Emily Seto*, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada Peter Picton, Centre for Global eHealth Innovation, University Health Network, Toronto, Canada Shivani Goya, Centre for Global eHealth Innovation, University Health Network-Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada Ahmad Zbib, Heart and Stroke Foundation of Canada, Toronto, Canada Joseph Cafazzo*, Centre for Global eHealth Innovation, University Health Network- Institute of Biomaterials and Biomedical Engineering, University of Toronto -Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada Track: Practice Presentation Topic: Mobile & Tablet Health Applications Presentation Type: Poster presentation Submission Type: Single Presentation Last modified: 2013-09-25

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Background: Heart disease and stroke are a leading cause of hospitalization and death worldwide. Approximately nine in ten adults have at least one risk factor for cardiovascular disease, such as obesity, diabetes, smoking, alcohol, physical inactivity, high blood pressure, and cholesterol. However, through lifestyle behaviour modification, individuals can reduce their risk of cardiovascular disease by up to 80%. As such, the Heart and Stroke Foundation of Canada engaged the Centre for Global eHealth Innovation to develop a user-centered mobile application to empower Canadians to assess and manage their cardiovascular risk by taking small steps towards improving their lifestyle behaviours. The iPhone application, <30 Days, was publically launched in September 2012. The application enables users to set goals based on their identified risk factors (poor nutrition, physical inactivity, stress, excessive salt consumption, excessive alcohol intake, and smoking) and complete daily challenges over a period of 30 days. The application also facilitates weekly progress evaluations, sharing of challenges using social media (Facebook, Twitter, and email), trends, weekly progress assessments, and virtual rewards for positive behaviours.

Objective: To evaluate the level of engagement and retention of the novel heart health mobile application based on usage analytics. Detailed mobile usage data was captured from approximately 74,000 users over a period of 5 months, and was used to derive correlations between demographics, duration of engagement, and usage patterns.

Methods: The project team conducted descriptive analysis of the available data to produce insight regarding the mobile users and reveal the effectiveness of the key design features. Once themes and usage patterns were identified, the team explored the correlations between different data sets. Specifically, the following questions guided the data analysis: (1) How many people downloaded the application and duration of their engagement? (2) What were the user demographics and identified risk factors? (3) How often were challenges linked to specific risk factors attempted?

Results: The data analysis revealed that 74% of the users were female, and more than half (58%) of all users were below the age of 30. The three most prevalent risk factors amongst the user group were (1) nutrition, (2) physical activity, and (3) stress. Given that users had the option of “passing” on the daily challenge and opting for a different activity, the most and least attempted challenges were associated with nutrition and physical activity respectively. This suggests that the user group was motivated to achieve improved heart health by adopting healthier dietary habits, and that modification of physical activity remains a challenge.

Conclusion: The data analysis offers a unique insight on the usage patterns of a consumer-focused mobile application developed for the prevention of heart disease and stroke. This analysis also provides insights on the effectiveness of various behaviour change strategies that can be used to guide the conceptualization of future mHealth tools for the prevention of chronic disease.