Food for Thought: The Impact of m-Health Enabled Interventions on Eating Behavior

Abstract

Mobile apps have great potential to deliver promising health-related interventions to engage consumers and change their behaviors such as healthy eating. Currently, the interventions for promoting healthy eating are either too onerous to keep consumers engaged or too restrictive for consumers to act upon when receiving feedback from healthcare professionals. In addition, while social media allows individuals to receive information from many sources, it is unclear how the effect from peer engagement interacts with professional support in the context of such interventions. This study proposes and evaluates three mobile-enabled interventions to address these challenges: a mobile-based visual diary, image-based dietitian support, and peer engagement. We examined their effects on user engagement and food choices via a 4-month randomized field experiment. We show strong positive impact of the mobile-based visual diary and dietitian support on improving customer engagement. Specifically, the mobile-based visual diary and dietitian support each increases the log-odds ratio of user engagement by 43.8% and 50.7%, respectively. Mediation analysis further reveals that while the use of a mobile app increases user engagement through improved self-efficacy, the influence mechanism of dietitian support is through improved intention and enhanced transition from intention to behavior. We also identify some negative effects of peer engagements, as the log-odds ratio of customer engagement is decreased by 33.8%. This negative effect may serve to caution researchers and developers against incorporating social engagement features into their mHealth apps without adequate consideration. The effectiveness of the mobile app varies across customers, both by ethnicity and age. Young, white customers tended to benefit the most from the mobile-based interventions presented in our study. We also find that the mobile-based visual diary had a significant positive impact on fruit and vegetable consumption as well as the control of portion sizes, increasing their scores by 0.30 and 0.37, respectively; in addition, users’ overall scores for healthy eating can also be improved by providing dietitian support, albeit with smaller effect sizes. These results provide quantitative evidence that highlight the promise of mobile apps for delivering advanced interventions to engage users and facilitate health behavior change.