Josh West*, Brigham Young University, Provo, United States Track: Research Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Oral presentation Submission Type: Single Presentation Building: Mermaid Room: Room 1 - Newgate Date: 2013-09-24 04:00 PM – 04:45 PM Last modified: 2013-09-25

If you are the presenter of this abstract (or if you cite this abstract in a talk or on a poster), please show the QR code in your slide or poster (QR code contains this URL).

Background: The Health & Fitness category in Apple’s App Store contains thousands of downloadable apps for Apple’s mobile devices, which include the iPhone, iPad, and iPod. The number of app installs is expected to reach 44 billion by 2016. Apps are being used to promote healthier diets, but in a recent analysis of health and weight loss app descriptions, researchers concluded that the majority of such apps contain insufficient evidence-informed content. Other recent research reported that the majority of apps lacked theoretical components known to facilitate health behavior change.

Objective: Whereas recent studies provide useful information and insight, they were based on developers’ descriptions of the apps alone and did not include an analysis of the actual apps. Insomuch as the description page is the marketing point by which app developers sell their product, it is possible that descriptions alone do not adequately represent app content and functionality. No study has examined the actual content of diet-related apps. The purpose of this study was to examine the content of diet-related apps available in Apple’s App Store to determine the extent to which constructs of health behavior theory were present.

Methods: This study consisted of 58 diet apps from iTunes’ Health & Fitness category. Coders downloaded the apps and rated (Cohen’s Kappa = .80) their inclusion of constructs from 4 prominent health behavior theories. The coding instrument was adapted from previous research and included the Health Belief Model, Theory of Planned Behavior, Social Cognitive Theory, and Transtheoretical Model. The assessment for each construct included five levels of user interaction for a total of 100 (20 constructs x 5 levels of user interaction) theory-based items. The five levels of user interaction were: 1) General information or guidelines; 2) Assessment; 3) Feedback; 4) General assistance; and 5) Individually tailored assistance.

Results: Most apps were theory deficient and provided just general information/assistance. The average theory score was 6.19 (SD = 6.52) out of a possible 100. Nine-percent (N = 5) of the study apps had a theory score of 0. Knowledge- and cognitive-based strategies were the most common, with constructs of General information and perceived benefits. Behavioral and emotion-focused strategies were least common, with constructs modeling and stress management. General information or guidelines and general assistance were the two user interaction levels most widely applied in the study apps. Six-percent of apps incorporated general information or guidelines and 7% of apps incorporated general assistance into their design levels.

Conclusions: This study represents the first analysis of health behavior theory constructs in diet-related apps. Diet-related apps could be a valuable part of the solution to the current public health crisis related to obesity and obesity-related diseases. Diet-related apps currently available are lacking in their inclusion of health behavior theory constructs. In addition, currently available apps largely fail to incorporate advances in technology, which allow for increasingly sophisticated user interaction levels (e.g., tailoring). An opportunity exists for health behavior change experts to partner with app developers to incorporate health behavior theories into the development apps.