Can Your Smartphone Help You Exercise?

Newstudy in the American Journal of PreventiveMedicine determined that behavior change techniques may be underutilizedin fitness apps

Ann Arbor, MI, January 12, 2015

Fitnessapplications (apps) use behavior changetechniques (BCTs) to help usersmodify their physical activities,but which apps andwhich techniques are mosteffective? In a study in the American Journalof Preventive Medicine, researchers evaluated 100top-ranked physical activity apps and analyzed whichBCTs are being used in these apps.They determined that at present BCTs havebeen only narrowly implementedin physical activity apps.

As the proliferation of smartphones andother mobile devices continues,healthcare professionals – andpatients – see promisingvehicles for the delivery of health-related interventions tolarge segments of the population. More than 50% of American adults own smartphonesand half of those ownersuse their phones to search for health information. Approximately 50% of mobile subscribers use a fitness app.

In the current study, trained inspectors usinga classification scheme of 93 specific BCTs examinedeach app to determine the presenceor absence of each BCT. Overall, only 39 of 93 possibleBCTs were found, with anaverage of 6.6 in each app. The most commonly observedtechniques involved providing social support viaonline communities (e.g.,Facebook, Twitter), information about others' approval, instructionson how to perform a behavior, demonstrations of the behavior, and feedback onthe behavior.

"Two types of apps emerged based on their BCT configuration, andthose classesroughly paralleled those identifiedfrom an analysis of onlinedescriptions of app features," commentedlead investigator David E. Conroy, PhD, professorin the Department of Preventive Medicine, NorthwesternUniversity Feinberg Schoolof Medicine. "User inspection revealed the ubiquity of social network integration across the two classes of apps, and the emphasis on feedbackfor motivation (as compared to techniques suchas goal setting). These findingsreinforce the conclusionthat all apps are not createdequal, and prospective users should considertheir individual needs when selectingan app to increase physicalactivity."

According to Dr. Conroy and co-investigators,most apps use a limited set of BCTs, and developers havefavored BCTs with a modest evidence baseover others with more establishedevidence of efficacy. For example, social media integration for providing social support is morecommonly integrated in apps than the more well-establishedBCT of active self-monitoring by users.

The lack of self-monitoring inphysical activity apps might be an unintended consequenceof the sophisticated sensing capabilities of mobile devices. With embedded accelerometers passively monitoring movement, the user haslittle incentive to participate and may lose the benefits gained from retrospectionand active self-reporting.

Apps that increase physical activitylevels are potentially valuable because insufficient physical activityis the second-leading preventablecauseof death in the U.S., with links toheightened risk for major non-communicable diseases. "Theinformation resulting from thisstudy will be valuable for scientistsand developers working cooperativelyin the mobile health domainas well as physicians and otherpractitioners who seek low-cost interventions to increasetheir patients' physical activity," concluded Dr. Conroy.

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Notes for editors
"Implementationof Behavior Change Techniques in Mobile Applicationsfor Physical Activity," by Chih-HsiangYang, MEd, Jaclyn P. Maher, MS, and David E. Conroy, PhD. DOI: http://dx.doi.org/10.1016/j.amepre.2014.10.010.Itis published in the American Journal of Preventive Medicine,online ahead of Volume 48, Issue 4 (April2015).

Full text of the article is available to credentialed journalists uponrequest; contact Angela J. Beck at +1 734 764 8775 or ajpmmedia@elsevier.com. Journalists wishingto interview the authors shouldcontact Erin White, Northwestern University, at +1 847 491 4888 or ewhite@northwestern.edu.

About the American Journalof Preventive Medicine
The AmericanJournal of Preventive Medicine (www.ajpmonline.org) is the official journalof The American College of Preventive Medicine (www.acpm.org) and theAssociation for Prevention Teaching and Research (http://www.aptrweb.org/). It publishesarticles in the areas of prevention research, teaching, practice and policy. Original research ispublished on interventions aimed at the prevention ofchronic and acute diseaseand the promotion of individualand community health. Thejournal features papersthat address the primary and secondary prevention of important clinical, behavioral and public health issuessuch as injury and violence,infectious disease,women's health, smoking, sedentary behaviors and physical activity,nutrition, diabetes,obesity, and alcohol and drug abuse.Papers also address educational initiatives aimed at improving theability of health professionals to provideeffective clinical prevention andpublic health services. The journal also publishes officialpolicy statements from the two co-sponsoring organizations, health services research pertinentto prevention and publichealth, review articles,media reviews, and editorials.

The AmericanJournal of Preventive Medicine, with an Impact Factor of4.281, is ranked 10thin Public, Environmental, and OccupationalHealth titles and 17th inGeneral & Internal Medicinetitles according to the 2013 JournalCitation Reports®published by Thomson Reuters,2014.

About Elsevier
Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Research Intelligence and ClinicalKey— and publishes over 2,500 journals, including The Lancet and Cell, and more than 35,000 book titles, including a number of iconic reference works. Elsevier is part of RELX Group, a world-leading provider of information and analytics for professional and business customers across industries. www.elsevier.com

Media contact
Angela J. Beck, PhD,
MPH Managing Editor
+1 734 764 8775
ajpmmedia@elsevier.com