To examine whether a multicomponent commercial fitness app with very small ('micro') financial incentives (FI) increased population-level device-assessed physical activity (PA) over 2 years. The secondary objective was to explore the influence of select covariates on longitudinal effects. This 24 month pre-post quasiexperiment was conducted in Ontario, Canada's largest province (December 2016-June 2019). Following a 1-to-2 week baseline period, users earned micro-FIs ($0.04 CAD/day) for achieving daily step goals. Multiple linear regression models estimated changes in weekly mean daily step count from baseline to key timepoints (eg, 24 months). To address the secondary objective, separate models were developed for each level of the selected covariates (eg, start season, baseline PA). The sample included 516 818 users (% female: 62.83; age (SD): 33.46 (12.65) years). Half were 'low' active at baseline (<5000 daily steps; 47.15%). Overall, daily step counts were greater than baseline at all key timepoints (eg, 242 steps/day at 24 months; p<0.001). Users from earlier start seasons and longer FI exposure exhibited larger differences from baseline (eg, 758 steps/day at 24 months; p<0.001). Differences were also more pronounced among 'low' active users (eg, 1986 steps/day at 24 months; p<0.001). Substantial daily step count reductions were observed among 'very high' active users (≥10 000 daily steps; eg, -3969 steps/day at 24 months; p<0.001). Modest PA increases of about 250 steps per day were sustained over 2 years. For important subgroups (ie, earlier start seasons, 'low' active) increases approached or surpassed 1000 steps/day-a level indicative of clinical significance. Substantial daily step count reductions among higher active users were also observed.

BackgroundMedication nonadherence is a significant barrier to therapy success. Smartphone apps represent reasonable tools for simple adherence-enhancing interventions. Many adherence apps are available in app stores with diverse content, quality, and outputs. We define “output of an adherence app” as the processing and visualization of data recorded by the user and related to adherence. In 2016, Santo et al defined 5 desirable features in the output of adherence apps: tracking history, charts, statistics, rewards, and an exportable file. With this, a reference point to evaluate outputs of adherence apps was delivered. Identifying and fulfilling users’ needs are essential when developing an adherence app for patients’ self-management and professional adherence services, such as therapy support provided by health care professionals (HCPs).ObjectiveWe aimed to investigate the smartphone app market regarding desirable features in the outputs, explore the users’ needs, and evaluate the concordance.MethodsWe searched for smartphone adherence apps in the 2 largest commercial app repositories by using keywords. Search results were screened for eligibility by applying inclusion and exclusion criteria. Eligible, freely available apps were tested regarding desirable features in their output. We conducted 2 focus groups and a cross-sectional online survey to explore users’ needs. Survey participants rated their desire for features on a 7-point Likert scale. Focus groups were analyzed using the previously reported framework method. Descriptive statistics were calculated by median and IQR or mean and SD. We compared survey subgroups with a 2-tailed t test. A P value <.05 was considered statistically significant.ResultsWe screened 80 apps for eligibility and included 9 in our analyses. All desirable features were present, with tracking history being the most frequent feature (in 8/9 apps). Other desirable features were observed in 3 or fewer of the apps. Eight individuals participated in the 2 focus groups. During the focus groups, a total of 13 categories of desired features emerged. All 5 desirable features were rated as important in adherence apps. Three additional features were mentioned: (1) professional feedback regarding therapy or intake course, (2) additional recommendations based on intake course, and (3) option to discuss the data with an HCP. A total of 42 individuals participated in the online survey. Tracking history was the most desired (mean rating of 5.29) and rewards the least desired feature (mean rating of 2.81) in the output. There was ambivalence regarding professional feedback, statistics, and charts. Participants with or without regular medication use showed no significant differences.ConclusionsThe outputs delivered by freely available smartphone adherence apps only partly match users’ needs. Users showed a special interest in the interpretation of their data with an HCP. Therefore, adherence apps cannot substitute for the HCP but can be used to enhance current patient care.

Artificial intelligence (AI) powered mobile health (mHealth) apps are emerging as vital self-triage tools for skin cancer detection. By utilizing smartphone cameras, these apps analyze skin lesions to assess the risk and provide tailored care recommendations, ranging from self-care guidance to directing users to appropriate healthcare providers. While this positively impacts Sustainable Development Goals 3, the rapid proliferation of these apps introduces significant challenges. A persistent digital divide, stratified by gender, geography, income, and education, limits widespread adoption. It is further exacerbated by varying levels of digital literacy and patient anxieties. The unregulated nature of commercial app stores poses diagnostic risks. At the same time, limited training data for AI models exposes individuals with underrepresented skin types to significant diagnostic errors. Increased self-diagnosis leads to increased downstream care pressures, overwhelming dermatology and pathology services in LMICs. This review highlights the increasing incidence of skin cancer and discusses the risk-benefit profile of mHealth apps in diagnosis. It covers the multifaceted challenges confronting LMICs, including the evolving and fragmented regulatory landscape, while comparing them with those of high-income countries. Finally, we developed a causal loop diagram (CLD) to facilitate informed multistakeholder action for improving public health outcomes through AI-based mHealth apps. The CLD establishes the positive and negative associations of key variables across four pillars: data acquisition and quality, AI model development and validation, user experience and accessibility, and public health impact. We advocate for a multidisciplinary convergence among dermatological experts, AI scientists, app developers, and regulators, fostering international collaboration, knowledge sharing, best practices, and targeted capacity building to ensure equitable and accountable mHealth deployment in LMICs.

This systematic review summarises the latest research on the use of augmented reality (AR) in biology education at primary, secondary and tertiary levels. Searching Web of Science, Scopus and Google Scholar, we found 40 empirical studies published up until early 2024. For each study, we analysed biological content, technical features, learning practices and pedagogical impact. AR is most used in human anatomy, particularly in the circulatory and respiratory systems, but also in genetics, cell biology, virology, botany, ecology and molecular processes. Mobile devices dominate as a mediation platform, with marker-based tracking and either commercial apps or self-developed Unity/Vuforia solutions. Almost all studies embed AR in constructivist or inquiry-based pedagogies, and report improved motivation, engagement and conceptual understanding. Nevertheless, reporting on the technical details is inconsistent and the long-term effects are not yet sufficiently researched. AR should therefore be viewed as a pedagogical tool rather than a technological goal that requires careful instructional design and equitable access to ensure meaningful and sustainable learning.

Backround: Self-care is essential for managing heart failure (HF), yet many patients struggle with adherence to prescribed medications, low sodium diet, and daily self-monitoring of vital signs and symptoms. Commercial mobile health (mHealth) technologies offer unique opportunities for improving HF self-care, but their efficacy is underexplored. Aim: This study aimed to assess the feasibility and preliminary efficacy of a patient-centered intervention (iCardia4HF) that integrates multiple commercial mHealth apps and devices with individually tailored text messages (TM) to promote HF self-care. Methods: We conducted a two-arm, pilot randomized trial (NCT04262544) with allocation concealment and masking of outcome assessors. Eligible patients (adults with Stage C HF) were randomly assigned to either the control or intervention group. The control group (CG) received usual care enhanced with the provision of three consumer mHealth devices: Fitbit activity tracker and Withings Body Cardio scale and blood pressure (BP) monitor. The intervention group (IG) received the iCardia4HF program which synergistically integrates these devices with three commercial mHealth apps (Health Storylines, Withings, and Fitbit) and a program of individually tailored TM promoting HF self-care adherence. The primary outcome was medication adherence (MEMS bottle) and daily weighing adherence (Withings scale) over 12 weeks. Secondary outcomes included daily BP monitoring (Withings BP cuff) and change in self-reported self-care (SCHFI v7.2). Timestamped adherence data were transmitted from the devices to a secure digital health platform. Two-sample t-tests were performed to assess intervention effects. Results: A total of 81 patients completed the 12-week follow up (IG=42, CG=39). Participants’ mean age was 54.7 years (SD=11.0), 81% were African American, 45% were female, 64% had HFrEF, and 85% had NYHA class II or III. There were significant differences between the IG and CG in medication adherence (85% vs 75%; d=0.5, 95% CI: 0.04, 0.96; p=0.03) and daily self-monitoring of weight (72% vs 54%; d=0.6, 95% CI: 0.15, 1.04; p=0.007) and BP (67% vs 50%; d=0.54, 95% CI: 0.08, 1.0; p=0.02) over 12 weeks. There were no significant differences between the two groups in self-reported HF self-care. Conclusion: This pilot study provides preliminary evidence of feasibility and potential efficacy warranting further evaluation of the iCardia4HF intervention in a larger, fully powered trial with longer follow-up.

Smartphone intervention apps for schizophrenia: A review of the academic literature and app stores.

This article argues that clinicians and researchers must apply the same evidence-based medicine (EBM) hierarchy to digital health interventions that they use for traditional treatments. When comparing interventions for the same clinical indication, evidentiary standards should not change based on delivery method - whether pharmacotherapy, psychotherapy, or digital therapeutics. The manuscript outlines the spectrum of digital health tools (Digital Health, Digital Medicine, and Digital Therapeutics) and examines the rigorous FDA approval process for digital therapeutics, which requires Phase III randomized controlled trials comparable to pharmaceutical standards. Using substance use disorder treatment as a concrete example, the article demonstrates the "evidence gap" between FDA-approved digital therapeutics with robust clinical trial data and unvalidated commercial apps that rely on testimonials or no published research. The framework extends to emerging artificial intelligence applications in therapeutic spaces. Finally, the article addresses systemic implementation barriers - including reimbursement uncertainty, limited provider awareness, and clinical workflow integration challenges - and practical considerations clinicians face when selecting digital tools, including cost-access trade-offs, engagement metrics, and professional liability concerns.

ObjectivesUse artificial intelligence–Human collaboration to investigate the unintended consequences of the most popular commercial fitness apps through social listening via X (formerly Twitter) posts.DesignMachine‐assisted topic analysis (MATA).MethodsX posts (n = 58,881) referring to the five most profitable fitness apps were collected via application programming interface and filtered for negative sentiment, resulting in 13,799. MATA was used to generate a structural topic model. This organized the data into topics and provided 20 representative posts per topic for further qualitative analysis, informed by a thematic analysis approach.ResultsSix topics were generated by machine analysis and subsequently retained as independent themes during human analysis. These reflected key challenges and unintended consequences of using commercial fitness apps, including negative psychological and behavioural impacts. These centred around the challenges of quantifying real‐world activities, implications for accuracy, difficulties associated with achieving algorithm‐set goals, and subsequent negative impacts on emotions, motivations, and engagement with apps and health behaviours more generally.ConclusionsThis study highlights the negative behavioural and psychological consequences of commercial fitness apps as reported by users on social media. Our findings suggest that these may undermine the apps' potential to promote health behaviour change and well‐being. This highlights the need for a more user‐centred app design based on psychological theory, prioritizing well‐being and intrinsic motivation over rigid, quantitative goals.

Digital device usage now transcends age and demographic boundaries, having become commonplace among children from all racial and ethnic groups. The rapid proliferation of touch screen use among infants (6–24 months) has outpaced evidence-based design standards, creating an urgent need for developmentally-grounded interfaces. In this paper, BabySens-an ethical Infant-Centered HCI Design (ICHD) framework that integrates stage-aligned interactions adapting to sensorimotor abilities, real-time scaffolding via on-device ML, built-in guardrails, and hybrid physical-digital play is developed using Bluetooth-connected toys. Through an approved and controlled lab study with infants (N = 12), our object permanence teaching prototype demonstrated significantly higher touch accuracy of 83–90% CI [78%, 88%] vs. 52% [45%, 59%] in controls; *p* &lt; 0.001, Cohen’s *d* = 1.87) and no sustained distress events compared to commercial apps, with positive transfer effects to real-world tasks (ρ = 0.41). Machine learning analysis revealed that the adaptive system reduced error distances by 68% for infants less than 12 months. These pilot study results challenge current "baby-proofing" approaches, showing that developmental alignment enhances efficacy while reducing risks. This paper emphasizes the need for larger-scale validation and advocate for industry standards based on Piagetian developmental milestones and parental mediation tools, offering BabySens as a concrete template for responsible infant-tech design that prioritizes learning over engagement.

Mindfulness training is widely recognized for its benefits in reducing depression, anxiety, and loneliness. With the rise of smartphone-based mindfulness apps, digital meditation has become more accessible, but sustaining long-term user engagement remains a challenge. This paper explores whether respiration biosignal feedback and mindfulness skill estimation enhance system usability and skill development. We develop a smartphone's accelerometer-based respiration tracking algorithm, eliminating the need for additional wearables. Unlike existing methods, our approach accurately captures slow breathing patterns typical of mindfulness meditation. Additionally, we introduce the first quantitative framework to estimate mindfulness skills---concentration, sensory clarity, and equanimity---based on accelerometer-derived respiration data. We develop and test our algorithms on 261 mindfulness sessions in both controlled and real-world settings. A user study comparing an experimental group receiving biosignal feedback with a control group using a standard app shows that respiration feedback enhances system usability. Our respiration tracking model achieves a mean absolute error (MAE) of 1.6 breaths per minute, closely aligning with ground truth data, while our mindfulness skill estimation attains F1 scores of 80-84% in tracking skill progression. By integrating respiration tracking and mindfulness estimation into a commercial app, we demonstrate the potential of smartphone sensors to enhance digital mindfulness training.

Abstract Background: While numerous mobile healthcare applications (apps) have been developed, there remains a paucity of evidence regarding their efficacy in enhancing the quality of life for cancer patients. To bridge this gap, we conducted a randomized trial involving 320 breast cancer patients to evaluate the impact of utilizing apps postoperatively for six months on their overall well-being. Methods: Between November 2020 and September 2021, we enrolled stage 0-III breast cancer patients aged 20-60 who underwent surgery at Asan Medical Center. These participants were randomly assigned in a 1:1:1:1 ratio to three commercial apps (A for general health management, B for walking encouragement, and C for cancer-specific support) or a control group receiving conventional care. Comprehensive assessments were conducted at baseline, 6 months, and 12 months using the five-dimension EuroQol five-level version (EQ-5D-5L) questionnaires. Quality of life was measured using both the index score and visual analog scale (VAS) of EQ-5D-5L. Additionally, we investigated the proportions of patients who reported problems in the five dimensions. Result: While the overall cohort showed no significant improvement in index score or VAS with the apps, a subgroup analysis revealed notable trends. High-compliance users of app B reported a lower proportion of problems in usual activities compared to the control group (0% vs. 27.4%, P &amp;lt; .001). Additionally, among those undergoing adjuvant chemotherapy—a population typically experiencing decreased quality of life—app C users demonstrated higher index scores than the control group (0.908 vs. 0.761, P = 0.004). Conclusion: Our study did not demonstrate the effectiveness of mobile apps in improving the quality of life for postoperative breast cancer patients. However, these healthcare apps showed the potential to enhance the quality of life not only among patients with high app adherence but also among those whose quality of life was initially compromised. Citation Format: Yung-Huyn Hwang, Young-Jin Lee, Seunghee Baek, Yura Lee, Seung Hee Seo, Jiyun Hwang, Tae-Kyung Robyn Yoo, Sae Byul Lee, Jisun Kim, Il Yong Chung, BeomSeok Ko, Hee Jeong Kim, Byung Ho Son, Chang-Min Choi, Seockhoon Chung, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee. Impact of Mobile Healthcare Apps on Patient-Reported Quality of Life after Breast Cancer Surgery: A Randomized Controlled Trial [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P2-01-04.

Commercial wearable and mobile wellness apps and devices have become increasingly affordable and ubiquitous. One of their aims is to assist the individual wearing them in adopting a healthier lifestyle through tracking and visualizing their data. Some of these devices and apps have a wheelchair mode that indicates that they are designed for different types of bodies (eg, wheelchair users with spinal cord injury [SCI]). However, research focuses mainly on designing and developing new condition-specific self-tracking technology, whereas the experiences of wheelchair users with SCI using self-tracking technology remain underexplored. The objectives of this study were to (1) provide a comprehensive overview of the literature in the field of self-tracking technology and wheelchair users (as a basis for the study), (2) present the self-tracking needs of wheelchair users with SCI, and (3) present their experiences and use of commercial self-tracking technology. We conducted semistructured interviews with wheelchair users with SCI to understand their experiences with self-tracking and self-tracking technologies, their self-tracking needs, and how they changed before and after the injury. The interviews were thematically analyzed using an inductive approach. Our findings comprised three themes: (1) being a wheelchair user with SCI, (2) reasons for self-tracking, and (3) experiences with self-tracking technologies and tools. The last theme comprised 3 subthemes: self-tracking technology use, trust in self-tracking technology, and calorie tracking. In the Discussion section, we present how our findings relate to the literature and discuss the lack of trust in commercial self-tracking technologies regarding calorie tracking, as well as the role of wheelchair users with SCI in the design of commercial self-tracking technology.

The multitasking mechanism between activities and fragments plays a fundamental role in the Android operating system, which involves a wide range of features, including launch modes, intent flags, task affinities, and structured activities containing fragments. All of them are being widely used in Android apps, both open source and commercial ones. In this article, we present a formal semantics of the Android multitasking mechanism between activities and fragments, which accommodates all the important features and gives insofar the most comprehensive and accurate formalization. In particular, our semantics is formulated based on multi-stack systems, and fully captures the behavior of task stacks and activity stacks regarding fragments. Based on the semantics, we provide new static analysis algorithms, which are both multi-stack aware and fragment sensitive, thus achieve more precise static analysis for Android apps. We validate our approach by extensive experiments on both open source and commercial Android apps. The results highlight the benefits of the considering the semantics of the multitasking mechanism between activities and fragments in static analysis, and confirm the efficacy of our approach.

Mobile-assisted language learning with commercial apps: A focused methodological review of quantitative/mixed methods research and ethics

BackgroundAlthough many studies have used smartphone apps to examine alcohol consumption, none have clearly delineated long-term (>1 year) consumption among the general population.ObjectiveThe objective of our study is to elucidate in detail the alcohol consumption behavior of alcohol drinkers in Japan using individual real-world data. During the state of emergency associated with the COVID-19 outbreak, the government requested that people restrict social gatherings and stay at home, so we hypothesize that alcohol consumption among Japanese working people decreased during this period due to the decrease in occasions for alcohol consumption. This analysis was only possible with individual real-world data. We also aimed to clarify the effects of digital interventions based on notifications about daily alcohol consumption.MethodsWe conducted a retrospective study targeting 5-year log data from January 1, 2018, to December 31, 2022, obtained from a commercial smartphone health care app (CALO mama Plus). First, to investigate the possible size of the real-world data, we investigated the rate of active users of this commercial smartphone app. Second, to validate the individual real-world data recorded in the app, we compared individual real-world data from 9991 randomly selected users with government-provided open data on the number of daily confirmed COVID-19 cases in Japan and with nationwide alcohol consumption data. To clarify the effects of digital interventions, we investigated the relationship between 2 types of notification records (ie, “good” and “bad”) and a 3-day daily alcohol consumption log following the notification. The protocol of this retrospective study was approved by the Ethics Committee of the Kyoto University Graduate School and Faculty of Medicine (R4699).

Forming a habit of practicing mindfulness meditation around the same time of day is one strategy that may support long-term maintenance and in turn improve physical and mental health. The purpose of this study was to identify common patterns in the time of day of meditation associated with long-term meditation app use to assess the importance of temporal consistency for maintaining meditation over time. App usage data were collected from a random sample of 15,000 users who had paid for an annual membership to a commercial meditation app in 2017. We constructed three measures of temporal consistency in the time of day of meditation sessions in order to categorize users into one of three behavioral phenotypes: Consistent, Inconsistent, or Indeterminate. Panel data models were used to compare temporal consistency across the three phenotypes. Of the 4205 users (28.0%) in the final analytic sample, 1659 (39.5%) users were Consistent, 2326 (55.3%) were Inconsistent, and 220 users (5.23%) were Indeterminate. Panel models confirmed that temporal consistency had contrasting relationships with meditation maintenance among these three phenotypes (p < 0.01). These findings revealed that temporal consistency was associated with meditation maintenance for less than half of app users, which suggests that other behavioral mechanisms in addition to temporally consistent habits can support meditation app use over time. This has important implications for researchers and policymakers trying to promote the maintenance of meditation and other complex health behaviors, such as increased physical activity and healthier diets.

Background: Mobile health (mHealth) interventions may provide a more accessible approach to a broader segment of the population needing weight loss treatment. Little is known about individuals’ perceptions of remotely-delivered diet-related feedback (FB) messages. Methods: The aim of this analysis was to assess perceptions of diet-related FB among participants randomized to the FB intervention (n = 251) of SMARTER, a randomized controlled trial that examined the efficacy of a 12-month remotely-delivered mHealth intervention targeting weight loss. Participants were asked to self-monitor (SM) diet using a commercial app and received FB messages in real-time in response to the SM data at least once daily. We conducted six focus groups (N=23) via Zoom to discuss participants’ perceptions of the FB intervention. Trained experts in qualitative research used a semi-structured focus group guide to facilitate discussion on how study participants interacted with technology and the FB they received. Participants were invited to participate in one of two focus groups based on weight loss at 12 months and average step counts during the 30 days prior to their 12-month assessment. After the final study visit, eligible participants were invited to participate in the focus groups and provided noteworthy comments. The data were analyzed using ATLAS.ti (version 9). Results: Four key themes emerged from the content analysis pertaining to FB and broader study issues: timing of the FB notifications, personalization of FB messages, issues with the SM app, and social aspect of the study design. Participants found FB helpful to engage in SM behaviors and reported a desire for more personalized FB messages related to diet. Some participants voiced a desire to set their own schedule for FB message delivery to ensure FB could be viewed when received. They also identified two challenges: the limited selection of foods in the diet SM app which in turn may have affected their SM and FB messaging and the absence of a social community. Conclusions: Our results suggest that giving participants the flexibility for FB notifications to align with their schedules and phone accessibility may improve receipt of FB and engagement. There is a need to enhance the personalization of FB while maintaining the scalability for a broader population reach. Incorporating contact with a coach to supplement remotely-delivered FB may further improve participant engagement in changing nutrition habits.

ABSTRACT Attention Deficit Hyperactivity Disorder (ADHD) is a prevalent neurodevelopmental disorder typically treated with pharmacotherapy; alternatives such as mobile apps have emerged to support individuals with ADHD. This review utilised the Arksey and O'Malley scoping framework to assess mobile apps for ADHD, examining their characteristics, target users, treatment modalities, techniques, gamification elements, and medical endorsements. We analyzed records from the past decade (2013–2023) across eight digital libraries and two virtual app stores (Google Play Store and Apple's App Store). From 3,474 potentially relevant apps, 46 were analyzed and categorised as commercial or non-commercial, and categorised into video game and non-video game mobile apps. Addressing four primary research questions, the study revealed significant insights: 29.7% of ADHD mobile apps that focused on cognitive treatment, 14.8% aided clinical diagnosis, and cognitive (13.66%) and executive functions (11.8%) techniques were the most commonly prioritised treatment methods. Notably, only two of the 35 commercial mobile apps received medical endorsements, while levels and statistics emerged as the most popular gamification elements. Therefore, this study highlights the widespread availability of mobile mental health apps for individuals with ADHD and their caregivers and underscores the need for future research to integrate mobile apps into ADHD diagnosis and treatment.

Limited access to nutrition support among populations with cancer is a major barrier to sustainable and quality cancer care. Increasing use of mobile health in health care has raised concerns about its validity and health impacts. This systematic review aimed to determine the effectiveness of commercial or cancer-specific nutritional mobile apps among people living with cancer. A systematic search of the CENTRAL, Embase, PubMed (MEDLINE), and Scopus databases was carried out in May 2024. All types of intervention studies were included, except observational studies, gray literature, and reference lists of key systematic reviews. Studies were eligible for inclusion if they involved (1) patients with or survivors of cancer and (2) nutrition-related mobile apps. Studies were excluded if the nutrition intervention was not delivered via mobile app or the app intervention was accompanied by dietary counseling. The review process was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Risk of Bias 2 and Risk of Bias in Nonrandomized Studies tools were used to assess the study quality. The Cochrane Review Manager (version 5.4) software was used to synthesize the results of the bias assessment. A total of 13 interventions were included, comprising 783 adults or teenagers with cancer. Most studies focused on breast cancer (6/13, 46%), overweight (6/13, 46%), and survivors (9/13, 69%). Data on anthropometry and body composition (7/13, 54%; 387 participants), nutritional status (3/13, 23%; 249 participants), dietary intake (7/13, 54%; 352 participants), and quality of life (6/13, 46%; 384 participants) were gathered. Experimental groups were more likely to report significant improvements in body weight or composition, dietary compliance, nutritional status, and quality of life than control groups. Although mobile app platforms are used to deliver nutrition interventions, the evidence for long-term efficacy, particularly in populations with cancer, remains elusive. More robust randomized controlled trials with larger sample sizes, as well as more homogeneous population characteristics and outcome measures, are warranted. PROSPERO CRD42023330575; https://tinyurl.com/55v56yaj.

BackgroundThe shift in medical care toward prediction and prevention has led to the emergence of digital health care as a valuable tool for managing health issues. Aiding long-term follow-up care for cancer survivors and contributing to improved survival rates. However, potential barriers to mobile health usage, including age-related disparities and challenges in user retention for commercial health apps, highlight the need to assess the impact of patients’ abilities and health status on the adoption of these interventions.ObjectiveThis study aims to investigate the app adherence and user experience of commercial health care apps among cancer survivors using an extended technology acceptance model (TAM).MethodsThe study enrolled 264 cancer survivors. We collected survey results from May to August 2022 and app usage records from the app companies. The survey questions were created based on the TAM.ResultsWe categorized 264 participants into 3 clusters based on their app usage behavior: short use (n=77), medium use (n=101), and long use (n=86). The mean usage days were 9 (SD 11) days, 58 (SD 20) days, and 84 (SD 176) days, respectively. Analysis revealed significant differences in perceived usefulness (P=.01), interface satisfaction (P<.01), equity (P<.01), and utility (P=.01) among the clusters. Structural equation modeling indicated that perceived ease-of-use significantly influenced perceived usefulness (β=0.387, P<.01), and both perceived usefulness and attitude significantly affected behavioral intention and actual usage.ConclusionsThis study showed the importance of positive user experience and clinician recommendations in facilitating the effective usage of digital health care tools among cancer survivors and contributing to the evolving landscape of medical care.