Barriers to and facilitators for using nutrition apps: a scoping review and conceptual framework (Preprint)

Abstract

BACKGROUND Nutrition apps are a prototypical mobile health (mHealth) technology supporting healthy eating behavior that are seen as promising tools for health promotion by policy makers. Although nutrition apps are increasingly popular, wide-spread adoption is yet to be achieved. Hence, profound knowledge regarding factors motivating and hindering (long-term) nutrition app use is crucial for developing design guidelines aiming at supporting uptake and prolonged use of nutrition apps. OBJECTIVE In this scoping review, we synthesized the literature on barriers to and facilitators for nutrition app use across disciplines including empirical qualitative and quantitative studies with current users, ex-users, and/or non-users of nutrition apps. METHODS A systematic literature search including six databases as well as backward and forward citation search was conducted. Search strategy, inclusion and exclusion criteria, and the planned data extraction process were preregistered. All empirical qualitative and quantitative studies published in German or English were eligible for inclusion if they examined adults or adolescents (aged 13 to 18) who were either current users, ex-users and/ or non-users of nutrition apps. Based on qualitative content analysis, extracted individual barriers and facilitators were grouped into categories. RESULTS Twenty-eight publications were identified as eligible. A framework with a three-level hierarchy was designed which grouped 326 individual barriers and facilitators into 21 sub-categories, twelve categories, and four clusters that focus on either the individual user (goals, goal attainment, goal abandonment, personal living conditions, lack of knowledge or skill, lack or loss of motivation, habit), different aspects of the app and the smartphone (features, usability of the app or food database, technical issues, data security, accuracy/trustworthiness, costs), positive and negative outcomes of nutrition app use, or interactions between the user and their social environment. CONCLUSIONS The resulting conceptual framework underlines a pronounced diversity of reasons for (not) using nutrition apps indicating that there is no “one-size-fits-all” approach for uptake and prolonged use of nutrition aps. Hence, tailoring nutrition apps to needs of specific user groups seems promising for increasing engagement.

Barriers to and Facilitators for Using Nutrition Apps: Systematic Review and Conceptual Framework

“…A protocol was prepared and published on the Open Science Framework [ 27 ] prior to completion of data extraction. This review reports on the generation of an overview of the evidence.…”

Characteristics of smartphone-based dietary assessment tools: a systematic review

“…Similarly, smartphone-based dietary assessment tools may differentially impact participants' willingness to take part in research and their willingness and ability to reliably record food intake. For instance, this might impact conclusions about frequency and timing of eating episodes as well as the amount of energy consumed per day (33,34). A previous review has already outlined potential differences in willingness to use food tracking apps based on the design of features, such as the food database (34).…”

“…For instance, this might impact conclusions about frequency and timing of eating episodes as well as the amount of energy consumed per day (33,34). A previous review has already outlined potential differences in willingness to use food tracking apps based on the design of features, such as the food database (34). For instance, if the food database is too extensive, searching for the correct food item might be too burdensome.…”

“…For instance, if the food database is too extensive, searching for the correct food item might be too burdensome. On the other hand, if the food database is not extensive enough, participants might struggle to find an entry that sufficiently describes the food at hand, which might also lead to disengagement (34). This further underlines the importance of providing detailed descriptions of the dietary assessment tool to facilitate readers' understanding of the potential impact the assessment tool might have had on participant retention and missed recordings (13).…”

“…Furthermore, different input features may vary in participant burden: Taking a photo is usually perceived as quick and easy, while breaking down the meal into its individual components to search them in a database usually is more burdensome, especially when the food database is very large and correct entries difficult to identify from a long list of options. This may impact both participants' willingness to take part in the study, and the number of records they provide overall (33,34).…”