Mobile Apps for Health Behavior Change: Protocol for a Systematic Review.

Madison Milne-Ives,Ching Lam,Michelle Helena Van Velthoven,Edward Meinert

doi:10.2196/16931

Abstract

BackgroundThe popularity and ubiquity of mobile apps have rapidly expanded in the past decade. With a growing focus on patient interaction with health management, mobile apps are increasingly used to monitor health and deliver behavioral interventions. The considerable variation in these mobile health apps, from their target patient group to their health behavior, and their behavioral change strategy, has resulted in a large but incohesive body of literature.ObjectiveThe purpose of this protocol is to provide an overview of the current landscape, theories behind, and effectiveness of mobile apps for health behavior change.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols will be used to structure this protocol. The focus of the systematic review is guided by a population, intervention, comparator, and outcome framework. A systematic search of Medline, EMBASE, CINAHL, and Web of Science will be conducted. Two authors will independently screen the titles and abstracts of identified references and select studies according to the eligibility criteria. Any discrepancies will then be discussed and resolved. One reviewer will extract data into a standardized form, which will be validated by a second reviewer. Risk of bias was assessed using the Cochrane Collaboration Risk of Bias tool, and a descriptive analysis will summarize the effectiveness of all the apps.ResultsAs of November 2019, the systematic review has been completed and is in peer review for publication.ConclusionsThis systematic review will summarize the current mobile app technologies and their effectiveness, usability, and coherence with behavior change theory. It will identify areas of improvement (where there is no evidence of efficacy) and help inform the development of more useful and engaging mobile health apps.Trial RegistrationPROSPERO CRD42019155604; https://tinyurl.com/sno4lcuInternational Registered Report Identifier (IRRID)PRR1-10.2196/16931

Highlights

Health care is becoming increasingly more digital
This systematic review will summarize the current mobile app technologies and their effectiveness, usability, and coherence with behavior change theory. It will identify areas of improvement and help inform the development of more useful and engaging mobile health apps
The authors only included randomized controlled trials (RCTs) to examine apps that aimed to change health behaviors but did not exclude any studies based on a particular type of patient, health behavior, or app intervention

Summary

Methods

We will use the population, intervention, comparator, and outcome template and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) [18] to identify appropriate Medical Subject Headings (MeSH) for the literature search and structure the review. Outcomes: The primary objective is to identify the types of mobile apps used in health care and behavioral change support and their effectiveness. This includes outcomes such as the extent and maintenance of behavior changes, adoption and adherence rates of the technology, patient-reported experience, feasibility and usability http://www.researchprotocols.org/2020/1/e16931/. Specific search terms, including health behaviors and health conditions, were identified in a preliminary scan of the literature and chosen in consultation with a medical librarian. Search terms will include MeSH terms and keywords related to mobile phones, mobile apps, health behaviors, and evaluation. Health Behavior OR Health Promotion OR Exercise OR Weight Loss OR Obesity (diet therapy, prevention & control, rehabilitation, therapy) OR Nutrition Therapy OR Diet OR Smoking Cessation OR Smoking Reduction OR Tobacco Use Cessation OR Alcohol Drinking (prevention & control, therapy) OR Mental Health OR Safe Sex OR Behavioral Medicine OR Chronic Disease “Health behaviour” OR “health behavior” OR “behaviour change” OR “behavior change” OR (Exercise ADJ3 (increase or start or maintain*)) OR “physical activity” OR “Weight loss” OR “healthy weight” OR “five a day” OR “diet” OR “nutrition” OR ((Maintenance OR maintain* OR achiev* Or retain*) ADJ4 (weight goal OR “weight loss” OR “goal weight” OR BMI)) OR (Smoking ADJ4 (cessation OR stop* OR quit* OR reduc*)) OR (Alcohol ADJ4 (reduc* OR limit* OR decreas* OR “cutting down” OR “cut down” OR “cut back” OR less* OR curb* OR abstain OR “dry January”)) OR “Protection from sun” OR “sun protection” OR “sun safe*” OR ((Sex OR “sex* behaviour” OR “sex* behavior”) ADJ4 (safe* OR protect*)) OR ((Alzheimer* disease OR arthritis OR asthma OR cancer OR COPD OR Crohn* disease OR cystic fibrosis OR dementia OR diabetes OR epilepsy OR heart disease OR HIV OR AIDS OR mood disorders OR bipolar OR depression OR anxiety OR multiple sclerosis OR Parkinson* disease) ADJ4 (manag* OR “self help” OR “self manag*” OR coping OR cope)) OR “Health management”

Conclusions

Introduction

Evaluation

Discussion