Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking

Abstract

Background Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. We outline the development of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We also explored acceptability, engagement with, associations between app usage and behavioral engagement, and perceived impact of the app in supporting behavior change. Methods Following development, fifty insufficiently physically active employees (M age = 44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to examine feasibility of the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively. Results Walkers rated the app quality favorably (M = 3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring. Conclusions The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be effective if they target users’ competence and integrate BCTs. Trial Registration: This study was part of a pilot larger randomized controlled trial, in which a component of the intervention involved the use of the mobile app. The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000807257) on 11 May 2018 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375049&isReview=true.

Healthy lifestyle interventions across diverse workplaces: a summary of the current evidence

“…For technologically based physical activity interventions, those longer than 8 weeks in duration and part of a multicomponent intervention are most beneficial. Self-monitoring of behavior, intention formation, follow-up prompts, goal setting, and app reminders have been found to be the most effective app behavioral change techniques [49].…”

Mobile health lifestyle intervention program leads to clinically significant loss of body weight in patients with NASH

“…For these reasons, we defined feasibility according to user engagement. 26 Following previous studies using NW, 27 engaged users were defined as those who complete at least 1 meaningful in-application action per week (eg, weight log, food log, exercise log, or article read). Smartphone app utilization data were recorded by Noom’s backend server.…”

Development, feasibility and acceptability of a self-efficacy-enhancing smartphone application among pregnant women with gestational diabetes mellitus: single- arm pilot clinical trial

“…Further, the majority of the motivational text messages were acknowledged and appreciated by the participants, suggesting the participant’s interest and interaction in using the app to foster their self-care behaviors. In Nicholas et al study (Nicholas et al, [ 22 ]), the participants appreciated the motivational text messages embedded within the START app as it provided them a sense of competence to adhere to self-monitoring. This study finding supports previous mobile health (mHealth) interventions that recommended the use of motivational text messages to promote behavioral changes among general adults (Kinnafick, Thøgersen-Ntoumani, & Duda, [ 17 ]; Samdal et al, [ 27 ]).…”