How Do Apps Work? An Analysis of Physical Activity App Users’ Perceptions of Behavior Change Mechanisms

Abstract

BackgroundPhysical activity apps are commonly used to increase levels of activity and health status. To date, the focus of research has been to determine the potential of apps to influence behavior, to ascertain the efficacy of a limited number of apps to change behavior, and to identify the characteristics of apps that users prefer.ObjectiveThe purpose of this study was to identify the mechanisms by which the use of physical activity apps may influence the users’ physical activity behavior.MethodsThis study used a cross-sectional survey of users of health-related physical activity apps during the past 6 months. An electronic survey was created in Qualtrics’ Web-based survey software and deployed on Amazon Mechanical Turk. Individuals who had used at least one physical activity app in the past 6 months were eligible to respond. The final sample comprised 207 adults living in the United States. 86.0% (178/207) of respondents were between the ages of 26 and 54 years, with 51.2% (106/207) of respondents being female. Behavior change theory informed the creation of 20 survey items relating to the mechanisms of behavior change. Respondents also reported about engagement with the apps, app likeability, and physical activity behavior.ResultsRespondents reported that using a physical activity app in the past 6 months resulted in a change in their attitudes, beliefs, perceptions, and motivation. Engagement with the app (P<.001), frequency of app use (P=.03), and app price (P=.01) were related to the reported impact of the behavior change theory or mechanisms of change. The mechanisms of change were associated with self-reported physical activity behaviors (P<.001).ConclusionsThe findings from this study provide an overview of the mechanisms by which apps may impact behavior. App developers may wish to incorporate these mechanisms in an effort to increase impact. Practitioners should consider the extent to which behavior change theory is integrated into a particular app when they consider making recommendations to others wishing to increase levels of physical activity.

Assessing the Quality of Mobile Phone Apps for Weight Management: User-Centered Study With Employees From a Lebanese University (Preprint)

“…Conversely, 'engagement' had the strongest correlation with 'subjective quality' (rho=0.68, p<0.001). This confirms the idea that engagement is an important factor related to sustained app usage [35,37].…”

“…Some qualitative studies show that users stop using apps due to hidden costs, increased data entry burden [33], and low perceived engagement [34]. Engagement with an app is generally associated with sustained app usage [1], but it has also been associated with positive changes in physical activity [35,36] and diet [37], fundamental behaviors in weight management.…”

Current Developments in Digital Quantitative Volume Estimation for the Optimisation of Dietary Assessment

“…Apps can provide nutrition education and allow for the setting of dietary goals. Many of these apps have been well received by consumers and facilitate improvements to the predictors of behavior change such as knowledge, self-efficacy and motivation [37,60,[67][68][69][70][71][72]. Being able to be in contact with a healthcare professional also provides a layer of support whenever required, and this has been shown to improve engagement and satisfaction with the lifestyle change [38,58,60,62,63].…”

“…Using digital solutions also reduces the burden placed on respondents and healthcare professionals [53,60,67,73]. Many studies have found that users prefer the use of digital dietary recording over traditional paper methods for ergonomic and practical reasons [27,28,37,38,52,58,60,62,67,71,72,74]. Smart devices are highly integrated into modern lifestyles and are less intrusive to daily routines as users do not need to carry around an additional item such as a journal to record their diets with.…”

Parents’ Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study (Preprint)

“…It is relatively well-established that usability modifies the degree to which a user perceives a given behavior change technique as central to the efficacy of an app. 23,24 Consequentially, our study is likely biased upward as respondents are likely assuming that apps are highly usable and that they would engage with them regularly.…”