Analysis Of Physical Activity-Related Smartphone Apps For Behavior Change Potential

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The majority of Americans do not meet physical activity (PA) guidelines. Adoption and adherence may be improved with personalized intervention. Smartphone app use has increased exponentially in the past decade, extending to many areas of life and crossing socioeconomic status, ethnicity, and gender. Free smartphone apps that address habitual PA may be a useful tool, but their potential to support PA behavior change is not well understood. PURPOSE: To evaluate top-ranked free health and fitness apps for PA behavior change potential and to determine the relationship between this evaluation and consumer perceptions of quality, such as app store ranking and consumer ratings. METHODS: The top 100 "free" health and fitness apps in the US iOS app store were screened for rinclusion. Apps were excluded if the descriptions did not address any aspects of PA or fitness; required an external device, purchase/subscription after a trial period, or a health club membership or specific health insurance. Apps were also excluded if their descriptions was not written in English. Two investigators downloaded and evaluated the remaining apps that met the inclusion criteria using the App Behavior Change Scale (ABACUS). Apps were scored on 21 strategies within 4 categories (knowledge/information, goals/planning, feedback/monitoring, and actions), and prevalence in the sample was calculated. Pearson correlations were estimated for the relationship between ABACUS total scores and relative app ranking, as well as consumer rating. Significance was set at p < 0.05. RESULTS: 23 apps met the inclusion criteria. 100% offered some form of personalization; 96% incorporated self-monitoring and/or rehearsal; and 70% included options for goal-setting. Only 13% recommended restructuring of the environment, and 4% provided advice on distraction or avoidance. There were no significant correlations between ABACUS score and store ranking (r2= -0.15, p = 0.49) or consumer rating (r2= -0.26, p = 0.91) . CONCLUSIONS: Free apps may have the potential to support PA behavior change, especially in the areas of planning and self-monitoring. There is no correlation between the total number of evidence-based behavior change strategies and app popularity, however, so it may be beneficial for wellness professionals to counsel patients and clients on app choice.