Abstract
BackgroundSmartphone apps promoting physical activity (PA) are abundant, but few produce substantial and sustained behavior change. Although many PA apps purport to induce users to compare themselves with others (by invoking social comparison processes), improvements in PA and other health behaviors are inconsistent. Existing literature suggests that social comparison may motivate PA for some people under some circumstances. However, 2 aspects of work that apply social comparison theory to PA apps remain unclear: (1) how comparison processes have been operationalized or harnessed in existing PA apps and (2) whether incorporating sources of variability in response to comparison have been used to tailor comparison features of apps, which could improve their effectiveness for promoting PA.ObjectiveThe aim of this meta-review was to summarize existing systematic, quantitative, and narrative reviews of behavior change techniques in PA apps, with an emphasis on social comparison features, to examine how social comparison is operationalized and implemented.MethodsWe searched PubMed, Web of Science, and PsycINFO for reviews of PA smartphone apps. Of the 3743 initial articles returned, 26 reviews met the inclusion criteria. Two independent raters extracted the data from these reviews, including the definition of social comparison used to categorize app features, the percentage of apps categorized as inducing comparison, specific features intended to induce comparison, and any mention of tailoring comparison features. For reference, these data were also extracted for related processes (such as behavioral modeling, norm referencing, and social networking).ResultsOf the included review articles, 31% (8/26) categorized app features as prompting social comparison. The majority of these employed Abraham and Michie’s earliest definition of comparison, which differs from versions in later iterations of the same taxonomy. Very few reviews specified what dimension users were expected to compare (eg, steps, physical fitness) or which features of the apps were used to induce comparison (eg, leaderboards, message boards). No review referenced tailoring of comparison features. In contrast, 54% (14/26) reviews categorized features for prompting behavioral modeling and 31% (8/26) referenced tailoring app features for users’ personal goals or preferences.ConclusionsThe heterogeneity across reviews of PA apps and the absence of relevant information (eg, about dimensions or features relevant for comparison) create confusion about how to best harness social comparison to increase PA and its effectiveness in future research. No evidence was found that important findings from the broader social comparison literature (eg, that people have differing preferences for and responses to social comparison information) have been incorporated in the design of existing PA apps. Greater integration of the mobile health (mHealth) and social comparison literatures may improve the effectiveness of PA apps, thereby increasing the public health impact of these mHealth tools.International Registered Report Identifier (IRRID)RR2-https://osf.io/nh4td/
Highlights
Despite decades of intervention efforts by several health care disciplines, physical inactivity remains a leading cause of morbidity and mortality in the United States [1]
No evidence was found that important findings from the broader social comparison literature have been incorporated in the design of existing physical activity (PA) apps
Greater integration of the mobile health and social comparison literatures may improve the effectiveness of PA apps, thereby increasing the public health impact of these mHealth tools
Summary
Despite decades of intervention efforts by several health care disciplines, physical inactivity remains a leading cause of morbidity and mortality in the United States [1]. More than 5000 apps available from the iTunes and Google Play app stores are designed to promote PA (alone or in the context of weight loss) [3] Many of these apps are user-friendly and elicit high user engagement [4], most are designed without input from behavioral scientists or other health professionals and reach the market without rigorous scientific evaluation [5,6]. Evidence-based PA apps have been developed by researchers, but these apps rarely reach the commercialization stage (due to a lack of resources) and research participants show modest engagement with them [7] These limitations may contribute to the low efficacy of existing PA apps; those that have been tested in randomized controlled trials produce only short-term increases in activity [8]. 2 aspects of work that apply social comparison theory to PA apps remain unclear: (1) how comparison processes have been operationalized or harnessed in existing PA apps and (2) whether incorporating sources of variability in response to comparison have been used to tailor comparison features of apps, which could improve their effectiveness for promoting PA
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