Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 17:7:e40851.
doi: 10.2196/40851.

SNapp, a Tailored Smartphone App Intervention to Promote Walking in Adults of Low Socioeconomic Position: Development and Qualitative Pilot Study

Anne L Vos  1 , Gert-Jan de Bruijn  2 , Michel C A Klein  3 , Jeroen Lakerveld  4 , Sophie C Boerman  5 , Edith G Smit  1
Affiliations

SNapp, a Tailored Smartphone App Intervention to Promote Walking in Adults of Low Socioeconomic Position: Development and Qualitative Pilot Study

Anne L Vos et al. JMIR Form Res. .

Abstract

Background: Adults of low socioeconomic position (SEP) are generally less physically active than those who are more socioeconomically advantaged, which increases their cardiovascular disease incidence risk. Moreover, individuals of low SEP are often less easily reached with physical activity (PA) interventions than individuals of higher SEP. Smartphone apps have been presented as a promising platform for delivering PA interventions to difficult-to-reach individuals of low SEP. Although PA apps are widely available, they are rarely based on health behavior theories and most predominantly offer generic PA advice. Consequently, it is unlikely that available apps are the most effective PA intervention tools.

Objective: To respond to these areas for improvement, we developed SNapp, an app-based intervention encouraging adults of low SEP to increase PA by providing tailored coaching messages targeting walking behavior. This study aimed to describe SNapp's stepwise development and pilot evaluation process.

Methods: We applied a stepwise approach: analyzing the health problem, developing a program framework, developing tailoring assessments, writing tailored messages, automating the tailoring process, and implementing and evaluating the program in a qualitative pilot study (11 participants).

Results: SNapp consisted of several elements. First, an app was developed to collect step count and geolocation data using smartphone sensor functionalities. In addition, a survey measure was created to assess users' behavior change technique (BCT) preferences. These 3 data types were used to tailor SNapp's coaching messages to stimulate walking. This allows SNapp to offer feedback on performance levels, contextually tailored prompts when users are near green spaces, and coaching content that aligns with individual BCT preferences. Finally, a server-based Python program that interacts with databases containing user data and tailored messages was built using Microsoft Azure to select and automatically send messages to users through Telegram messenger. Pilot study findings indicated that SNapp was rated positively, with participants reporting that its design, technical functioning, and message content were acceptable. Participants suggested additional functionalities that are worth considering for future updates.

Conclusions: SNapp is an app-based intervention that aims to promote walking in adults of low SEP by offering tailored coaching messages. Its development is theory based, and it is among the first to incorporate contextualized feedback and content tailored to individual BCT preferences. The effectiveness of SNapp will be evaluated in a 12-month real-life parallel cluster-randomized controlled trial.

Keywords: behavior change techniques; cardiovascular disease; intervention development; mHealth; mobile app; mobile health; mobile phone; physical activity; smartphone; socioeconomic position; tailoring; walking.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Components of the SNapp framework. BCT: behavior change technique.
Figure 2
Figure 2
Screenshots: (A) launch screen, (B) log-in screen, (C) step count screen, and (D) settings screen.
Figure 3
Figure 3
Screenshots of the (A) log-in procedure and (B) tailored coaching messages sent by the SNapp Telegram account.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Cardiovascular diseases (CVDs) World Health Organization. [2022-07-06]. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases...
    1. Clark AM, DesMeules M, Luo W, Duncan AS, Wielgosz A. Socioeconomic status and cardiovascular disease: risks and implications for care. Nat Rev Cardiol. 2009 Nov 22;6(11):712–22. doi: 10.1038/nrcardio.2009.163.nrcardio.2009.163 - DOI - PubMed
    1. de Mestral C, Stringhini S. Socioeconomic status and cardiovascular disease: an update. Curr Cardiol Rep. 2017 Sep 30;19(11):115. doi: 10.1007/s11886-017-0917-z.10.1007/s11886-017-0917-z - DOI - PubMed
    1. Kraus W, Powell K, Haskell W, Janz KF, Campbell WW, Jakicic JM, Troiano RP, Sprow K, Torres A, Piercy KL, 2018 PHYSICAL ACTIVITY GUIDELINES ADVISORY COMMITTEE* Physical activity, all-cause and cardiovascular mortality, and cardiovascular disease. Med Sci Sports Exerc. 2019 Jun;51(6):1270–81. doi: 10.1249/MSS.0000000000001939. https://europepmc.org/abstract/MED/31095084 00005768-201906000-00022 - DOI - PMC - PubMed
    1. Guthold R, Stevens GA, Riley LM, Bull FC. Worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1·9 million participants. Lancet Global Health. 2018 Oct;6(10):e1077–86. doi: 10.1016/s2214-109x(18)30357-7. - DOI - PubMed

LinkOut - more resources