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. 2014 Jun 25:14:646.
doi: 10.1186/1471-2458-14-646.

Do physical activity and dietary smartphone applications incorporate evidence-based behaviour change techniques?

Artur Direito  1 , Leila Pfaeffli Dale, Emma Shields, Rosie Dobson, Robyn Whittaker, Ralph Maddison
Affiliations

Do physical activity and dietary smartphone applications incorporate evidence-based behaviour change techniques?

Artur Direito et al. BMC Public Health. .

Abstract

Background: There has been a recent proliferation in the development of smartphone applications (apps) aimed at modifying various health behaviours. While interventions that incorporate behaviour change techniques (BCTs) have been associated with greater effectiveness, it is not clear to what extent smartphone apps incorporate such techniques. The purpose of this study was to investigate the presence of BCTs in physical activity and dietary apps and determine how reliably the taxonomy checklist can be used to identify BCTs in smartphone apps.

Methods: The top-20 paid and top-20 free physical activity and/or dietary behaviour apps from the New Zealand Apple App Store Health & Fitness category were downloaded to an iPhone. Four independent raters user-tested and coded each app for the presence/absence of BCTs using the taxonomy of behaviour change techniques (26 BCTs in total). The number of BCTs included in the 40 apps was calculated. Krippendorff's alpha was used to evaluate interrater reliability for each of the 26 BCTs.

Results: Apps included an average of 8.1 (range 2-18) techniques, the number being slightly higher for paid (M = 9.7, range 2-18) than free apps (M = 6.6, range 3-14). The most frequently included BCTs were "provide instruction" (83% of the apps), "set graded tasks" (70%), and "prompt self-monitoring" (60%). Techniques such as "teach to use prompts/cues", "agree on behavioural contract", "relapse prevention" and "time management" were not present in the apps reviewed. Interrater reliability coefficients ranged from 0.1 to 0.9 (Mean 0.6, SD = 0.2).

Conclusions: Presence of BCTs varied by app type and price; however, BCTs associated with increased intervention effectiveness were in general more common in paid apps. The taxonomy checklist can be used by independent raters to reliably identify BCTs in physical activity and dietary behaviour smartphone apps.

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Figures

Figure 1
Figure 1
Selection of sample of apps. Procedure for selection of sample of physical activity and dietary apps.
Figure 2
Figure 2
Incorporation of BCTs within the top-40 apps. Percentage of apps incorporating each of the 26 BCTs within the Top-40 Applications from the New Zealand Apple App Store Health & Fitness category by cost and overall.
See this image and copyright information in PMC

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