Mobile apps for health behaviour change in physical activity, diet, drug and alcohol use, and mental health: a systematic review
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Published version
Author(s)
Milne-Ives, Madison
Lam, Ching
De Cock, Caroline
Van Velthoven, Michelle
Meinert, Edward
Type
Journal Article
Abstract
Background: With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioural health interventions. The large variation in these mobile health apps - their target patient group, health behaviour, and behavioural change strategies - has resulted in a large but incohesive body of literature.
Objective: The purpose of this systematic review was to assess the effectiveness of mobile apps at improving health behaviours and outcomes, and to examine the inclusion and effectiveness of Behaviour Change Techniques in mobile health apps.
Methods: Medline, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behaviour change. Two authors independently screened and selected studies according to the eligibility criteria. Data was extracted and risk of bias assessed by one reviewer and validated by a second reviewer.
Results: 52 randomized controlled trials met the inclusion criteria and were included in analysis - 37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive - only one app was rated as less helpful and satisfactory than the control - and the studies that measured engagement and usability found relatively high study completion rates (mean = 83.3%, n = 18) and ease of use ratings (3 significantly better than control, 9/15 rated >70%) . However, there was little evidence of changed behaviour or health outcomes.
Conclusions: There was not strong evidence found to support the effectiveness of mobile apps at improving health behaviours or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the behaviour change techniques that are most effective at promoting behaviour change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.
Objective: The purpose of this systematic review was to assess the effectiveness of mobile apps at improving health behaviours and outcomes, and to examine the inclusion and effectiveness of Behaviour Change Techniques in mobile health apps.
Methods: Medline, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behaviour change. Two authors independently screened and selected studies according to the eligibility criteria. Data was extracted and risk of bias assessed by one reviewer and validated by a second reviewer.
Results: 52 randomized controlled trials met the inclusion criteria and were included in analysis - 37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive - only one app was rated as less helpful and satisfactory than the control - and the studies that measured engagement and usability found relatively high study completion rates (mean = 83.3%, n = 18) and ease of use ratings (3 significantly better than control, 9/15 rated >70%) . However, there was little evidence of changed behaviour or health outcomes.
Conclusions: There was not strong evidence found to support the effectiveness of mobile apps at improving health behaviours or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the behaviour change techniques that are most effective at promoting behaviour change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.
Date Issued
2020-03-18
Date Acceptance
2020-01-26
Citation
JMIR mHealth and uHealth, 2020, 8 (3), pp.1-16
ISSN
2291-5222
Publisher
JMIR Publications
Start Page
1
End Page
16
Journal / Book Title
JMIR mHealth and uHealth
Volume
8
Issue
3
Copyright Statement
©Madison Milne-Ives, Ching Lam, Caroline De Cock, Michelle Helena Van Velthoven, Edward Meinert. Originally published
in JMIR mHealth and uHealth (http://mhealth.jmir.org), 18.03.2020. This is an open-access article distributed under the terms of
the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is
properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as
this copyright and license information must be included.
in JMIR mHealth and uHealth (http://mhealth.jmir.org), 18.03.2020. This is an open-access article distributed under the terms of
the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work, first published in JMIR mHealth and uHealth, is
properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as
this copyright and license information must be included.
Sponsor
European Institute of Innovation and Technology
Identifier
https://mhealth.jmir.org/2020/3/e17046/
Subjects
Science & Technology
Life Sciences & Biomedicine
Health Care Sciences & Services
Medical Informatics
telemedicine
evidence-based medicine
mobile health
digital health
mobile applications
app
cell phone
smartphone
mobile phone
health behavior
intervention
behavior change
systematic review
RANDOMIZED CONTROLLED-TRIAL
SMARTPHONE APPLICATION
PATIENT ENGAGEMENT
INTERVENTION
METAANALYSIS
TECHNOLOGY
SUPPORT
CARE
app
behavior change
cell phone
digital health
evidence-based medicine
health behavior
intervention
mobile applications
mobile health
mobile phone
smartphone
systematic review
telemedicine
1117 Public Health and Health Services
Publication Status
Published
Date Publish Online
2020-03-18