Use of mobile applications in the management of overweight and obesity in primary and secondary care

Summary Mobile technology has emerged as a potentially useful application in the process of facilitating weight loss management. While several empirical studies have demonstrated the positive effects of mobile-based interventions, the extent of such effectiveness is still a topic of debate. Thus, the current systematic review involved searching electronic databases for studies on the use of mobile app-based interventions in the management of overweight and obesity among adults over 18 years of age in a primary and secondary care setting. The results of the review revealed that mobile apps are effective tools for weight loss management and sustaining such loss when compared to standard interventions. However, further research is needed to consider the sustained benefits and the applicability of mobile app-based interventions for large-scale population coverage.

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Appscapes in everyday life

MedieKultur Journal of media and communication research ◽

10.7146/mediekultur.v36i69.121018 ◽

2020 ◽

Vol 36 (69) ◽

pp. 029-051

Author(s):

Signe Sophus Lai ◽

Sofie Flensburg

Keyword(s):

Everyday Life ◽

Mobile Apps ◽

Empirical Studies ◽

Qualitative Interviews ◽

Mobile App ◽

Trade Off ◽

Online Tracking ◽

Material Conditions ◽

Infrastructure Studies ◽

App Economy

It has long been acknowledged that the use of ‘free’ mobile apps comes at a price,but few empirical studies have looked into this supposed trade-off. This articlecombines qualitative interviews with mappings of infrastructures for dataficationin order to study the implications of mobile app usage from the perspectiveof individual users. It analyses users’ understanding of online tracking, maps theinfrastructural tenets of mobile datafication, and finds a disconnect between whatusers believe happens to their data and the actual data harvesting and distributionmechanisms of their apps. We thereby argue that users’ resigned attitudes shouldbe understood in light of the material conditions of the app economy and, as such,that user and infrastructure studies should join forces in exploring and enhancingusers’ agency, empowerment and emancipation.

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Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study (Preprint)

10.2196/preprints.9801 ◽

2018 ◽

Author(s):

Sherry Pagoto ◽

Bengisu Tulu ◽

Emmanuel Agu ◽

Molly E Waring ◽

Jessica L Oleski ◽

...

Keyword(s):

Weight Loss ◽

Problem Solving ◽

Mobile Apps ◽

Mobile App ◽

Behavioral Weight Loss ◽

Problem Solving Therapy ◽

Pilot Studies ◽

Self Monitoring ◽

Problem Solving Skills ◽

Automated Delivery

BACKGROUND Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. OBJECTIVE This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. METHODS Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. RESULTS Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). CONCLUSIONS Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. CLINICALTRIAL ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2)

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Mid-upper arm circumference for identifying adult overweight in large-scale population-based surveys: empirical evaluation using data of the EAT Addis study, Ethiopia

BMJ Open ◽

10.1136/bmjopen-2021-049602 ◽

2021 ◽

Vol 11 (12) ◽

pp. e049602

Author(s):

Tigest Shifraw ◽

Katarina Selling ◽

Alemayehu Worku ◽

Hanna Yemane Berhane ◽

Eva-Charlotte Ekström ◽

...

Keyword(s):

Large Scale ◽

Addis Ababa ◽

Population Based ◽

Overweight And Obesity ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Overweight Women ◽

Arm Circumference ◽

Scale Population ◽

Mid Upper Arm Circumference

ObjectivesThe present study evaluates body circumferences as a nutrition screening tool for women of reproductive age with children less than 5 years of age to improve the detection of overweight and obesity in a community setting.DesignThis study draws data from a community-based cross-sectional study conducted between July–August 2017 and January–February 2018 to account for seasonality in Addis Ababa, Ethiopia.SettingOne hundred and sixteen districts were included in Addis Ababa, Ethiopia.ParticipantsA total of 4914 women of reproductive age with children less than 5 years of age were participated in this study.Primary and secondary outcome measuresPrimary outcome measures included anthropometric indices. There were no secondary outcomes.ResultsThe optimal cut-off points to identify overweight women of reproductive age were >87.5 cm for waist circumference (WC), >31.7 cm for neck circumference (NC) and >28.0 cm for mid-upper arm circumference (MUAC) based on the highest corresponding Youden index. The area under the receiver operating characteristics curve was 0.92 (95% CI: 0.91 to 0.93) for WC, 0.83 (95% CI: 0.82 to 0.84) for NC and 0.91 (95% CI: 0.89 to 0.92) for MUAC.ConclusionsOur result shows that WC and MUAC are alternative tools to body mass index. Both WC and MUAC are effective in identifying overweight women. We recommend using MUAC in large-scale population-based assessments to identify overweight and obesity in low-income settings as it is logistically simpler and operationally feasible.

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A Self-Directed Mobile Intervention (WaznApp) to Promote Weight Control Among Employees at a Lebanese University: Protocol for a Feasibility Pilot Randomized Controlled Trial (Preprint)

10.2196/preprints.9793 ◽

2018 ◽

Author(s):

Marco Bardus ◽

Ghassan Hamadeh ◽

Bouchra Hayek ◽

Rawan Al Kherfan

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Weight Management ◽

Weight Control ◽

Mobile Apps ◽

Controlled Trial ◽

Overweight And Obesity ◽

Randomized Controlled ◽

Obesity And Overweight ◽

And Control

BACKGROUND Overweight and obesity have become major health problems globally with more than 1.9 billion overweight adults. In Lebanon, the prevalence of obesity and overweight is 65.4% combined. Risk factors of obesity and overweight are preventable and can be addressed by modifications in the environment and in an individual’s lifestyle. Mobile technologies are increasingly used in behavioral, self-directed weight management interventions, providing users with additional opportunities to attain weight control (weight loss, weight gain prevention, etc). Mobile apps may allow for the delivery of Just-in-Time Adaptive Interventions (JITAIs), which provide support through skill building, emotional support, and instrumental support, following the participants’ progress. A few commercially available apps offer JITAI features, but no studies have tested their efficacy. OBJECTIVE The primary objective of this study is to examine the feasibility of a self-directed weight loss intervention, targeting employees of an academic institution, using a virtual coaching app with JITAI features (Lark) and a self-help calorie-counting app (MyFitnessPal). The secondary objective is to estimate the effects of the intervention on main study outcomes. METHODS This study is a single-center, parallel, randomized controlled trial with 2 study arms (intervention and control). Participants will be randomly allocated in equal proportions to the intervention (Lark) and control groups (MyFitnessPal). To be eligible for this study, participants must be employed full- or part-time at the university or its medical center, able to read English, have a smartphone, and be interested in controlling their weight. Recruitment strategies entail email invitations, printed posters, and social media postings. We will assess quantitative rates of recruitment, adherence, and retention, self-reported app quality using the user version of the Mobile App Rating Scale. We will also assess changes in weight-related outcomes (absolute weight and waist circumference), behavioral outcomes (physical activity and diet), and cognitive factors (motivation to participate in the trial and to manage weight). RESULTS WaznApp was funded in June 2017, and recruitment started in March 2018. CONCLUSIONS This study will provide information as to whether the selected mobile apps offer a feasible solution for promoting weight management in an academic workplace. The results will inform a larger trial whose results might be replicated in similar workplaces in Lebanon and the Middle East and North Africa region, and will be used as a benchmark for further investigations in other settings and similar target groups. CLINICALTRIAL ClinicalTrials.gov NCT03321331; https://clinicaltrials.gov/ct2/show/NCT03321331 (Archived by WebCite at http://www.webcitation.org/6ys9NOLo5) REGISTERED REPORT IDENTIFIER RR1-10.2196/9793

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Silencing Women? Gender and Online Harassment

Social Science Computer Review ◽

10.1177/0894439319865518 ◽

2019 ◽

pp. 089443931986551 ◽

Cited By ~ 3

Author(s):

Marjan Nadim ◽

Audun Fladmoe

Keyword(s):

Gender Differences ◽

Large Scale ◽

Empirical Studies ◽

Online Harassment ◽

Public Debates ◽

Different Types ◽

Scale Population ◽

Gendered Patterns ◽

Group Characteristics ◽

Different Levels

While gendered online harassment has received increased attention in academic and public debates, there is a lack of empirical studies examining gender differences in experiences with online harassment. Relying on two independent large-scale population surveys carried out in Norway, this article examines whether women experience more—and different—online harassment than men, to what extent different types of online harassment silence its targets, and whether there are gendered patterns in how online harassment works as a silencing mechanism. Analytically, we distinguish between different levels of severity of online harassment and what the harassment is directed toward. Contrary to popular expectations, we find that more men than women have experienced online harassment. The main reason is that men receive more comments directed at their opinions and attitudes; women and men are equally exposed to harassment directed toward group characteristics. However, targeted women are more likely than targeted men to become more cautious in expressing their opinions publicly. Furthermore, the gender differences increase as the harassment becomes more aggressive and directed toward group characteristics.

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Retention, Fasting Patterns, and Weight Loss With an Intermittent Fasting App: A Large-scale, 52-week Observational Study (Preprint)

10.2196/preprints.35896 ◽

2021 ◽

Author(s):

Luisa Torres ◽

Joy L Lee ◽

Seho Park ◽

R Christian Di Lorenzo ◽

Jonathan P Branam ◽

...

Keyword(s):

Weight Loss ◽

Large Scale ◽

Mobile Apps ◽

Demographic Data ◽

Caloric Intake ◽

Intermittent Fasting ◽

Dietary Control ◽

Healthy Weight ◽

Linear Predictor ◽

Loss Analysis

BACKGROUND Intermittent Fasting (IF) is an increasingly popular approach to dietary control that focuses on the timing of eating rather than the quantity and content of caloric intake. IF practitioners typically seek to improve their weight and other health factors. Millions of practitioners have turned to purpose-built mobile applications to help them track and adhere to their fasts and monitor changes in their weight and other biometrics. OBJECTIVE This study aimed to quantify user retention, fasting patterns, and weight loss by users of two commonly used IF mobile apps. We aimed to describe starting BMI, amount of fasting, frequency of weight tracking, and other demographics as correlates of retention and weight change. METHODS We assembled height, weight, fasting and demographic data for adult users (age 18-100yo) of the LIFE Fasting Tracker and LIFE Extend apps from 2018-2020. Retention up to 52 weeks was quantified based on recorded fasts and correlated with user demographics. Users who provided height and at least two weights and whose first fast and weight records were contemporaneous were included in the weight loss analysis. Fasting was quantified as Extended Fasting Hours (hours beyond 12 in a fast) averaged per Day (EFH/Day). RESULTS 792,692 users were followed for retention based on 26 million recorded fasts. 132,775 (16.7%) of users were retained at 13 weeks, 54,881 (6.9%) at 26 weeks, and 16,478 (2.1%) at 52 weeks, allowing 4 consecutive weeks of inactivity. Weight loss in the qualifying cohort (n=161,346) was strongly correlated with starting BMI and EFH/Day. Users with BMI ≥ 40 lost 11.3% of their starting weight by 52 weeks versus a slight weight gain on average for users with starting BMI <23. Additionally, EFH/Day was an approximately linear predictor of weight loss for a given time point and starting BMI. By week 26, users lost over 1% of their starting weight per EFH/Day on average. Furthermore, users who recorded their weight monthly lost considerably more weight than those who did not (eg, 8.5% vs 3.7% weight loss at week 13 for users with BMI ≥25). By 26 weeks, 69.2% (2985/4313) of users with starting BMI ≥ 25 who recorded monthly weights lost at least 5% of their starting weight, and 39.9% (1722/4313) lost at least 10% body weight. CONCLUSIONS Intermittent Fasting with the LIFE mobile apps appears to be a sustainable approach to weight reduction in the overweight and obese population. Healthy weight and underweight individuals do not lose much weight on average, even with extensive fasting. Obese users lose substantial weight over time, with more weight loss in those who fast more and who record their weight more frequently.

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Retailing Mobile App Usefulness

International Journal of E-Services and Mobile Applications ◽

10.4018/ijesma.2018100101 ◽

2018 ◽

Vol 10 (4) ◽

pp. 1-17 ◽

Cited By ~ 2

Author(s):

Sunday Adewale Olaleye ◽

Jari Salo ◽

Ismaila Temitayo Sanusi ◽

Adekunle O Okunoye

Keyword(s):

Structural Equation ◽

Mobile Apps ◽

Empirical Studies ◽

Primary Objective ◽

Mobile App ◽

Quantitative Methodology ◽

Customer Perception ◽

Performance Expectation ◽

Use Of Technology ◽

Analysis Technique

Despite the huge leap of mobile apps, there are limited empirical studies that focus on the relationship between customer perception of performance expectation, trust, tension free and mobile apps usefulness. This study integrates and extends the unified theory of acceptance and use of technology (UTAUT) with trust and gratification theories to explain mobile app usefulness to retailing customers. Quantitative methodology and variance structural equation modelling forms the data analysis technique for this study. The primary objective of this article is to examine the mobile app usefulness in the context of retailing customers. Specifically, the study intention is to illuminate the retailers and other stakeholders to invest positively on mobile app market segment and to optimize their mobile app strategy for the betterment and advancement of their business especially in getting more revenue from the mobile app segment. The study highlights practical implications and emphasize an appropriate future study.

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Use of a Mobile App for the Process Evaluation of an Intervention in Health Care: Development and Usability Study (Preprint)

10.2196/preprints.20739 ◽

2020 ◽

Author(s):

Winnie Szu Yun Chin ◽

Alicia Kurowski ◽

Rebecca Gore ◽

Guanling Chen ◽

Laura Punnett ◽

...

Keyword(s):

Health Care ◽

New England ◽

Process Evaluation ◽

Large Scale ◽

Mobile Apps ◽

Health And Safety ◽

End Users ◽

Mobile App ◽

System Usability Scale ◽

Stage 1

BACKGROUND Process evaluation measures the context in which an outcome was or was not achieved through the ongoing monitoring of operations. Mobile apps are a potentially less burdensome tool for collecting these metrics in real time from participants. Research-driven apps are not always developed while paying attention to their usability for target users. Usability testing uncovers gaps in researchers’, developers’, and users’ mental models of what an efficient, effective, and satisfying product looks like and facilitates design improvement. Models may vary by user demographics. OBJECTIVE This study describes the development of a mobile app for collecting process evaluation metrics in an intervention study with health care workers that uses feedback at multiple stages to refine the app design, quantify usage based on workers' overall adoption of the app and the app's specific function, and compare the demographic and job characteristics of end users. METHODS An app was developed to evaluate the Center for Promotion of Health in the New England Workplace Healthy Workplace Participatory Program, which trains teams to develop solutions for workforce health obstacles. Labor-management health and safety committee members, program champions, and managers were invited to use the app. An accompanying website was available for team facilitators. The app’s 4 functions were meeting creation, postmeeting surveys, project time logs, and chat messages. Google Analytics recorded screen time. Two stages of pilot tests assessed functionality and usability across different device software, hardware, and platforms. In stage 1, student testers assessed the first functional prototype by performing task scenarios expected from end users. Feedback was used to fix issues and inform further development. In stage 2, the app was offered to all study participants; volunteers completed task scenarios and provided feedback at deployment. End user data for 18 months after deployment were summarized and compared by user characteristics. RESULTS In stage 1, functionality problems were documented and fixed. The System Usability Scale scores from 7 student testers corresponded to good usability (mobile app=72.9; website=72.5), whereas 15 end users rated usability as ok (mobile app=64.7; website=62.5). Predominant usability themes from student testers were flexibility and efficiency and visibility of system status; end users prioritized flexibility and efficiency and recognition rather than recall. Both student testers and end users suggested useful features that would have resulted in the large-scale restructuring of the back end; these were considered for their benefits versus cost. In stage 2, the median total use time over 18 months was 10.9 minutes (IQR 23.8) and 14.5 visits (IQR 12.5). There were no observable patterns in use by demographic characteristics. CONCLUSIONS Occupational health researchers developing a mobile app should budget for early and iterative testing to find and fix problems or usability issues, which can increase eventual product use and prevent potential gaps in data.

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Where did my 256 GB go? A Measurement Analysis of Storage Consumption on Smart Mobile Devices

Proceedings of the ACM on Measurement and Analysis of Computing Systems ◽

10.1145/3460095 ◽

2021 ◽

Vol 5 (2) ◽

pp. 1-28

Author(s):

Ashish Bijlani ◽

Umakishore Ramachandran ◽

Roy Campbell

Keyword(s):

Mobile Devices ◽

Large Scale ◽

User Study ◽

Mobile Apps ◽

Mobile App ◽

Android Apps ◽

Measurement Analysis ◽

Redundant Storage ◽

Smart Mobile ◽

Smart Mobile Devices

This work presents the first-ever detailed and large-scale measurement analysis of storage consumption behavior of applications (apps) on smart mobile devices. We start by carrying out a five-year longitudinal static analysis of millions of Android apps to study the increase in their sizes over time and identify various sources of app storage consumption. Our study reveals that mobile apps have evolved as large monolithic packages that are packed with features to monetize/engage users and optimized for performance at the cost of redundant storage consumption. We also carry out a mobile storage usage study with 140 Android participants. We built and deployed a lightweight context-aware storage tracing tool, called cosmos, on each participant's device. Leveraging the traces from our user study, we show that only a small fraction of apps/features are actively used and usage is correlated to user context. Our findings suggest a high degree of app feature bloat and unused functionality, which leads to inefficient use of storage. Furthermore, we found that apps are not constrained by storage quota limits, and developers freely abuse persistent storage by frequently caching data, creating debug logs, user analytics, and downloading advertisements as needed. Finally, drawing upon our findings, we discuss the need for efficient mobile storage management, and propose an elastic storage design to reclaim storage space when unused. We further identify research challenges and quantify expected storage savings from such a design. We believe our findings will be valuable to the storage research community as well as mobile app developers.

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Impact of Gamification on the Self-Efficacy and Motivation to Quit of Smokers: An Observational Study of Two Gamified Smoking Cessation Mobile Apps (Preprint)

10.2196/preprints.27290 ◽

2021 ◽

Author(s):

Nikita B Rajani ◽

Nikolaos Mastellos ◽

Filippos T Filippidis

Keyword(s):

Smoking Cessation ◽

Self Efficacy ◽

Mobile Apps ◽

Mobile App ◽

Ease Of Use ◽

Perceived Usefulness ◽

The Self ◽

Positive Effects ◽

Motivation To Quit ◽

The Impact

BACKGROUND Both the number of smokers making quit attempts and the number of smokers successfully quitting has been falling over the past years. Past studies have shown that smokers with high self-efficacy and motivation to quit have an increased likelihood of quitting and staying quit. Consequently, further research on strategies which can improve the self-efficacy and motivation of smokers seeking to quit could lead to substantially higher cessation rates. Some studies have found that gamification can positively impact cognitive components of behavioural change, including self-efficacy and motivation. However, the impact of gamification in the context of smoking cessation and mobile health has been sparsely investigated. OBJECTIVE The study aims to examine the association between perceived usefulness, perceived ease of use and frequency of use of gamification features embedded in smoking cessation apps on the self-efficacy and motivation to quit of smokers. METHODS Participants were assigned to use one of two mobile apps for a duration of four weeks. Online questionnaires were provided to participants before app usage, two weeks after and four weeks after they started using the app. Gamification was quantitatively operationalized based on Cugelman’s gamification framework and concepts from the technology acceptance model. Mean values of perceived frequency, ease of use and usefulness of gamification features were calculated at mid-study and end-study. Two linear regression models were performed to investigate the impact of gamification on self-efficacy and motivation to quit. RESULTS 116 participants completed the study. Mean self-efficacy increased from 37.38 to 42.47 points and motivation to quit increased from 5.94 to 6.32 points after app usage. “Goal setting” was perceived to be the most useful gamification feature whilst “sharing” was perceived to be the least useful. Participants self-reported that they used the progress dashboards the most often whilst the sharing feature the least often. Average perceived frequency of gamification features was statistically significantly associated with change in self-efficacy (β=3.35, 95% CI: 0.31 to 6.40) and change in motivation to quit (β=0.54, 95% CI: 0.15 to 0.94) between baseline and end-study. CONCLUSIONS Gamification embedded into mobile apps can have positive effects on the self-efficacy and motivation to quit of smokers. The findings of the study can provide important insights for tobacco control policy makers, mobile app developers and smokers seeking to quit.

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