Quality of Publicly Available Physical Activity Apps: Review and Content Analysis

Abstract

BackgroundWithin the new digital health landscape, the rise of health apps creates novel prospects for health promotion. The market is saturated with apps that aim to increase physical activity (PA). Despite the wide distribution and popularity of PA apps, there are limited data on their effectiveness, user experience, and safety of personal data.ObjectiveThe purpose of this review and content analysis was to evaluate the quality of the most popular PA apps on the market using health care quality indicators.MethodsThe top-ranked 400 free and paid apps from iTunes and Google Play stores were screened. Apps were included if the primary behavior targeted was PA, targeted users were adults, and the apps had stand-alone functionality. The apps were downloaded on mobile phones and assessed by 2 reviewers against the following quality assessment criteria: (1) users’ data privacy and security, (2) presence of behavior change techniques (BCTs) and quality of the development and evaluation processes, and (3) user ratings and usability.ResultsOut of 400 apps, 156 met the inclusion criteria, of which 65 apps were randomly selected to be downloaded and assessed. Almost 30% apps (19/65) did not have privacy policy. Every app contained at least one BCT, with an average number of 7 and a maximum of 13 BCTs. All but one app had commercial affiliation, 12 consulted an expert, and none reported involving users in the app development. Only 12 of 65 apps had a peer-reviewed study connected to the app. User ratings were high, with only a quarter of the ratings falling below 4 stars. The median usability score was excellent—86.3 out of 100.ConclusionsDespite the popularity of PA apps available on the commercial market, there were substantial shortcomings in the areas of data safety and likelihood of effectiveness of the apps assessed. The limited quality of the apps may represent a missed opportunity for PA promotion.

Human Behavior with Mobile Health: Smartphone/ Devices, Apps and Cognition

“…14 Despite the popularity of physical activity apps available on the commercial market, there were substantial shortcomings in the areas of data safety and likelihood of effectiveness. 22 A review of medication adherence apps in the Apple App Store and the Google Play Store (N=5,881) found of those accessible without payment (N=420), only 3 with an evidence base and there were 3 broad categories of adherence strategies (i.e., reminder, behavioral, and educational). 23 A total of 250 apps utilized a single method, 149 apps used two methods, and only 22 apps utilized all 3 methods.…”

Exploring Users’ Experiences of the Uptake and Adoption of Physical Activity Apps: Longitudinal Qualitative Study (Preprint)

“…However, we believe that our findings may generalise to other commercial apps as the selected ones were characterised by most of the BCTs generally implemented in PA apps (e.g. [26]). Finally, the 2-week longitudinal study design was aimed at understanding what and why particular app features sustained engagement over time.…”

“…These apps were chosen because i) their main goal was to increase physical activity among healthy adults, ii) they were freely available both on iTunes and Google Play, iii) they incorporated many BCTs (see table 1 for a description of the BCTs incorporated in the selected apps) that are common among top-ranked publicly available PA apps [26], and iv) they had received high user ratings (i.e., 4.5 stars), which is considered to be an indicator of positive user experiences with PA apps. Table 1.…”

Tracking physical activity using smart phone apps: assessing the ability of a current app and systematically collecting patient recommendations for future development

“…As highlighted by Bradley et al's review, it appears that patients are receptive to remote assessment [28]. Despite these advancements in app technologies, the feasibility of remotely monitoring patients' health-related data via apps is largely unexplored, few studies address evidence-based physical activity guidelines, and there is greater scope for these apps to deliver theoretically informed and empirically supported behaviour change techniques [29].…”