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Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review.

ABSTRACT: A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applications to increase fruit and vegetable intake. PubMed and Web of Science were used to conduct this systematized review, and the inclusion criteria were: randomized controlled trials evaluating mobile phone applications focused on increasing fruit and/or vegetable intake as a primary or secondary outcome performed from 2008 to 2018. Eight studies were included in the final assessment. The interventions described in six of these studies were effective in increasing fruit and/or vegetable intake. Targeting stratified populations and using long-lasting interventions were identified as key aspects that could influence the effectiveness of these interventions. In conclusion, evidence shows the effectiveness of mHealth application interventions to increase fruit and vegetable consumption. Further research is needed to design effective interventions and to determine their efficacy over the long term.

SUBMITTER: Mandracchia F

PROVIDER: S-EPMC6471011 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review.

Mandracchia Floriana F Llauradó Elisabet E Tarro Lucia L Del Bas Josep Maria JM Valls Rosa Maria RM Pedret Anna A Radeva Petia P Arola Lluís L Solà Rosa R Boqué Noemi N

Nutrients 20190322 3

A wide range of chronic diseases could be prevented through healthy lifestyle choices, such as consuming five portions of fruits and vegetables daily, although the majority of the adult population does not meet this recommendation. The use of mobile phone applications for health purposes has greatly increased; these applications guide users in real time through various phases of behavioural change. This review aimed to assess the potential of self-monitoring mobile phone health (mHealth) applica ...[more]

PMID: 30909484

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Project description:BackgroundMobile phone apps are increasingly used to deliver health interventions, which provide the opportunity to present health information via different communication modes. However, scientific evidence regarding the effects of such health apps is scarce.ObjectiveIn a randomized controlled trial, we tested the efficacy of a 6-month intervention delivered via a mobile phone app that communicated either textual or auditory tailored health information aimed at stimulating fruit and vegetable intake. A control condition in which no health information was given was added. Perceived own health and health literacy were included as moderators to assess for which groups the interventions could possibly lead to health behavior change.MethodsAfter downloading the mobile phone app, respondents were exposed monthly to either text-based or audio-based tailored health information and feedback over a period of 6 months via the mobile phone app. In addition, respondents in the control condition only completed the baseline and posttest measures. Within a community sample (online recruitment), self-reported fruit and vegetable intake at 6-month follow-up was our primary outcome measure.ResultsIn total, 146 respondents (ranging from 40 to 58 per condition) completed the study (attrition rate 55%). A significant main effect of condition was found on fruit intake (P=.049, partial η(2)=0.04). A higher fruit intake was found after exposure to the auditory information, especially in recipients with a poor perceived own health (P=.003, partial η(2)=0.08). In addition, health literacy moderated the effect of condition on vegetable intake 6 months later (P<.001, partial η(2)=.11). A higher vegetable intake was found for recipients with high health literacy after exposure to the textual or auditory intervention compared to the control condition (contrasts P=.07 and P=.004, respectively). In the case of relatively low health literacy, vegetable intake was the highest in the control condition (contrasts text control: P=.03; audio control: P=.04).ConclusionsThis study provides evidence-based insight into the effects of a mobile health app. The app seems to have the potential to change fruit and vegetable intake up to 6 months later, at least for specific groups. We found different effects for fruit and vegetable intake, respectively, suggesting that different underlying psychological mechanisms are associated with these specific behaviors. Based on our results, it seems worthwhile to investigate additional ways to increase fruit and vegetable intake in recipients with low health literacy.ClinicaltrialInternational Standard Randomized Controlled Trial Number (ISRCTN): 23466915; http://www.isrctn.com/ISRCTN23466915 (Archived by WebCite at http://www.webcitation.org/6hTtfSvaz).

Project description:BackgroundFruit and vegetable consumption is important for health, but many individuals fail to consume adequate amounts for health benefits. Although many individuals are aware of current fruit and vegetable consumption recommendations, research suggests that adherence to these is hampered by low knowledge of the details of these recommendations.ObjectiveThis paper reports the development and details of a pilot randomized controlled test of a novel interactive mobile phone app for addressing low knowledge of the UK 5-a-day fruit and vegetable recommendations.MethodsRequirements for the app were first defined by researchers and potential end users and prioritized using the MoSCoW (Must have, Should have, Could have, Won't have) method. Second, a prototype mobile phone app was developed using an agile approach. Third, the prototype app was tested in a randomized controlled pilot trial for impacts on knowledge and intake of fruit and vegetables. Volunteers were randomized to either receive (n=50) or not receive the app (n=44) for 2 or 4 weeks, and fruit and vegetable knowledge, intake, and behavior were assessed at the beginning of the study and after 1 and 2 weeks or after 2 and 4 weeks, respectively. App usage and qualitative feedback were also investigated. All findings then informed the development of a final app.ResultsLow knowledge of consumption recommendations centered around portion sizes and the need for variety, and an interactive mobile phone app was considered a suitable tool for improving this knowledge in a practical manner that would be available both at time of consumption and outside of these times. The pilot test revealed improved behavior after 2 weeks compared with baseline in volunteers who received the app, but improvements in knowledge on fruit and vegetable recommendations were found in both groups, and no improvements in fruit and vegetable intakes were found in formal measures. Patterns of app usage and qualitative feedback also suggested a number of modifications. The resultant final app incorporates several behavior change techniques (goal-setting, self-monitoring, and personalized feedback) as well as aiming to improve knowledge.ConclusionsA novel interactive mobile phone app was successfully developed based on requirements, and when tested in a pilot randomized controlled trial, this app was found to have some impacts on fruit and vegetable outcomes. Although benefits from the app were small, impacts will likely increase as a result of recent modifications. The final SMART 5-A-DAY app is available in the Google Play Store and now needs testing in the target population.Trial registrationClinicalTrials.gov NCT02779491; https://www.clinicaltrials.gov/ct2/show/NCT02779491.

Project description:BACKGROUND:Large-scale initiatives to improve diet quality through increased vegetable consumption have had small to moderate success. Digital technologies have features that are appealing for health-related behavior change interventions. OBJECTIVE:This study aimed to describe the implementation and evaluation of a mobile phone app called VegEze, which aims to increase vegetable intake among Australian adults. METHODS:To capture the impact of this app in a real-world setting, the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework was utilized. An uncontrolled, quantitative cohort study was conducted, with evaluations after 21 and 90 days. The app was available in the Apple App Store and was accompanied by television, radio, and social media promotion. Evaluation surveys were embedded into the app using ResearchKit. The primary outcomes were vegetable intake (servings per day) and vegetable variety (types per day). Psychological variables (attitudes, intentions, self-efficacy, and action planning) and app usage were also assessed. Descriptive statistics and multiple linear regression were used to describe the impact of the app on vegetable intake and to determine the characteristics associated with the increased intake. RESULTS:Data were available from 5062 participants who completed the baseline survey; 1224 participants completed the 21-day survey, and 273 completed the 90-day survey. The participants resided across Australia and were mostly women (4265/5062, 84.3%) with a mean age of 48.2 years (SD 14.1). The mean increase in intake was 0.48 servings, from 3.06 servings at baseline to 3.54 servings at the end of the 21-day challenge (t1223=8.71; P<.001). The variety of vegetables consumed also increased by 0.35 types per day (t1123=9.59; P<.001). No changes in intake and variety were found from day 21 to the 90-day follow-up. Participants with the highest app usage increased their vegetable intake by 0.63 (SD 2.02) servings per day compared with 0.32 (SD 1.69) servings per day for those with the lowest app usage. On the basis of multiple linear regression, gender; age; BMI; psychological variables of self-efficacy, attitudes, intentions, and action planning specific to vegetable intake; baseline vegetable intake; and active days of app usage accounted for 23.3% of the variance associated with the change in intake (F9,1208=42.09; P<.001). Baseline vegetable intake was the strongest predictor of change in intake (beta=-.495; P<.001), with lower baseline intake associated with a greater change in intake. Self-efficacy (beta=.116; P<.001), action planning (beta=.066; P=.02), BMI (beta=.070; P=.01), and app usage (beta=.081; P=.002) were all significant predictors of the change in intake. CONCLUSIONS:The VegEze app was able to increase intake by half a serving in a large sample of Australian adults. Testing the app in a real-world setting and embedding the consent process allowed for greater reach and an efficient, robust evaluation. Further work to improve engagement is warranted.

Project description:BACKGROUND:Literature shows mixed evidence about the power of mobile phone applications to foster physical activity. A systematic integration that offers insights into which mobile phone application techniques can or cannot foster physical activity is lacking, as is a theoretical integration of current research. OBJECTIVES:We performed a systematic review guided by a theoretical framework focusing on effects that certain mobile phone application techniques have on physical activity, to improve our understanding of what techniques are more or less effective. METHODS:We identified articles by searching EBSCO Business Source Complete, Science Direct, PsycINFO, Springer, PLoS ONE, Taylor and Francis, IEEE, Social Science Citation Index, Science Citation Index Expanded, PUBMED, MEDLINE, and Google Scholar. We considered articles if (1) they referred to the use of mobile phone applications to promote physical activity; (2) their methodological approach allowed one to derive appropriate results (e.g., intervention-based approach, observational study); (3) they were published in peer-reviewed journals or conference proceedings; and (4) they were written in English. The literature search resulted in 41 usable studies. Meta-synthesis and vote counting were applied to analyze these studies. RESULTS:Based on the ratio of supportive versus non-supportive evidence in both the qualitative and the quantitative studies, we propose the following descending rank order for the effectiveness of application techniques to foster physical activity. This is tentative in nature because the current overall small body of literature made coming to definite conclusions difficult: (1) feedback, (2) goal setting and its sub-forms, (3) competition, social sharing with familiar users in both segregated and social network groups, and (4) social sharing with strangers in segregated groups, reward, and social sharing with strangers in social network groups. Rewards in particular provided mixed results, and social sharing with strangers in segregated and social network groups seemed rather ineffective but may work under special conditions that need to be identified in additional research. One limitation of our study was that our results are mostly derived from qualitative studies, since quantitative studies are underrepresented in the field. CONCLUSION:Several mobile phone application techniques were identified that have the potential to foster physical activity, whereas others were identified that are unlikely to increase physical activity. Major avenues for future research include more theoretical development and more quantitative studies, among others.

Dataset Information

Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review.

Publications

Potential Use of Mobile Phone Applications for Self-Monitoring and Increasing Daily Fruit and Vegetable Consumption: A Systematized Review.

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