The fitness of apps: a theory-based examination of mobile fitness app usage over 5 months

Abstract

Background: There are thousands of fitness-related smartphone applications ("apps") available for free and purchase, but there is uncertainty if these apps help individuals achieve and maintain personal fitness.Technology usage attrition is also a concern among research studies on health technologies.Methods: Usage of three fitness apps was examined over 5 months to assess adherence and effectiveness.Initially, 64 participants downloaded three free apps available on Android and iOS and 47 remained in the study until posttest. With a one group pre-posttest design and checkpoints at months 1, 3, and 5, exercise and exercise with fitness apps were examined in the framework of the Theory of Planned Behavior (TPB) using a validated survey. Apps were selected based on their function from the Functional Triad. Perceived fitness was also measured. T-tests, sign tests, Fisher's exact tests, and linear and logistic regression were used to compare pre to posttests and users to non-users of the apps.Results: Forty-seven participants completed both pre and posttests. Individual item scores indicated no significant change pre to posttest except for decreases observed in usefulness of using apps for exercise (attitude) (−0.78, P<0.01), peer influence on exercise (subjective norm) (−0.51, P<0.05), peer influence on exercise with apps (subjective norm) (−1.02, P<0.01), perceived difficulties in exercising with apps (perceived behavioral control) (−1.29, P<0.001), and the expected frequency of exercise with apps over the next 2 weeks (behavioral intention) (P<0.0001 in a sign test). Subscale total scores indicated significant decreases in subjective norm regarding exercise (−0.72, P<0.05), subjective norm regarding exercise with apps (−1.72, P<0.01), and perceived behavioral control over exercising with apps (−2.56, P<0.01) between pre and posttest.When comparing app users (n=32) to non-users (n=15), there was only a significant difference in subscale total scores at posttest for attitude toward exercising using apps, which was significantly more favorable among users than non-users (32.3 vs. 27.6, P<0.05). Fitness perception did not change over 5 months regarding cardiovascular fitness, strength, endurance, flexibility, or body composition. Technology usage attrition was desirable at 31.9%.Conclusions: App usage and effectiveness appears to have a connection to usefulness (attitude) and to perceived difficulties of exercising using apps (perceived behavioral control). Exercise and exercise using apps are not influenced by peer influence (subjective norm). Intention to exercise using these particular apps decreased (behavioral intention). Those who utilized the apps were more likely to have a positive attitude about the apps. Usefulness and perceived difficulties in particular should be considered with future app development.App usefulness and ease of use may be facilitated by using health behavior theories to guide development.

Contradictions in digital health engagement: An activity tracker’s ambiguous influence on vulnerable young adults’ engagement in own health

“…In addition to research on activity trackers’ influence on health effects, a minor but significant part of related work is occupied with understanding people’s motives and experience of using tracking technology and includes studies of why and how people use activity trackers, 25 – 28 how people experience self-tracking, 29 why people abandon activity trackers, 30 digital health engagement strategies 6 and broader studies of the appropriation of self-monitoring devices in everyday domestic environments. 31 This research is characterised by critical examinations of technology use and emphasises that the health behaviour associated with activity trackers is interwoven in complex contextual factors and raises concerns that too simple assumptions are made about tracking technology’s influence on health behaviour.…”

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“…From the perspective of Physical Therapy, numerous mobile electronic applications, especially with potential for use in the field of neurorehabilitation, have been proposed (Sánchez Rodríguez et al, 2018). In the field of Sports Science, there are also many mobile applications that serve to monitor health in general and the physical fitness levels, especially (Hermann and Kim, 2017). Moreover, healthcare providers and some insurance companies are proposing applications that can better help individuals to reach their health and fitness goals (Higgins, 2016).…”

App-based supplemental exercise in rehabilitation, adherence, and effect on outcomes: a randomized controlled trial

“…A recent study which tracked participants' behaviour with use of three fitness apps over a five-month period found a high drop off in behaviour after the first month. 26 Interestingly, maximal average use in the first month was only 56 minutes. 26 Similarly, in our study, the participants' utility of the Pt Pal app could be considered low and also diminished over time.…”

“…26 Interestingly, maximal average use in the first month was only 56 minutes. 26 Similarly, in our study, the participants' utility of the Pt Pal app could be considered low and also diminished over time. The intervention led to a slight increase in the amount of physical activity performed, however did not affect physical function.…”