Use Of Physical Activity Apps Research Articles

FEASIBILITY OF USING SMARTPHONES AS A TOOL TO PROMOTE PHYSICAL ACTIVITY IN OLDER ADULTS

Abstract Smartphones have potential to allow asynchronous education, individualized feedback and coaching around physical activity (PA) though it’s unclear if older adults make use of these capabilities. We conducted anonymous, semi-structured interviews/surveys on current PA levels, and experience with mobile technology and PA programs with a convenience sample of older adults, and family members/caregivers receiving care at a large geriatrics academic practice over a 3-month period. Data included demographics, experience with smartphone and PA applications. Current levels of PA were measured with the International Physical Activity Questionnaire (IPAQ). Comparisons of PA levels based on mild vs moderate vs vigorous activity. 25 completed surveys, most of whom were female (67%) and identified as non-White (68%), with a mean age of 80.8 years, range 67-96. The majority (84%) reported owning smartphones, 8% reported using PA apps, and 8% used wearable activity trackers (WATs). 44% walked at least 10 minutes per day, but only 32% reported attaining moderate PA, and 12% vigorous PA. Average time/day walking 1.1-hour, average time/day moderate activity 0.74 hours. Both younger (age≤80 years) and older (age>80 years) adults were similar in owning Smartphones (85% vs. 83%) and using WATs (8% vs. 8%). Only the younger group used PA apps (15% vs. 0%). The ubiquity of Smartphones especially among such a demographically heterogeneous group suggests this may be a viable tool for increasing PA among a wide range of older adults. Next steps should address low rates of PA app use, intergenerational differences, and the possibility of incorporating socialization with technology.

Determinants of physical activity maintenance during the Covid-19 pandemic: a focus on fitness apps.

There are various health benefits of regular physical activity (PA) and health risks of sedentariness. The Covid-19 pandemic may have decreased PA and increased sedentariness for several reasons (e.g., closure of gyms, family-related time constraints, and reduced outdoor mobility). Yet, to date, there are no longitudinal studies that examined whether the pandemic affects PA levels and what factors help people remain physically active during lockdown. This study aims to investigate changes in U.S. residents' PA during (vs. before) the Covid-19 pandemic and predictors of changes, with a focus on PA smartphone applications (apps) and their features (i.e., motivational, educational, or gamification related). The study utilized a two-wave longitudinal survey design with an online panel. Healthy adults (N = 431) from 45 U.S. states self-reported their PA levels before and during lockdown. PA app use and app feature ratings were assessed. t-tests and regression analyses were conducted. Moderate PA, vigorous PA, and PA measured in metabolic equivalent of task (MET) minutes per week decreased during lockdown (all p < .01). Controlling for PA before lockdown and individuals' PA intentions, PA app use was positively related to overall change in PA, measured in MET minutes per week (β = 15.68, standard error = 7.84, p < .05). PA decreased less with increasing app use frequency. When app features were added to the model, a buffering effect for gamification features was identified. The Covid-19-caused lockdown decreased U.S. residents' PA levels by 18.2%. The use of PA apps may help buffer the decline, and gamification-related app features may be particularly helpful in this context.

Psychological mechanisms underlying the relationship between commercial physical activity app use and physical activity engagement

PurposePrevious studies have indicated a relationship between the use of commercial physical activity apps (e.g., Fitbit, Strava) and physical activity engagement. The use of social components of such apps, in particular app-specific communities (connecting with other app users) and existing social networking platforms (e.g., Facebook) have the potential to enhance physical activity. This study aimed to explore the psychological mechanisms underlying the relationship between the use of commercial physical activity apps (and their social components) and physical activity engagement. MethodAn online cross-sectional survey assessed physical activity, use of commercial physical activity apps (and their associated social components), and psychological constructs (social support, self-efficacy, motivation, trait competitiveness, trait social comparison). Results1274 adults aged 18–83 years (Mage = 34.1 ± 13.5 years, 87.6% female) participated. App use was positively associated with physical activity engagement. The relationship between app use and physical activity was fully mediated by social support, self-efficacy, intrinsic motivation and identified regulation. Trait competitiveness, but not trait social comparison, moderated the relationship between app use and physical activity. Most features (e.g., sharing posts, providing or receiving encouragement) of the social components of apps were positively associated with psychological constructs linked to engagement in physical activity. Mediation pathways linking features of existing social networking platforms with physical activity were found. Specifically, sharing posts was linked to higher engagement in physical activity via positive associations with self-efficacy, and receiving encouragement with linked to higher engagement in physical activity via positive associations with both self-efficacy and identified regulation. In addition, engagement in comparisons was associated with lower self-efficacy and higher external regulation, and in turn, lower physical activity. ConclusionsThe relationship between the use of commercial physical activity apps and physical activity is underpinned by social support, self-efficacy and autonomous motivations. The findings highlight the importance of trait competitiveness, which should be taken into consideration when leveraging physical activity apps. Overall, the present study demonstrated that commercial physical activity apps (and their social components) hold great potential to increase physical activity engagement given their associations with psychological constructs strongly linked with physical activity.

Health Gain, Cost Impacts, and Cost-Effectiveness of a Mass Media Campaign to Promote Smartphone Apps for Physical Activity: Modeling Study.

BackgroundPhysical activity smartphone apps are a promising strategy to increase population physical activity, but it is unclear whether government mass media campaigns to promote these apps would be a cost-effective use of public funds.ObjectiveWe aimed to estimate the health impacts, costs, and cost-effectiveness of a one-off national mass media campaign to promote the use of physical activity apps.MethodsWe used an established multistate life table model to estimate the lifetime health gains (in quality-adjusted life years [QALYs]) that would accrue if New Zealand adults were exposed to a one-off national mass media campaign to promote physical activity app use, with a 1-year impact on physical activity, compared to business-as-usual. A health-system perspective was used to assess cost-effectiveness. and a 3% discount rate was applied to future health gains and health system costs.ResultsThe modeled intervention resulted in 28 QALYs (95% uncertainty interval [UI] 8-72) gained at a cost of NZ $81,000/QALY (2018 US $59,500; 95% UI 17,000-345,000), over the remaining life course of the 2011 New Zealand population. The intervention had a low probability (20%) of being cost-effective at a cost-effectiveness threshold of NZ $45,000 (US $32,900) per QALY. The health impact and cost-effectiveness of the intervention were highly sensitive to assumptions around the maintenance of physical activity behaviors beyond the duration of the intervention.ConclusionsA mass media campaign to promote smartphone apps for physical activity is unlikely to generate much health gain or be cost-effective at the population level. Other investments to promote physical activity, particularly those that result in sustained behavior change, are likely to have greater health impacts.

Associations Between Commercial App Use and Physical Activity: Cross-Sectional Study.

BackgroundIn today’s society, commercial physical activity apps (eg, Fitbit and Strava) are ubiquitous and hold considerable potential to increase physical activity behavior. Many commercial physical activity apps incorporate social components, in particular app-specific communities (allowing users to interact with other app users) or the capacity to connect to existing social networking platforms (eg, Facebook or Instagram). There is a growing need to gain greater insights into whether commercial physical activity apps and specific components of these apps (social components) are beneficial in facilitating physical activity.ObjectiveThis study aimed to examine the relationship between the use of commercial physical activity apps and engagement in physical activity. The social components of commercial physical activity apps (app-specific communities and existing social networking platforms) were also explored. This involved isolating specific features (eg, sharing, providing, and receiving encouragement, comparisons, and competitions) of app-specific communities and existing social networking platforms that were most valuable in facilitating physical activity.MethodsA cross-sectional web-based survey was conducted. Participants were 1432 adults (mean age 34.1 years, 1256/1432, 88.00% female) who completed measures assessing physical activity, the use of commercial physical activity apps, and engagement with app-specific communities and existing social networking platforms.ResultsOverall, 53.14% (761/1432) of the sample reported engaging with a commercial physical activity app. The most commonly used apps were Fitbit (171/761, 22.5%), Strava (130/761, 17.1%), and Garmin (102/761, 13.4%). The use of physical activity apps was significantly associated with physical activity. Notably, the use of app-specific communities and existing social networking platforms facilitated significantly greater engagement in physical activity. The features of app-specific communities that were most beneficial in promoting engagement in physical activity were providing encouragement to a partner, receiving encouragement from close friends and family, and engaging in competitions with members of public app-specific communities. In relation to existing social networking platforms, sharing physical activity posts predicted engagement in physical activity.ConclusionsThe findings indicate that app-specific communities and existing social networking platforms are components of apps that are fundamental in facilitating physical activity. They further suggest that commercial physical activity apps afford high population level reach and hold great potential to promote engagement in physical activity, an important public health consideration.

The Association Among Social Support, Self-Efficacy, Use of Mobile Apps, and Physical Activity: Structural Equation Models With Mediating Effects.

BackgroundPhysical inactivity is a risk factor for chronic noncommunicable diseases. Insufficient physical activity has become an important public health problem worldwide. As mobile apps have rapidly developed, physical activity apps have the potential to improve the level of physical activity among populations.ObjectiveThis study aimed to evaluate the effect of physical activity apps on levels of physical activity among college students.MethodsA Web-based questionnaire was used to survey college students in Beijing from December 27, 2017, to January 5, 2018. According to a previous survey, 43% of college students using physical activity apps and 36% of those who never used such apps achieved the physical activity recommendations. In this study, the sample size was calculated to be 500. The questionnaire consisted of 5 parts: the use of physical activity apps, sports habits, social support, self-efficacy, and social demographic information. Structural equation modeling was used to test the relationships between the use of physical activity apps, self-efficacy, social support, and level of physical activity.ResultsOf the 1245 participants, 384 college students (30.8%) used physical activity apps (in the past month). Of these 384 students, 191 (49.7%) gained new friends via the app. College students who were using physical activity apps had a higher level of physical activity and higher scores for social support and self-efficacy (P<.001) than those who did not use such apps. The use of physical activity apps significantly affected the mediating effect of physical activity level through social support (beta=.126; P<.001) and self-efficacy (beta=.294; P<.001). Gender played an important role in app use, self-efficacy, and physical activity in the mediation model: male users spent more time on physical activity and had higher self-efficacy scores (P<.001).ConclusionsThis study focused on college students in Beijing and found that the use of physical activity apps is associated with higher physical activity levels among these students. This effect is mainly through the mediation effect of social support and self-efficacy, rather than the direct effect of physical activity apps. The use of physical activity apps is associated with a higher social support level and higher self-efficacy score. Furthermore, a high social support level and high self-efficacy score are associated with higher physical activity levels.

Using the Unified Theory of Acceptance and Use of Technology (UTAUT) to Investigate the Intention to Use Physical Activity Apps: Cross-Sectional Survey.

BackgroundMany university students are lacking adequate physical exercise and are failing to develop physical activity (PA) behaviors in China. PA app use could improve this situation.ObjectiveThe aim of this study was to use the unified theory of acceptance and use of technology (UTAUT) to investigate the intention to use PA apps among university students in Guangzhou, China, and how body mass index (BMI) moderates the effects of UTAUT in explaining PA app use intention.MethodsA cross-sectional study was conducted among 1704 university students from different universities in Guangzhou, China. The UTAUT model was used to measure the determinants of intention to use PA apps.ResultsOf the participants, 41.8% (611/1461) intended to use PA apps. All three UTAUT-related scales (performance expectancy, effort expectancy, and social influence) were positively associated with the intention to use PA apps after adjusting for background variables (adjusted odds ratio 1.10-1.31, P<.001). The performance expectancy scale had stronger associations with the intention to use PA apps among those whose BMI were beyond normal range compared with those whose BMI were within normal range (P<.001).ConclusionsUTAUT is useful for understanding university students’ intention to use PA apps. Potential moderating effects should be kept in mind when designing UTAUT-based interventions to improve PA via app use.

Exploring Users' Experiences of the Uptake and Adoption of Physical Activity Apps: Longitudinal Qualitative Study.

BackgroundAlthough smartphone apps might support physical activity (PA), engagement with them tends to be low.ObjectiveThis study aimed to examine potential users’ needs and preferences regarding their engagement with PA apps during a first exposure to a never-used PA app and after 2 weeks’ usage.MethodsA longitudinal, one-arm qualitative study was conducted with potential PA app users. At baseline, participants (N=20) were asked to explore 1 of 3 randomly allocated PA apps while thinking aloud. Semistructured interview techniques allowed participants to elaborate on their statements. After 2 weeks, follow-up interviews explored participants’ (n=17) lived experiences of real-world app use. Verbal reports from both time points were analyzed using inductive thematic analysis.ResultsFeatures that promote a fair and simple user experience, support users’ self-regulation skills, and address users’ exercise motives were considered important for engagement both during a first exposure and after a 2-week use of PA apps. Features that support users’ need for relatedness as well as those that facilitate users to implement their intentions were expected to be important for engagement mainly during a first exposure to PA apps. Proactive and tailored features that integrate behavioral, psychological, and contextual information to provide adaptive exercise plans and just-in-time support were considered relevant to sustain engagement over time.ConclusionsApp features that address users’ exercise motives, promote self-regulation, and fulfill users’ need for relatedness might promote engagement with PA apps. Tailored and proactive features were expected to promote sustained engagement.

How Do Apps Work? An Analysis of Physical Activity App Users' Perceptions of Behavior Change Mechanisms.

BackgroundPhysical activity apps are commonly used to increase levels of activity and health status. To date, the focus of research has been to determine the potential of apps to influence behavior, to ascertain the efficacy of a limited number of apps to change behavior, and to identify the characteristics of apps that users prefer.ObjectiveThe purpose of this study was to identify the mechanisms by which the use of physical activity apps may influence the users’ physical activity behavior.MethodsThis study used a cross-sectional survey of users of health-related physical activity apps during the past 6 months. An electronic survey was created in Qualtrics’ Web-based survey software and deployed on Amazon Mechanical Turk. Individuals who had used at least one physical activity app in the past 6 months were eligible to respond. The final sample comprised 207 adults living in the United States. 86.0% (178/207) of respondents were between the ages of 26 and 54 years, with 51.2% (106/207) of respondents being female. Behavior change theory informed the creation of 20 survey items relating to the mechanisms of behavior change. Respondents also reported about engagement with the apps, app likeability, and physical activity behavior.ResultsRespondents reported that using a physical activity app in the past 6 months resulted in a change in their attitudes, beliefs, perceptions, and motivation. Engagement with the app (P<.001), frequency of app use (P=.03), and app price (P=.01) were related to the reported impact of the behavior change theory or mechanisms of change. The mechanisms of change were associated with self-reported physical activity behaviors (P<.001).ConclusionsThe findings from this study provide an overview of the mechanisms by which apps may impact behavior. App developers may wish to incorporate these mechanisms in an effort to increase impact. Practitioners should consider the extent to which behavior change theory is integrated into a particular app when they consider making recommendations to others wishing to increase levels of physical activity.

Apps for IMproving FITness and Increasing Physical Activity Among Young People: The AIMFIT Pragmatic Randomized Controlled Trial.

BackgroundGiven the global prevalence of insufficient physical activity (PA), effective interventions that attenuate age-related decline in PA levels are needed. Mobile phone interventions that positively affect health (mHealth) show promise; however, their impact on PA levels and fitness in young people is unclear and little is known about what makes a good mHealth app.ObjectiveThe aim was to determine the effects of two commercially available smartphone apps (Zombies, Run and Get Running) on cardiorespiratory fitness and PA levels in insufficiently active healthy young people. A second aim was to identify the features of the app design that may contribute to improved fitness and PA levels.MethodsApps for IMproving FITness (AIMFIT) was a 3-arm, parallel, randomized controlled trial conducted in Auckland, New Zealand. Participants were recruited through advertisements in electronic mailing lists, local newspapers, flyers posted in community locations, and presentations at schools. Eligible young people aged 14-17 years were allocated at random to 1 of 3 conditions: (1) use of an immersive app (Zombies, Run), (2) use of a nonimmersive app (Get Running), or (3) usual behavior (control). Both smartphone apps consisted of a fully automated 8-week training program designed to improve fitness and ability to run 5 km; however, the immersive app featured a game-themed design and narrative. Intention-to-treat analysis was performed using data collected face-to-face at baseline and 8 weeks, and all regression models were adjusted for baseline outcome value and gender. The primary outcome was cardiorespiratory fitness, objectively assessed as time to complete the 1-mile run/walk test at 8 weeks. Secondary outcomes were PA levels (accelerometry and self-reported), enjoyment, psychological need satisfaction, self-efficacy, and acceptability and usability of the apps.ResultsA total of 51 participants were randomized to the immersive app intervention (n=17), nonimmersive app intervention (n=16), or the control group (n=18). The mean age of participants was 15.7 (SD 1.2) years; participants were mostly NZ Europeans (61%, 31/51) and 57% (29/51) were female. Overall retention rate was 96% (49/51). There was no significant intervention effect on the primary outcome using either of the apps. Compared to the control, time to complete the fitness test was –28.4 seconds shorter (95% CI –66.5 to 9.82, P=.20) for the immersive app group and –24.7 seconds (95% CI –63.5 to 14.2, P=.32) for the nonimmersive app group. No significant intervention effects were found for secondary outcomes.ConclusionsAlthough apps have the ability to increase reach at a low cost, our pragmatic approach using readily available commercial apps as a stand-alone instrument did not have a significant effect on fitness. However, interest in future use of PA apps is promising and highlights a potentially important role of these tools in a multifaceted approach to increase fitness, promote PA, and consequently reduce the adverse health outcomes associated with insufficient activity.Trial RegistrationAustralian New Zealand Clinical Trials Registry: ACTRN12613001030763; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12613001030763 (Archived by WebCite at http://www.webcitation.org/6aasfJVTJ).