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. 2020 Mar 18;8(3):e17046.
doi: 10.2196/17046.

Mobile Apps for Health Behavior Change in Physical Activity, Diet, Drug and Alcohol Use, and Mental Health: Systematic Review

Madison Milne-Ives  1 , Ching Lam  1 , Caroline De Cock  1 , Michelle Helena Van Velthoven  1 , Edward Meinert  1   2
Affiliations

Mobile Apps for Health Behavior Change in Physical Activity, Diet, Drug and Alcohol Use, and Mental Health: Systematic Review

Madison Milne-Ives et al. JMIR Mhealth Uhealth. .

Abstract

Background: With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioral health interventions. The large variation in these mobile health apps-their target patient group, health behavior, and behavioral change strategies-has resulted in a large but incohesive body of literature.

Objective: This systematic review aimed to assess the effectiveness of mobile apps in improving health behaviors and outcomes and to examine the inclusion and effectiveness of behavior change techniques (BCTs) in mobile health apps.

Methods: PubMed, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behavior change. Two authors independently screened and selected studies according to the eligibility criteria. Data were extracted and the risk of bias was assessed by one reviewer and validated by a second reviewer.

Results: A total of 52 randomized controlled trials met the inclusion criteria and were included in the analysis-37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive-only one app was rated as less helpful and satisfactory than the control-and the studies that measured engagement and usability found relatively high study completion rates (mean 83%; n=18, N=39) and ease-of-use ratings (3 significantly better than control, 9/15 rated >70%). However, there was little evidence of changed behavior or health outcomes.

Conclusions: There was no strong evidence in support of the effectiveness of mobile apps in improving health behaviors or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the BCTs that are most effective at promoting behavior change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.

Keywords: app; behavior change; cell phone; digital health; evidence-based medicine; health behavior; intervention; mobile applications; mobile health; mobile phone; smartphone; systematic review; telemedicine.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram. eHealth: electronic health; RCT: randomized controlled trial.
Figure 2
Figure 2
Risk of bias summary: the review authors’ judgements about each risk of bias item for each included study.
Figure 3
Figure 3
Risk of bias graph: the review authors’ judgements about each risk of bias item presented as percentages across all included studies.
See this image and copyright information in PMC

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