A systematic evaluation of primary headache management apps leveraging behavior change techniques

Cephalalgia ◽  
2021 ◽  
pp. 033310242110535
Author(s):  
Amy E Noser ◽  
Kimberly L Klages ◽  
Kaitlyn L Gamwell ◽  
Caitlin N Brammer ◽  
Kevin A Hommel ◽  
...  
Keyword(s):  
Behavior Change ◽  
Relaxation Training ◽  
Rating Scale ◽  
Mobile App ◽  
Systematic Evaluation ◽  
Evidence Based ◽  
Management Behavior ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Headache Management

Background Mobile health apps have the potential to promote adherence to headache management through the use of evidence-based behavior change techniques (e.g., self-monitoring). While many headache management apps exist, the extent to which these apps include behavior change techniques remains unknown. Thus, the present study systematically evaluated the content and quality of commercially available headache management apps. Methods Headache apps were identified using a systematic search in the Apple App and Google Play stores. A total of 55 apps were evaluated using the taxonomy of behavior change techniques and app quality using the Mobile App Rating Scale. Results Headache management apps included 0–14 behavior change techniques (Mean [M] = 5.89) and 0–8 headache management behavior change techniques (M = 4.29). App quality ranged from 2.84–4.67 (M = 3.73) out of 5.00. Three apps, Migraine Trainer, Easeday: Headache & Migraine, and PainScale, included the highest number of overall and headache management behavior change techniques along with good quality scores. Conclusions While randomized controlled trials are necessary to determine the efficacy of individual headache apps, most existing apps include evidence-based headache management behavior change techniques. Headache apps often focus on either self-monitoring or stress management via relaxation training, suggesting that patients’ needs should be used to inform app selection.

scholarly journals The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps (Preprint)

2019 ◽  
Author(s):  
Nino Fijačko ◽  
Lucija Gosak ◽  
Leona Cilar ◽  
Alenka Novšak ◽  
Ruth Masterson Creber ◽  
...  
Keyword(s):  
Public Health ◽  
Behavior Change ◽  
Oral Hygiene ◽  
Rating Scale ◽  
Self Care ◽  
Public Health Problem ◽  
Mobile App ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Evidence Based Dentistry

BACKGROUND Poor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches. OBJECTIVE The primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene. METHODS We searched six online app stores using four search terms (“oral hygiene game,” “oral hygiene gamification,” “oral hygiene brush game,” and “oral hygiene brush gamification”). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change. RESULTS Of 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94%), virtual characters (14/17, 82%), and fantasy (13/17, 76%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app. CONCLUSIONS The majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement.

scholarly journals The Effects of Gamification and Oral Self-Care on Oral Hygiene in Children: Systematic Search in App Stores and Evaluation of Apps

10.2196/16365 ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. e16365
Author(s):  
Nino Fijačko ◽  
Lucija Gosak ◽  
Leona Cilar ◽  
Alenka Novšak ◽  
Ruth Masterson Creber ◽  
...  
Keyword(s):  
Public Health ◽  
Behavior Change ◽  
Oral Hygiene ◽  
Rating Scale ◽  
Self Care ◽  
Public Health Problem ◽  
Mobile App ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Evidence Based Dentistry

Background Poor oral hygiene is a great public health problem worldwide. Oral health care education is a public health priority as the maintenance of oral hygiene is integral to overall health. Maintaining optimal oral hygiene among children is challenging and can be supported by using relevant motivational approaches. Objective The primary aim of this study was to identify mobile smartphone apps that include gamification features focused on motivating children to learn, perform, and maintain optimal oral hygiene. Methods We searched six online app stores using four search terms (“oral hygiene game,” “oral hygiene gamification,” “oral hygiene brush game,” and “oral hygiene brush gamification”). We identified gamification features, identified whether apps were consistent with evidence-based dentistry, performed a quality appraisal with the Mobile App Rating Scale user version (uMARS), and quantified behavior scores (Behavior Change score, uMARS score, and Coventry, Aberdeen, and London-Refined [CALO-RE] score) using three different instruments that measure behavior change. Results Of 612 potentially relevant apps included in the analysis, 17 met the inclusion criteria. On average, apps included 6.87 (SD 4.18) out of 31 possible gamification features. The most frequently used gamification features were time pressure (16/17, 94%), virtual characters (14/17, 82%), and fantasy (13/17, 76%). The most common oral hygiene evidence-based recommendation was brushing time (2-3 minutes), which was identified in 94% (16/17) of apps. The overall mean uMARS score for app quality was high (4.30, SD 0.36), with good mean subjective quality (3.79, SD 0.71) and perceived impact (3.58, SD 0.44). Sufficient behavior change techniques based on three taxonomies were detected in each app. Conclusions The majority of the analyzed oral hygiene apps included gamification features and behavior change techniques to perform and maintain oral hygiene in children. Overall, the apps contained some educational content consistent with evidence-based dentistry and high-quality background for oral self-care in children; however, there is scope for improvement.

scholarly journals Adults’ Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study (Preprint)

2019 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Behavior Change ◽  
Repeated Measures ◽  
Self Regulation ◽  
Mobile App ◽  
User Preferences ◽  
Movement Behavior ◽  
Survey Study ◽  
User Engagement ◽  
Behavior Change Techniques ◽  
Self Monitoring

BACKGROUND There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. OBJECTIVE This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. METHODS A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample <italic>t</italic> tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. RESULTS Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (<italic>P</italic>=.03), information on behavior health outcome (<italic>P</italic>=.048), and feedback (<italic>P</italic>=.04) and incorporate social support (<italic>P</italic>=.048) to help those who are further removed from healthy sleep. A virtual coach (<italic>P</italic><.001) and video modeling (<italic>P</italic>=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (<italic>P</italic>=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. CONCLUSIONS The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.

Development and evaluation of a mobile phone application designed to support physically inactive employees to increase walking (Preprint)

2019 ◽  
Author(s):  
Joanna Nicholas ◽  
Cecilie Thøgersen-Ntoumani ◽  
Brendan Smith ◽  
Eleanor Quested ◽  
Nikos Ntoumanis
Keyword(s):  
Behavior Change ◽  
Rating Scale ◽  
Controlled Trial ◽  
Mobile App ◽  
Health Concern ◽  
Physically Active ◽  
Self Monitoring ◽  
Walking Behavior ◽  
Mobile Phone Application ◽  
Step Counts

BACKGROUND Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. OBJECTIVE We evaluated the usability of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We aimed to explore acceptability, engagement with, and effectiveness of the app in supporting behavior change. METHODS Insufficiently physically active employees (M age =44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to evaluate the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively. RESULTS Walkers rated the app quality favorably (M=3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring. CONCLUSIONS The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be more effective if they target users’ self-determined motivation for behavior change and integrate BCTs. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR). Trial registration number: ACTRN12618000807257 http://www.ANZCTR.org.au/ACTRN12618000807257.aspx

scholarly journals Adults’ Preferences for Behavior Change Techniques and Engagement Features in a Mobile App to Promote 24-Hour Movement Behaviors: Cross-Sectional Survey Study

10.2196/15707 ◽  
2019 ◽  
Vol 7 (12) ◽  
pp. e15707 ◽  
Author(s):  
Ann DeSmet ◽  
Ilse De Bourdeaudhuij ◽  
Sebastien Chastin ◽  
Geert Crombez ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Behavior Change ◽  
Repeated Measures ◽  
Self Regulation ◽  
Mobile App ◽  
User Preferences ◽  
Movement Behavior ◽  
Survey Study ◽  
User Engagement ◽  
Behavior Change Techniques ◽  
Self Monitoring

Background There is a limited understanding of components that should be included in digital interventions for 24-hour movement behaviors (physical activity [PA], sleep, and sedentary behavior [SB]). For intervention effectiveness, user engagement is important. This can be enhanced by a user-centered design to, for example, explore and integrate user preferences for intervention techniques and features. Objective This study aimed to examine adult users’ preferences for techniques and features in mobile apps for 24-hour movement behaviors. Methods A total of 86 participants (mean age 37.4 years [SD 9.2]; 49/86, 57% female) completed a Web-based survey. Behavior change techniques (BCTs) were based on a validated taxonomy v2 by Abraham and Michie, and engagement features were based on a list extracted from the literature. Behavioral data were collected using Fitbit trackers. Correlations, (repeated measures) analysis of variance, and independent sample t tests were used to examine associations and differences between and within users by the type of health domain and users’ behavioral intention and adoption. Results Preferences were generally the highest for information on the health consequences of movement behavior self-monitoring, behavioral feedback, insight into healthy lifestyles, and tips and instructions. Although the same ranking was found for techniques across behaviors, preferences were stronger for all but one BCT for PA in comparison to the other two health behaviors. Although techniques fit user preferences for addressing PA well, supplemental techniques may be able to address preferences for sleep and SB in a better manner. In addition to what is commonly included in apps, sleep apps should consider providing tips for sleep. SB apps may wish to include more self-regulation and goal-setting techniques. Few differences were found by users’ intentions or adoption to change a particular behavior. Apps should provide more self-monitoring (P=.03), information on behavior health outcome (P=.048), and feedback (P=.04) and incorporate social support (P=.048) to help those who are further removed from healthy sleep. A virtual coach (P<.001) and video modeling (P=.004) may provide appreciated support to those who are physically less active. PA self-monitoring appealed more to those with an intention to change PA (P=.03). Social comparison and support features are not high on users’ agenda and may not be needed from an engagement point of view. Engagement features may not be very relevant for user engagement but should be examined in future research with a less reflective method. Conclusions The findings of this study provide guidance for the design of digital 24-hour movement behavior interventions. As 24-hour movement guidelines are increasingly being adopted in several countries, our study findings are timely to support the design of interventions to meet these guidelines.

scholarly journals Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanna Catherine Nicholas ◽  
Nikos Ntoumanis ◽  
Brendan John Smith ◽  
Eleanor Quested ◽  
Emmanuel Stamatakis ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Behavior Change ◽  
Rating Scale ◽  
Controlled Trial ◽  
Mobile App ◽  
Trial Registration ◽  
Health Concern ◽  
Self Monitoring ◽  
Step Counts ◽  
Randomized Controlled

Abstract Background Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. We outline the development of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We also explored acceptability, engagement with, associations between app usage and behavioral engagement, and perceived impact of the app in supporting behavior change. Methods Following development, fifty insufficiently physically active employees (M age = 44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to examine feasibility of the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively. Results Walkers rated the app quality favorably (M = 3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring. Conclusions The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be effective if they target users’ competence and integrate BCTs. Trial Registration: This study was part of a pilot larger randomized controlled trial, in which a component of the intervention involved the use of the mobile app. The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000807257) on 11 May 2018 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375049&isReview=true.

scholarly journals Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

2021 ◽  
pp. 104973232199344
Author(s):  
Oladunni Oluwoye ◽  
Elizabeth Fraser
Keyword(s):  
Substance Use ◽  
Behavior Change ◽  
Theoretical Domains Framework ◽  
First Episode Psychosis ◽  
Barriers And Facilitators ◽  
First Episode ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Episode Psychosis ◽  
And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

Content analysis of behavior change techniques in maternal and infant health apps

2020 ◽  
Author(s):  
Rizwana Biviji ◽  
Joshua R Vest ◽  
Brian E Dixon ◽  
Theresa Cullen ◽  
Christopher A Harle
Keyword(s):  
Decision Making ◽  
Health Education ◽  
Behavior Change ◽  
Infant Health ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Final Sample ◽  
Maternal And Infant Health ◽  
Health Expert ◽  
App Design

Abstract Maternal and infant health (MIH) mobile applications (apps) are increasingly popular and frequently used for health education and decision making. Interventions grounded in theory-based behavior change techniques (BCTs) are shown to be effective in promoting healthy behavior changes. MIH apps have the potential to be useful tools, yet the extent to which they incorporate BCTs is still unknown. The objective of this study was to assess the presence of BCTs in popular MIH apps available in the Apple App and Google Play stores. Twenty-nine popular MIH apps were coded for the presence of 16 BCTs using the mHealth app taxonomy. Popular MIH apps whose purpose was to provide health education or decision-making support to pregnant women or parents/caregivers of infants were included in the final sample. On an average, the reviewed apps included seven BCTs (range 2–16). Techniques such as personalization, review of general or specific goals, macro tailoring, self-monitoring of goals, and health behavior linkages were most frequently present. No differences in the presence of BCTs between paid and free apps were observed. Popular MIH apps typically included only a minority of BCTs found to be useful for health promotion. However, apps developed by healthcare developers incorporated a higher number of BCTs within the app content. Therefore, app developers and policymakers may consider strategies to increase health expert involvement in app design and content delivery.

scholarly journals The German Version of the Mobile App Rating Scale (MARS-G): Development and Validation Study

10.2196/14479 ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. e14479 ◽  
Author(s):  
Eva-Maria Messner ◽  
Yannik Terhorst ◽  
Antonia Barke ◽  
Harald Baumeister ◽  
Stoyan Stoyanov ◽  
...  
Keyword(s):  
Internal Consistency ◽  
Rating Scale ◽  
Assessment Tool ◽  
Disease Onset ◽  
Mobile App ◽  
Systematic Evaluation ◽  
German Version ◽  
Validity And Reliability ◽  
Health Apps

Background The number of mobile health apps (MHAs), which are developed to promote healthy behaviors, prevent disease onset, manage and cure diseases, or assist with rehabilitation measures, has exploded. App store star ratings and descriptions usually provide insufficient or even false information about app quality, although they are popular among end users. A rigorous systematic approach to establish and evaluate the quality of MHAs is urgently needed. The Mobile App Rating Scale (MARS) is an assessment tool that facilitates the objective and systematic evaluation of the quality of MHAs. However, a German MARS is currently not available. Objective The aim of this study was to translate and validate a German version of the MARS (MARS-G). Methods The original 19-item MARS was forward and backward translated twice, and the MARS-G was created. App description items were extended, and 104 MHAs were rated twice by eight independent bilingual researchers, using the MARS-G and MARS. The internal consistency, validity, and reliability of both scales were assessed. Mokken scale analysis was used to investigate the scalability of the overall scores. Results The retranslated scale showed excellent alignment with the original MARS. Additionally, the properties of the MARS-G were comparable to those of the original MARS. The internal consistency was good for all subscales (ie, omega ranged from 0.72 to 0.91). The correlation coefficients (r) between the dimensions of the MARS-G and MARS ranged from 0.93 to 0.98. The scalability of the MARS (H=0.50) and MARS-G (H=0.48) were good. Conclusions The MARS-G is a reliable and valid tool for experts and stakeholders to assess the quality of health apps in German-speaking populations. The overall score is a reliable quality indicator. However, further studies are needed to assess the factorial structure of the MARS and MARS-G.

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