Abstract
BackgroundThousands of mobile health apps are now available for use on mobile phones for a variety of uses and conditions, including cancer survivorship. Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories.ObjectiveThis study is designed to assess the presence of and manner in which health behavior change and health communication theories are applied in mobile phone cancer survivorship apps.MethodsThe research team selected a set of criteria-based health apps for mobile phones and assessed each app using qualitative coding methods to assess the application of health behavior change and communication theories. Each app was assessed using a coding derived from the taxonomy of 26 health behavior change techniques by Abraham and Michie with a few important changes based on the characteristics of mHealth apps that are specific to information processing and human computer interaction such as control theory and feedback systems.ResultsA total of 68 mobile phone apps and games built on the iOS and Android platforms were coded, with 65 being unique. Using a Cohen’s kappa analysis statistic, the inter-rater reliability for the iOS apps was 86.1 (P<.001) and for the Android apps, 77.4 (P<.001). For the most part, the scores for inclusion of theory-based health behavior change characteristics in the iOS platform cancer survivorship apps were consistently higher than those of the Android platform apps. For personalization and tailoring, 67% of the iOS apps (24/36) had these elements as compared to 38% of the Android apps (12/32). In the area of prompting for intention formation, 67% of the iOS apps (34/36) indicated these elements as compared to 16% (5/32) of the Android apps.ConclusionsMobile apps are rapidly emerging as a way to deliver health behavior change interventions that can be tailored or personalized for individuals. As these apps and games continue to evolve and include interactive and adaptive sensors and other forms of dynamic feedback, their content and interventional elements need to be grounded in human computer interface design and health behavior and communication theory and practice.
Highlights
We tend to overestimate the effect of a technology in the short run and underestimate the effect in the long run. [Roy Amara, leader at the Institute for the Future]
In considering our secondary aim of comparing platforms, we found that the iOS cancer survivorship apps received higher scores across most of the health behavior change techniques information-motivation-behavioral skills model (IMB) (HBCT) areas
A primary aim of this study was to analyze the linkage of HBCT interventions in cancer survivorship mHealth apps to theories and models that are used to predict health behavior change and communications, including those that are specific to information processing and human computer interaction such as control theory and feedback systems
Summary
Thousands of mobile health apps are available for use on mobile phones for a variety of uses and conditions, including cancer survivorship Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories. Conclusions: Mobile apps are rapidly emerging as a way to deliver health behavior change interventions that can be tailored or personalized for individuals. As these apps and games continue to evolve and include interactive and adaptive sensors and other forms of dynamic feedback, their content and interventional elements need to be grounded in human computer interface design and health behavior and communication theory and practice. Personal mobile apps are a critical component of mHealth, providing educational resources, decision-making tools, psychosocial communication, and social support
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