-Generated Data Across Clinical Settings

“…General [23,26,54] Irritable bowel syndrome [13,14] Sleep [44,50] Chronic illness [30] Diagnosis [51] Multiple chronic conditions [2,3] Weight loss [11] Itching [29] Hospitalisation [33] Parkinson's [32] Diabetes [39,42] Breast cancer [24,40] Disease prevention [15,26] Mental health [25] Structure Data structure is unfamiliar or inconsistent. Table 2.…”

Methodological Foundations of Mhealth Design Studies: A Content Analysis of Literature

“…Social Cognitive Theory (SCT) is the most common theory among behavioral change techniques to inform the mHealth intervention. For example, Choo et al derived theoretical basis for their mHealth study from SCT by adopting key mediators such as; self-regulation skills, goal setting and self-monitoring of behaviors (Choo et al, 2016). Other studies (Lubans et al, 2014;Zhu et al, 2017;Lau et al, 2018) create their own blended theoretical basis by making use of multiple frameworks.…”