Do fitness apps do what they promise to obtain?
Insufficient physical activity is a major worldwide public health problem. Even small increases in activity at a population level could have far-reaching positive impacts on chronic diseases such as diabetes, cardiovascular diseases, and several cancers. Despite evidence supporting improved health outcomes from regular physical activity, population levels of physical activity remain low, and inactivity is prevalent.
Behavioral physical activity interventions are typically successful in increasing activity levels, but these interventions are costly and require professional expertise in delivering behavior change techniques (BCTs).
Electronic activity monitors show promise as a delivery medium, as they can perform most aspects of pedometer-based interventions while providing options for individually tailored intervention content. The market is large and growing quickly.
However, little is known about how these monitors differ from one another, what options they provide in their apps, and how these options may impact their effectiveness. The low cost, wide reach, and apparent effectiveness of electronic activity monitors make them appealing for recommendation by practitioners, but the growing number of options precludes practitioners’ ability to provide informed recommendations to patients.
The purpose of this study was to systematically investigate currently available commercial electronic activity monitors to
1. characterize their behavior change techniques
2. determine the extent to which they include techniques associated with successful outcomes
3. compare implementation of several critical techniques to theory-based and evidence-based recommendations.
The researchers tested 13 different activity monitors for 1 week. All monitors measured physical activtiy and provided feedbak via an app. The study identified 93 behaviour change techniques (BCT's), such as self-monitoring, feedback, goal setting, social comparison, prompts/cues and rewards.
Electronic activity monitor systems include a variety of evidence-based BCTs, many of which conform to recommendations for their implementation. The most commonly found techniques were integral to the nature of the monitor: self-monitoring, feedback provision, adding objects to the environment, and goal-setting. Problem solving, action planning, commitment, instruction on how to perform the behavior, and behavioral practice were rare.
Electronic activity monitors include many different empirically tested behavior change techniques that are commonly implemented in clinical interventions. Many of these techniques are associated with successful physical activity and/or weight loss, and implementation of most of the techniques adhered closely to theory-based recommendations.
Many questions remain unanswered though: how do you monitor ever-changing apps, what is the impact on privacy of sharing GPS and health data, how effective is eHealth as compared to traditional face-to-face interventions, what about the lack of professional supervision,
This study provides preliminary information on the extent and type of technique implementation, thus laying a foundation for clinical, public health, and rehabilitation applications. Only research with human subjects—from small qualitative investigations to large-scale randomized trials—can investigate hypotheses related to feasibility, acceptability, and effectiveness. But the prospects are exiting!
> From: Lyons et al., J Med Internet Res 16 (2015) e192. All rights reserved to The Author(s). Click here for the Pubmed summary.