Abstract
BackgroundThere has been a recent proliferation in the development of smartphone applications (apps) aimed at modifying various health behaviours. While interventions that incorporate behaviour change techniques (BCTs) have been associated with greater effectiveness, it is not clear to what extent smartphone apps incorporate such techniques. The purpose of this study was to investigate the presence of BCTs in physical activity and dietary apps and determine how reliably the taxonomy checklist can be used to identify BCTs in smartphone apps.MethodsThe top-20 paid and top-20 free physical activity and/or dietary behaviour apps from the New Zealand Apple App Store Health & Fitness category were downloaded to an iPhone. Four independent raters user-tested and coded each app for the presence/absence of BCTs using the taxonomy of behaviour change techniques (26 BCTs in total). The number of BCTs included in the 40 apps was calculated. Krippendorff’s alpha was used to evaluate interrater reliability for each of the 26 BCTs.ResultsApps included an average of 8.1 (range 2-18) techniques, the number being slightly higher for paid (M = 9.7, range 2-18) than free apps (M = 6.6, range 3-14). The most frequently included BCTs were “provide instruction” (83% of the apps), “set graded tasks” (70%), and “prompt self-monitoring” (60%). Techniques such as “teach to use prompts/cues”, “agree on behavioural contract”, “relapse prevention” and “time management” were not present in the apps reviewed. Interrater reliability coefficients ranged from 0.1 to 0.9 (Mean 0.6, SD = 0.2).ConclusionsPresence of BCTs varied by app type and price; however, BCTs associated with increased intervention effectiveness were in general more common in paid apps. The taxonomy checklist can be used by independent raters to reliably identify BCTs in physical activity and dietary behaviour smartphone apps.
Highlights
There has been a recent proliferation in the development of smartphone applications aimed at modifying various health behaviours
Lifestyle behaviours, such as diet and physical activity, are modifiable risk factors associated with many noncommunicable diseases (NCDs), which account for 63% of deaths worldwide [1]
While theoretically grounded mHealth behaviour interventions increase the likelihood of achieving behaviour change, it has been suggested that current theories are inadequate to guide mHealth interventions, which need to be more interactive and dynamic [16]
Summary
There has been a recent proliferation in the development of smartphone applications (apps) aimed at modifying various health behaviours. The purpose of this study was to investigate the presence of BCTs in physical activity and dietary apps and determine how reliably the taxonomy checklist can be used to identify BCTs in smartphone apps Lifestyle behaviours, such as diet and physical activity, are modifiable risk factors associated with many noncommunicable diseases (NCDs), which account for 63% of deaths worldwide [1]. Abraham and Michie have suggested that there are a number of behaviour change techniques (BCTs) common to many health behaviour theories [17], of which at least five are evident in effective physical activity and dietary interventions (i.e. self-monitoring, intention formation, specific goal setting, review of behavioural goals and feedback on performance) [18]. While studies have been conducted to determine the extent to which behaviour change theory has been applied to app development, none have quantified the extent to which specific BCTs are included
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