Physical Activity Mobile Apps Research Articles

The Influence of Physical Activity and Diet Mobile Apps on Cardiovascular Disease Risk Factors: Meta-Review.

The literature on whether physical activity (PA) and PA and diet (PA+Diet) mobile apps improve cardiovascular disease (CVD) risk factors is promising. The aim of this meta-review is to provide an evidence synthesis of systematic reviews and meta-analyses examining the influence of PA and PA+Diet apps on the major CVD risk factors. We systematically searched 5 databases until January 12, 2022. Included systematic reviews and meta-analyses (1) reported the CVD risk factor outcomes of BMI, waist circumference, body weight, blood pressure (BP), hemoglobin A1c (HbA1c), fasting blood glucose, blood lipids, or PA; (2) enrolled healthy participants ≥18 years who may or may not have the metabolic syndrome, diabetes mellitus, or preexisting CVD risk factors; (3) reviewed PA or PA+Diet app interventions integrating behavioral change techniques (BCT) to deliver their information; and (4) had a nonapp control. In total, 17 reviews (9 systematic reviews and 8 meta-analyses) published between 2012 and 2021 qualified. Participants were middle-aged, mostly women ranging in number from 10 to 62,219. Interventions lasted from 1 to 24 months, with the most common behavioral strategies being personalized feedback (n=8), self-monitoring (n=7), and goal setting (n=5). Of the PA app systematic reviews (N=4), the following CVD risk factors improved: body weight and BMI (n=2, 50%), BP (n=1, 25%), HbA1c (n=1, 25%), and blood lipids (n=1, 25%) decreased, while PA (n=4, 100%) increased. Of the PA+Diet app systematic reviews (N=5), the following CVD risk factors improved: body weight and BMI (n=3, 60%), BP (n=1, 20%), and HbA1c (n=3, 60%) decreased, while PA (n=3, 60%) increased. Of the PA app meta-analyses (N=1), the following CVD risk factors improved: body weight decreased (-0.73 kg, 95% CI -1.45 to -0.01; P=.05) and PA increased by 25 minutes/week (95% CI 0.58-1.68; P<.001), while BMI (-0.09 kg/m2, 95% CI -0.29 to 0.10; P=.35) and waist circumference (-1.92 cm, 95% CI -3.94 to 0.09; P=.06) tended to decrease. Of the PA+Diet app meta-analyses (n=4), the following CVD risk factors improved: body weight (n=4, 100%; from -1.79 kg 95% CI -3.17 to -0.41; P=.01 to -2.80 kg 95% CI -4.54 to -1.06, P=.002), BMI (n=1, 25%; -0.64 kg/m2, 95% CI -1.09 to -0.18; P=.01), waist circumference (n=1, 25%; -2.46 cm, 95% CI -4.56 to -0.36; P=.02), systolic/diastolic BP (n=1, 25%; -4.22/-2.87 mm Hg, 95% CI -6.54 to -1.91/ -4.44 to -1.29; P<.01), and HbA1c (n=1, 25%; -0.43%, 95% CI -0.68 to -0.19; P<.001) decreased. PA and PA+Diet apps appear to be most consistent in improving PA and anthropometric measures with favorable but less consistent effects on other CVD risk factors. Future studies are needed that directly compare and better quantify the effects of PA and PA+Diet apps on CVD risk factors. PROSPERO CRD42023392359; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=392359.

Physical Activity Mobile App (CareFit) for Informal Carers of People With Dementia: Protocol for a Feasibility and Adaptation Study.

Physical activity is a critical component of both well-being and preventative health, reducing the risk of both chronic mental and physical conditions and early death. Yet, there are numerous groups in society who are not able to undertake as much physical activity as they would like to. This includes informal (unpaid) carers, with the United Kingdom national survey data suggesting that 81% would like to do more physical activity on a regular basis. There is a clear need to develop innovations, including digital interventions that hold implementation potential to support regular physical activity in groups such as carers. This study aims to expand and personalize a cross-platform digital health app designed to support regular physical activity in carers of people with dementia for a period of 8 weeks and evaluate the potential for implementation. The CareFit for dementia carers study was a mixed methods co-design, development, and evaluation of a novel motivational smartphone app to support home-based regular physical activity for unpaid dementia carers. The study was planned to take place across 16 months in total (September 1, 2022, to December 31, 2023). The first phase included iterative design sprints to redesign an initial prototype for widespread use, supported through a bespoke content management system. The second phase included the release of the "CareFit" app across Scotland through invitations on the Apple and Google stores where we aimed to recruit 50 carers and up to 20 professionals to support the delivery in total. Partnerships for the work included a range of stakeholders across charities, health and social care partnerships, physical activity groups, and carers' organizations. We explored the implementation of CareFit, guided by both Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and the Complex Intervention Frameworks. Project processes and outcomes were evaluated using mixed methods. The barriers and enablers for professional staff to signpost and use CareFit with clients were assessed through interviews or focus groups and round stakeholder meetings. The usability of CareFit was explored through qualitative interviews with carers and a system usability scale. We examined how CareFit could add value to carers by examining "in-app" data, pre-post questionnaire responses, and qualitative work, including interviews and focus groups. We also explored how CareFit could add value to the landscape of other online resources for dementia carers. Results from this study will contribute new knowledge including identifying (1) suitable pathways to identify and support carers through digital innovations; (2) future design of definitive studies in carer populations; and (3) an improved understanding of the Reach, Effectiveness, Adoption, Implementation, and Maintenance across a range of key stakeholders. DERR1-10.2196/53727.

The Use of Physical Activity Mobile Apps Improves the Psychological State of Adolescents: A Randomized Controlled Trial

The Use of Physical Activity Mobile Apps Improves the Psychological State of Adolescents: A Randomized Controlled Trial

Using photovoice to explore young women’s experiences of behaviour change techniques in physical activity mobile apps

BackgroundResearch shows that inactive young women are attracted to using mobile phone applications (apps) to increase physical activity. Apps can promote physical activity by delivering a range of behaviour change techniques to influence determinants of user behaviour. Previous qualitative research has examined user experiences with techniques in physical activity apps, however there is little research specifically among young women. This study aimed to explore young women’s experiences using commercial physical activity apps to change their behaviour.MethodsYoung women were recruited online to use a randomly assigned app for two weeks to achieve a personal goal. Using photovoice, a qualitative participatory research method, participants generated insights about their experiences through photographs and semi-structured interviews. Thematic analysis was conducted on photograph and interview data.ResultsThirty-two female participants, aged 18–24 years, completed the study. Behaviour change techniques tended to cluster around four key themes: logging and monitoring physical activity; reminders and prompts; workout videos and written instructions; and social features. Social support also strongly influenced participants’ experiences.ConclusionsResults suggest that behaviour change techniques influenced physical activity in line with social cognitive models, and these models are useful to understand how apps can target user behaviour for young women. The findings identified factors important for young women that seemed to moderate their experiences, such as social norms about women’s appearance, which should be further explored within the context of behaviour change models and app design.

A Physical Activity Mobile Game for Hematopoietic Stem Cell Transplant Patients: App Design, Development, and Evaluation.

Physical activity mobile apps may encourage patients with cancer to increase exercise uptake, consequently decreasing cancer-related fatigue. While many fitness apps are currently available for download, most are not suitable for patients with cancer due to the unique barriers these patients face, such as fatigue, pain, and nausea. The aim of this study is to design, develop, and perform alpha testing of a physical activity mobile health game for hematopoietic stem cell transplant (HSCT) patients. The ultimate future goal of this project is to motivate HSCT patients to increase physical activity and provide them with a safe and fun way to exercise. A mobile health game called Walking Warrior was designed as a puzzle game where tiles are moved and matched. Walking Warrior interfaces with an open-source step counter and communicates with a central online MySQL database to record game play and walking performance. The game came to fruition after following an iterative process model with several prototypes. Game developers and bone marrow transplant nurses were recruited to perform an expert usability evaluation of the Walking Warrior prototype by completing a heuristic questionnaire and providing qualitative suggestions for improvement. Experts also made qualitative recommendations for improvements on speed, movement of tiles, appearance, and accuracy of the step counter. We recruited 5 additional usability evaluators who searched for and compared 4 open-source step counter programs, then qualitatively compared them for accuracy, robustness, cheat proofing, ease of use, and battery drain issues. Patient recruitment is planned at a later stage in this project. This paper only describes software design, development, and evaluation, rather than behavioral evaluation (ie, impact on physical activity), which is the long-term goal of this project. Internal consistency and the instrument's reliability evaluation results from 1 clinical expert and 4 technical experts were deemed excellent (Cronbach α=.933). A hierarchical cluster analysis of the questionnaire item responses for similarity/dissimilarity among the experts indicated that the two expert groups were not clustered into two separate groups in the dendrogram. This indicates that the item responses were not affected by profession. Factor analyses indicate that responses from the 40-item questionnaire were classified into five primary factors. The associated descriptive statistics for each of these categories were as follows (on a scale of 1 to 5): clarity and ease (median 4; mean 3.7, SD 0.45), appropriateness (median 4; mean 3.7, SD 0.49), game quality (median 3.5; mean 3.3, SD 0.42), motivation to walk (median 3; mean 3.1, SD 0.58), and mental effort (median 3.5; mean 3.1, SD 1.27). The evaluation from experts and clinicians provided qualitative information to further improve game design and development. Findings from the expert usability evaluation suggest the game's assets of clarity, ease of use, appropriateness, quality, motivation to walk, and mental effort were all favorable. This mobile game could ultimately help patients increase physical activity as an aid to recovery.

Obstetric Patients and Healthcare Providers Perspectives to Inform Mobile App Design for Physical Activity and Weight Control During Pregnancy and Postpartum in a Rural Setting.

BackgroundMobile health technology offers the opportunity for women to engage with physical activity promotion programs without many of the barriers commonly associated with exercise during and after pregnancy (eg, childcare concerns, rigid schedules, fear of doing harm to fetus or self, access to fitness facilities, uncomfortable with body in front of others) which may be particularly useful in under-resourced rural environments. We conducted the first known study on perspectives of pregnant women, postpartum women, and obstetric healthcare providers in a rural setting on needs related to the development of a mobile app designed to increase physical activity during pregnancy and postpartum.MethodsFocus groups and in-depth face-to-face personal interviews were conducted with 14 pregnant women, 13 postpartum women, and 11 healthcare providers in a rural community. Semi-structured questions utilizing constructs of the Health Belief Model were used to identify barriers, facilitators, and other influences on physical activity during pregnancy and postpartum. Recordings of all in-depth interviews and focus groups were transcribed and standard content analyses for qualitative data were conducted.ResultsRural women and healthcare providers expressed several key perspectives about and recommendations to promote physical activity during and after pregnancy. Broadly, these perspectives encapsulated two main themes: 1) physical activity as critical for weight control and 2) the need for evidence-based exercise information. Key desired features of this app identified include goal setting/progress tracking, evidence-based exercise guidance tailored to specific time points of pregnancy and postpartum, social support via community-based forum, symptom tracking, time-efficient workouts, and push notifications.ConclusionThe perspectives identified by participants should be utilized when designing mobile health physical activity mobile apps for pregnant and postpartum women in rural areas.

Engagement Features in Physical Activity Smartphone Apps: Focus Group Study With Sedentary People

BackgroundEngagement with physical activity mobile apps has been reported to be a core precondition for their effectiveness in digital behavior change interventions. However, to date, little attention has been paid to understanding the perspectives, needs, expectations, and experiences of potential users with physical activity mobile apps.ObjectiveThe aim of this study was to investigate the features that are judged to be important for engagement with a physical activity mobile app and the reasons for their importance.MethodsA qualitative focus-group methodology with elements of co-design was adopted in this study. Participants reporting sedentary lifestyles and willingness to improve their physical activity behavior through mobile technology were recruited. The focus group sessions consisted of 13 participants (8 men and 5 women, mean [SD] age 41.9 [7.1] years). Two researchers conducted the data analysis independently by using the inductive thematic approach.ResultsFour main themes emerged in relation to the research question and were named as follows: “physical activity participation motives,” “autonomy and self-regulation,” “need for relatedness,” and “smart.” Additionally, 2 subthemes originated from “physical activity participation motives” (ie, “medical guidance” and “weight loss and fitness for health”) and “smart” (ie, “action planning” and “adaptable and tailored”).ConclusionsFeatures enhancing autonomy and self-regulation and positively affecting health and physical well-being as well as the need for relatedness, adaptability, and flexibility should be considered as core elements in the engagement of potential users with physical activity mobile apps. The emerged findings may orient future research and interventions aiming to foster engagement of potential users with physical activity apps.

Weight loss before total joint arthroplasty using a remote dietitian and mobile app: study protocol for a multicenter randomized, controlled trial

BackgroundThe months prior to elective surgery may present an opportunity for patients to initiate behavior changes that will simultaneously ready them for surgery and improve their overall health status. An upcoming elective total joint arthroplasty (TJA) may serve as motivation for patients with severe obesity (body mass index [BMI]> 40 kg/m2) to lose weight, as it may optimize clinical outcomes following TJA and help them become eligible for TJA since some surgeons use a BMI of 40 kg/m2 as a cut-off for offering surgery in an effort to optimize outcomes.MethodsThe purpose of this multicenter randomized, controlled trial is to assess the feasibility and efficacy of a 12-week remote dietitian (RD) supervised dietary and physical activity weight loss intervention and mobile app for 60 patients with severe obesity prior to undergoing TJA. Intervention participants will receive access to a smartphone app and connect with an RD who will contact these participants weekly or bi-weekly via video calls for up to nine video calls. Together, participants and RDs will set goals for lifestyle modifications, and RDs will check on progress towards achieving these goals using in-app tools such as food logs and text messages between video calls. All patients will be encouraged to lose at least 20 pounds with a goal BMI < 40 kg/m2 after 12 weeks. Individuals randomized to the control group will receive clinical standard of care, such as nutritionist and/or physical therapy referrals. Outcome and demographic data will be collected from blood serology, chart review, mobile app user data, pre- and postintervention surveys, and phone interviews. The primary outcome measure will be weight change from baseline. Secondary outcome measures will include percentage of patients eligible to undergo TJA, number of sessions completed with dietitians, self-reported global health status (PROMIS Global Health scale), self-reported joint-specific pain and function (Knee injury and Osteoarthritis Outcome Score (KOOS) or Hip disability and Osteoarthritis Outcome Score (HOOS)), and serologies such as hemoglobin A1c, total lymphocyte count, albumin, and transferrin. Qualitative responses transcribed from phone interviews about the intervention will also be analyzed.DiscussionThis will be the first study to assess pre-operative weight loss in patients with severe obesity anticipating orthopaedic surgery using an RD and mobile app intervention aimed at helping patients become eligible for TJA.Trial registrationRegistered on 1 April 2020 at Clincialtrials.gov. Trial number is NCT04330391.

The efficacy of using mobile applications in changing adolescent girls’ physical activity behaviour during weekends

Smartphones are omnipresent and offer real-time information on the go. Predominantly, adolescent girls have been found to be engaged in levels of physical activity (PA) below the daily recommended guideline of at least 60 minutes of moderate-to-vigorous intensity, and especially during weekends. Lack of sufficient PA can lead to a risk of contracting non-communicable diseases. The purpose of this exploratory study was to investigate the efficacy of using mobile applications (app) (i.e. MapMyFitness [MMF]) in changing adolescent girls’ PA behaviour during weekends. It also examined the perceived benefits, challenges and recommendations for using mobile apps. Thirty-six participants aged 15 years ( Mage = 14.9; SD = 0.30) from a convenience sample volunteered and took part in the present study, which spanned four weekends. Quantitative results showed a significant difference in the mean step count between experimental and control groups during week two, probably due to the novelty effect when the participants were introduced to the new MMF mobile app. Overall, the use of the MMF app seems to be able to attenuate the decline of adolescent girls’ PA level during weekends. Qualitative results revealed benefits of using mobile apps to promote PA, such as a sense of autonomy in selecting PA, the ability to view friends’ postings of PA and self-monitoring of PA. The study revealed specific challenges to using such PA mobile apps - in particular, factors such as the cumbersome and confusing functions in the app that discouraged users from performing PA. Recommendations included allowing users to customise their accounts, simplifying the app’s functions, and including rewards and videos as motivators to enhance users’ PA experience. Although mobile apps may have the potential to encourage participation in PA, a careful selection of mobile app functions is required to engage adolescent girls to continue to use it for PA.

Breast, Prostate, and Colorectal Cancer Survivors' Experiences of Using Publicly Available Physical Activity Mobile Apps: Qualitative Study.

BackgroundPhysical activity (PA) can improve a range of outcomes following a cancer diagnosis. These include an improvement in experience of side effects of treatment (eg, fatigue) and management of comorbid conditions. PA might also increase survival and reduce recurrence. Digital interventions have shown potential for PA promotion among cancer survivors, but most in a previous review were Web-based, and few studies used mobile apps. There are many PA apps available for general public use, but it is unclear whether these are suitable as a PA intervention after a cancer diagnosis.ObjectiveThis study sought posttreatment nonmetastatic breast, prostate, and colorectal cancer survivors’ opinions of using smartphone apps to promote PA and gathered their views on existing publicly available PA apps to inform a future intervention.MethodsEach participant was randomly assigned to download 2 of 4 apps (Human, The Walk, The Johnson & Johnson Official 7 Minute Workout, and Gorilla Workout). Participants used each app for 1 week consecutively. In-depth semistructured telephone interviews were then conducted to understand participants’ experiences of using the apps and how app-based PA interventions could be developed for cancer survivors. The interviews were analyzed using thematic analysis.ResultsThirty-two participants took part: 50% (16/32) had prostate cancer, 25% (8/32) had breast cancer, and 25% (8/32) had colorectal cancer. Three core themes were identified. The first theme was that multiple factors affect engagement with PA apps and this is highly personalized. Factors affecting engagement included participants’ perceptions of (1) the advantages and disadvantages of using apps to support PA, (2) the relevance of the app to the user (eg, in terms of cancer-related factors, their PA goals, the difficulty level of the app, the way in which they interact with their mobile phone, and the extent to which the app fits with their self-identity), (3) the quality of the app (eg, usability, accuracy, quality of production, and scientific evidence-base), and (4) the behavior change techniques used to promote PA. In the second theme, participants recommended that apps that promote walking are most appealing, as walking removes many barriers to PA. Finally, the participants suggested that PA apps should be integrated into cancer care, as they valued guidance and recommendations from health care professionals.ConclusionsThis sample of breast, prostate, and colorectal cancer survivors was receptive to the use of apps to promote PA. Although no publicly available PA app was deemed wholly suitable, many suggestions for adaptation and intervention development were provided. The results can inform the development of an app-based PA intervention for cancer survivors. They also highlight the wide-ranging and dynamic influences on engagement with digital interventions, which can be applied to other evaluations of mobile health products in other health conditions and other health behaviors.

A quasi-experimental investigation of college students' ratings of two physical activity mobile apps with varied behavior change technique quantity.

BackgroundAn assessment of how users rate physical activity apps of varying behavior change technique content is necessary to understand if users recognize differences in an app’s ability to promote physical activity.ObjectiveThe purpose of this study was to compare user ratings of an app with a lower behavior change technique count to an app with a higher behavior change technique count.MethodParticipants were randomly assigned to interact with either the high behavior change technique app or the low behavior change technique app using an iPad. Participants then completed a Mobile App Rating questionnaire.ResultsThe final sample included 83 participants with an average age of 22.66 years (SD = 2.13; range = 20–29). Independent t-tests revealed significant group differences for perceived impact, t(81) = 5.27, p < .001, g = 1.15, 95% confidence interval (0.69, 1.62); engagement, t(81) = 6.71, p < .001, g = 1.15, 95% confidence interval (1.02, 1.87); aesthetics, t(81) = 4.29, p < .001, g = 1.15, 95% confidence interval (0.50, 1.38); and subjective quality, t(81) = 6.46, p < .001, g = 1.15, 95% confidence interval (0.75, 1.42), with participants from the high behavior change technique group scoring these qualities more positively than participants from the low behavior change technique group.ConclusionApp users rated a physical activity app with higher behavior change technique content more favorably on aesthetics, engagement, subjective quality, and perceived impact than those with reduced behavior change technique content. Additional research is needed to understand how these perceptions influence users during the app selection process, as well as the efficacy of apps for promoting physical activity behavior change.

Differences in Eating Behavior, Physical Activity, and Health-related Lifestyle Choices between Users and Nonusers of Mobile Health Apps

ABSTRACTBackground: Weight gain and lifestyle behaviors during college may contribute to future health problems. This population may not have sufficient self-monitoring skills to maintain healthy lifestyle behaviors. Purpose: The purpose of this study was to determine the relationship between usages of mobile health applications (apps) designed to track diet and physical activity and health-related behaviors of college students. Methods: In a cross-sectional study, 401 university students completed a survey to assess eating behavior, physical activity, and health-related lifestyle choices and mobile health app usage. Results: Mobile health app users had significantly higher scores for eating behavior than nonusers, and the impact of using more than one type of mobile health app significantly improved eating behavior. Most participants also identified app use with feeling healthier, better self-monitoring of food intake and exercise, and having more motivation to eat healthier and increase physical activity. Discussion: Use of mobile health apps may have a positive effect on eating behavior, and demographic background appears to be influential with regard to health-related behaviors. Translation to Health Education Practice: Health Educators need to consider the use of apps as a supplementary component of a health promotion program to assist individuals who want to make improvements in their overall health and to prevent chronic disease.

Assessment of Cancer Survivors' Experiences of Using a Publicly Available Physical Activity Mobile Application.

BackgroundRegular participation in physical activity (PA) is associated with improved physical and psychosocial outcomes in cancer survivors. However, PA levels are low during and after cancer treatment. Interventions to promote PA in this population are needed. PA mobile apps are popular and have potential to increase PA participation, but little is known about how appropriate or relevant they are for cancer survivors.ObjectiveThis study aims to (1) assess recruitment, study uptake, and engagement for a publicly available PA mobile app (GAINFitness) intervention in cancer survivors; (2) assess cancer survivors’ attitudes towards the app; (3) understand how the app could be adapted to better meet the needs of cancer survivors; and (4) to determine the potential for change in PA participation and psychosocial outcomes over a 6-week period of using the app.MethodsThe present study was a one-arm, pre-post design. Cancer survivors (N=11) aged 33 to 62 years with a mean (SD) age of 45 (9.4), and 82% (9/11) female, were recruited (via community/online convenience sampling to use the app for 6 weeks). Engagement with the app was measured using self-reported frequency and duration of usage. Qualitative semi-structured telephone interviews were conducted after the 6-week study period and were analyzed using thematic analysis. PA, well-being, fatigue, quality of life (QOL), sleep quality, and anxiety and depression were self-reported at baseline and at a 6-week follow-up using the Godin Leisure Time Exercise Questionnaire (GLTEQ), the Functional Assessment of Cancer Therapy-General (FACT-G), the Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue Scale Questionnaire, the Health and Quality of Life Outcomes (EQ5D) Questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS), respectively.ResultsOf the people who responded to the study advertisement, 73% (16/22) agreed to participate and 100% (11/11) of the participants who started the study completed all baseline and follow-up outcome measures and the telephone interview. On average, participants used the app twice a week for 25 minutes per session. Four themes were identified from the qualitative interviews surrounding the suitability of the app for cancer survivors and how it could be adapted: (1) barriers to PA, (2) receiving advice about PA from reliable sources, (3) tailoring the application to one’s lifestyle, and (4) receiving social support from others. Pre-post comparison showed significant increases in strenuous PA, improvements in sleep quality, and reductions in mild PA. There were no significant changes in moderate PA or other psychosocial outcomes.ConclusionsAll participants engaged with the app and qualitative interviews highlighted that the app was well-received. A generic PA mobile app could bring about positive improvements in PA participation and psychosocial outcomes among cancer survivors. However, a targeted PA app aimed specifically towards cancer survivors may increase the relevance and suitability of the app for this population.

A systematic review: is there an app for that? Translational science of pediatric behavior change for physical activity and dietary interventions.

Systematically review and meta-analyze the pediatric literature on behavior-change techniques (BCT) as defined by Abraham & Michie (Health Psychology, 27, 379-387, 2008), and describe whether the most effective BCTs are incorporated in physical activity (PA) and dietary mobile apps. Randomized controlled trials (n = 74) targeting diet or PA were meta-analyzed. Metaregressions were used to determine which BCTs predict aggregate effect size (ES). iTunes™ apps were coded for presence/absence of BCTs that produce larger ES. Modeling was the only predictor of PA ES in children (aged 6-13 years). Consequences for behavior, other's approval, self-monitoring, intention formation, and behavioral contracting significantly predicted PA for adolescents. Modeling and social support predicted dietary ES in adolescents and children, respectively. Practice was also a significant predictor for children. A majority of effective strategies for children were not widely incorporated in apps; however, the picture is more optimistic for adolescents. More collaboration is needed between pediatric psychologists and technologists to incorporate evidence-based BCTs into developmentally appropriate mobile apps.