Adoption of Mobile Health Apps in Dietetic Practice: Case Study of Diyetkolik.
Ontology highlight
ABSTRACT: Background
Dietetics mobile health apps provide lifestyle tracking and support on demand. Mobile health has become a new trend for health service providers through which they have been shifting their services from clinical consultations to online apps. These apps usually offer basic features at no cost and charge a premium for advanced features. Although diet apps are now more common and have a larger user base, in general, there is a gap in literature addressing why users intend to use diet apps. We used Diyetkolik, Turkey's most widely used online dietetics platform for 7 years, as a case study to understand the behavioral intentions of users.Objective
The aim of this study was to investigate the factors that influence the behavioral intentions of users to adopt and use mobile health apps. We used the Technology Acceptance Model and extended it by exploring other factors such as price-value, perceived risk, and trust factors in order to assess the technology acceptance of users.Methods
We conducted quantitative research on the Diyetkolik app users by using random sampling. Valid data samples gathered from 658 app users were analyzed statistically by applying structural equation modeling.Results
Statistical findings suggested that perceived usefulness (P<.001), perceived ease of use (P<.001), trust (P<.001), and price-value (P<.001) had significant relationships with behavioral intention to use. However, no relationship between perceived risk and behavioral intention was found (P=.99). Additionally, there was no statistical significance for age (P=.09), gender (P=.98), or previous app use experience (P=.14) on the intention to use the app.Conclusions
This research is an invaluable addition to Technology Acceptance Model literature. The results indicated that 2 external factors (trust and price-value) in addition to Technology Acceptance Model factors showed statistical relevance with behavioral intention to use and improved our understanding of user acceptance of a mobile health app. The third external factor (perceived risk) did not show any statistical relevance regarding behavioral intention to use. Most users of the Diyetkolik dietetics app were hesitant in purchasing dietitian services online. Users should be frequently reassured about the security of the platform and the authenticity of the platform's dietitians to ensure that users' interactions with the dietitians are based on trust for the platform and the brand.
SUBMITTER: Akdur G
PROVIDER: S-EPMC7568214 | biostudies-literature | 2020 Oct
REPOSITORIES: biostudies-literature
Publications
Adoption of Mobile Health Apps in Dietetic Practice: Case Study of Diyetkolik.
Akdur Gorkem G Aydin Mehmet Nafiz MN Akdur Gizdem G
JMIR mHealth and uHealth 20201002 10
<h4>Background</h4>Dietetics mobile health apps provide lifestyle tracking and support on demand. Mobile health has become a new trend for health service providers through which they have been shifting their services from clinical consultations to online apps. These apps usually offer basic features at no cost and charge a premium for advanced features. Although diet apps are now more common and have a larger user base, in general, there is a gap in literature addressing why users intend to use ...[more]
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Project description:BACKGROUND:Emerging research suggests that mobile apps can be used to effectively treat common mental illnesses like depression and anxiety. Despite promising efficacy results and ease of access to these interventions, adoption of mobile health (mHealth; mobile device-delivered) interventions for mental illness has been limited. More insight into patients' perspectives on mHealth interventions is required to create effective implementation strategies and to adapt existing interventions to facilitate higher rates of adoption. OBJECTIVE:The aim of this study was to examine, from the patient perspective, current use and factors that may impact the use of mHealth interventions for mental illness. METHODS:This was a cross-sectional survey study of veterans who had attended an appointment at a single Veterans Health Administration facility in early 2016 that was associated with one of the following mental health concerns: unipolar depression, any anxiety disorder, or posttraumatic stress disorder. We used the Veteran Affairs Corporate Data Warehouse to create subsets of eligible participants demographically stratified by gender (male or female) and minority status (white or nonwhite). From each subset, 100 participants were selected at random and mailed a paper survey with items addressing the demographics, overall health, mental health, technology ownership or use, interest in mobile app interventions for mental illness, reasons for use or nonuse, and interest in specific features of mobile apps for mental illness. RESULTS:Of the 400 potential participants, 149 (37.3%, 149/400) completed and returned a survey. Most participants (79.9%, 119/149) reported that they owned a smart device and that they use apps in general (71.1%, 106/149). Most participants (73.1%, 87/149) reported interest in using an app for mental illness, but only 10.7% (16/149) had done so. Paired samples t tests indicated that ratings of interest in using an app recommended by a clinician were significantly greater than general interest ratings and even greater when the recommending clinician was a specialty mental health provider. The most frequent concerns related to using an app for mental illness were lacking proof of efficacy (71.8%, 107/149), concerns about data privacy (59.1%, 88/149), and not knowing where to find such an app (51.0%, 76/149). Participants expressed interest in a number of app features with particularly high-interest ratings for context-sensitive apps (85.2%, 127/149), and apps focused on the following areas: increasing exercise (75.8%, 113/149), improving sleep (73.2%, 109/149), changing negative thinking (70.5%, 105/149), and increasing involvement in activities (67.1%, 100/149). CONCLUSIONS:Most respondents had access to devices to use mobile apps for mental illness, already used apps for other purposes, and were interested in mobile apps for mental illness. Key factors that may improve adoption include provider endorsement, greater publicity of efficacious apps, and clear messaging about efficacy and privacy of information. Finally, multifaceted apps that address a range of concerns, from sleep to negative thought patterns, may be best received.
| S-EPMC6367667 | biostudies-other
Project description:Consumers are living longer, creating more pressure on the health system and increasing their requirement for self-care of chronic conditions. Despite rapidly-increasing numbers of mobile health applications ('apps') for consumers' self-care, there is a paucity of research into consumer engagement with electronic self-monitoring. This paper presents a qualitative exploration of how health consumers use apps for health monitoring, their perceived benefits from use of health apps, and suggestions for improvement of health apps.'Health app' was defined as any commercially-available health or fitness app with capacity for self-monitoring. English-speaking consumers aged 18 years and older using any health app for self-monitoring were recruited for interview from the metropolitan area of Perth, Australia. The semi-structured interview guide comprised questions based on the Technology Acceptance Model, Health Information Technology Acceptance Model, and the Mobile Application Rating Scale, and is the only study to do so. These models also facilitated deductive thematic analysis of interview transcripts. Implicit and explicit responses not aligned to these models were analyzed inductively.Twenty-two consumers (15 female, seven male) participated, 13 of whom were aged 26-35 years. Eighteen participants reported on apps used on iPhones. Apps were used to monitor diabetes, asthma, depression, celiac disease, blood pressure, chronic migraine, pain management, menstrual cycle irregularity, and fitness. Most were used approximately weekly for several minutes per session, and prior to meeting initial milestones, with significantly decreased usage thereafter. Deductive and inductive thematic analysis reduced the data to four dominant themes: engagement in use of the app; technical functionality of the app; ease of use and design features; and management of consumers' data.The semi-structured interviews provided insight into usage, benefits and challenges of health monitoring using apps. Understanding the range of consumer experiences and expectations can inform design of health apps to encourage persistence in self-monitoring.
| S-EPMC4876999 | biostudies-other
Project description:BackgroundMobile health applications (mHealth apps) are increasingly being used to perform tasks that are conventionally performed by general practitioners (GPs), such as those involved in promoting health, preventing disease, diagnosis, treatment, monitoring, and support for health services. This raises an important question: can mobile apps replace GPs? This study aimed to systematically search for and identify mobile apps that can perform GP tasks.MethodsA scoping review was carried out. The Google Play Store and Apple App Store were searched for mobile apps, using search terms derived from the UK Royal College of General Practitioners (RCGP) guideline on GPs' core capabilities and competencies. A manual search was also performed to identify additional apps.ResultsThe final analysis included 17 apps from the Google Play Store and Apple App Store, and 21 apps identified by the manual search. mHealth apps were found to have the potential to replace GPs for tasks such as recording medical history and making diagnoses; performing some physical examinations; supporting clinical decision making and management; assisting in urgent, long-term, and disease-specific care; and health promotion. In contrast, mHealth apps were unable to perform medical procedures, appropriately utilise other professionals, and coordinate a team-based approach.ConclusionsThis scoping review highlights the functions of mHealth apps that can potentially replace GP tasks. Future research should focus on assessing the performance and quality of mHealth apps in comparison with that of real doctors.
| S-EPMC6945711 | biostudies-literature
Project description:BackgroundMobile health (mHealth) apps that support individuals pursuing health and wellness goals, such as weight management, stress management, smoking cessation, and self-management of chronic conditions have been on the rise. Despite their potential benefits, the use of these tools has been limited, as most users stop using them just after a few times of use. Under this circumstance, achieving the positive outcomes of mHealth apps is less likely.ObjectiveThe objective of this study was to understand continued use of mHealth apps and individuals' decisions related to this behavior.MethodsWe conducted a qualitative longitudinal study on continued use of mHealth apps. We collected data through 34 pre- and postuse interviews and 193 diaries from 17 participants over two weeks.ResultsWe identified 2 dimensions that help explain continued use decisions of users of mHealth apps: users' assessment of mHealth app and its capabilities (user experience) and their persistence at their health goals (intent). We present the key factors that influence users' assessment of an mHealth app (interface design, navigation, notifications, data collection methods and tools, goal management, depth of knowledge, system rules, actionable recommendations, and user system fit) and relate these factors to previous literature on behavior change technology design. Using these 2 dimensions, we developed a framework that illustrated 4 decisions users might make after initial interaction with mHealth apps (to abandon use, limit use, switch app, and continue use). We put forth propositions to be explored in future research on mHealth app use.ConclusionsThis study provides insight into the factors that shape users' decisions to continue using mHealth apps, as well as other likely decision scenarios after the initial use experience. The findings contribute to extant knowledge of mHealth use and provide important implications for design of mHealth apps to increase long-term engagement of the users.
| S-EPMC6740166 | biostudies-literature
Project description:BackgroundNoncommunicable diseases (NCDs) are the leading global health problem in this century and are the principal causes of death and health care spending worldwide. Mobile health (mHealth) apps can help manage and prevent NCDs if people are willing to use them as supportive tools. Still, many people are reluctant to adopt these technologies. Implementing new apps could result in earlier intervention for many health conditions, preventing more serious complications.ObjectiveThis research project aimed to test the factors that facilitate the adoption of mHealth apps by users with NCDs. We focused on determining, first, what user interface (UI) qualities and complexity levels appeal to users in evaluating mHealth apps. We also wanted to determine whether people prefer that the data collected by an mHealth app be analyzed using a physician or an artificial intelligence (AI) algorithm. The contribution of this work is both theoretical and practical. We examined users' considerations when adopting mHealth apps that promote healthy lifestyles and helped them manage their NCDs. Our results can also help direct mHealth app UI designers to focus on the most appealing aspects of our findings.MethodsA total of 347 respondents volunteered to rate 3 models of mHealth apps based on 16 items that measured instrumentality, aesthetics, and symbolism. Respondents rated each model after reading 1 of 2 different scenarios. In one scenario, a physician analyzed the data, whereas, in the other, the data were analyzed by an AI algorithm. These scenarios tested the degree of trust people placed in AI algorithms versus the "human touch" of a human physician regarding analyzing data collected by an mHealth app.ResultsAs shown by the responses, the involvement of a human physician in the application had a significant effect (P<.001) on the perceived instrumentality of the simple model. The complex model with more controls was rated significantly more aesthetic when associated with a physician performing data analysis rather than an AI algorithm (P=.03).ConclusionsGenerally, when participants found a human touch in the mHealth app (connection to a human physician who they assumed would analyze their data), they judged the app more favorably. Simple models were evaluated more positively than complex ones, and aesthetics and symbolism were salient predictors of preference. These trends suggest that designers and developers of mHealth apps should keep the designs simple and pay special attention to aesthetics and symbolic value.
| S-EPMC8928053 | biostudies-literature
Project description:BackgroundMindful eating is an emerging area of research for managing unhealthy eating and weight-related behaviors such as binge eating and emotional eating. Although there are numerous commercial mindful eating apps available, their quality, effectiveness, and whether they are accurately based on mindfulness-based eating awareness are unknown.ObjectiveThis review aimed to appraise the quality of the mindful eating apps and to appraise the quality of content on mindful eating apps.MethodsA review of mindful eating apps available on Apple iTunes was undertaken from March to April 2018. Relevant apps meeting the inclusion criteria were subjectively appraised for general app quality using the Mobile App Rating Scale (MARS) guidelines and for the quality of content on mindful eating. A total of 22 apps met the inclusion criteria and were appraised.ResultsMany of the reviewed apps were assessed as functional and had moderate scores in aesthetics based on the criteria in the MARS assessment. However, some received lower scores in the domains of information and engagement. The majority of the apps did not teach users how to eat mindfully using all five senses. Hence, they were scored as incomplete in accurately providing mindfulness-based eating awareness. Instead, most apps were either eating timers, hunger rating apps, or diaries. Areas of potential improvement were in comprehensiveness and diversity of media, in the quantity and quality of information, and in the inclusion of privacy and security policies. To truly teach mindful eating, the apps need to provide guided examples involving the five senses beyond simply timing eating or writing in a diary. They also need to include eating meditations to assist people with their disordered eating such as binge eating, fullness, satiety, and craving meditations that may help them with coping when experiencing difficulties. They should also have engaging and entertaining features delivered through diverse media to ensure sustained use and interest by consumers.ConclusionsFuture mindful eating apps could be improved by accurate adherence to mindful eating. Further improvement could be achieved by ameliorating the domains of information, engagement, and aesthetics and having adequate privacy policies.
| S-EPMC6727629 | biostudies-literature
Project description:BackgroundPrivacy has always been a concern, especially in the health domain. The proliferation of mobile health (mHealth) apps has led to a large amount of sensitive data being generated. Some authors have performed privacy assessments of mHealth apps. They have evaluated diverse privacy components; however, different authors have used different criteria for their assessments.ObjectiveThis scoping review aims to understand how privacy is assessed for mHealth apps, focusing on the components, scales, criteria, and scoring methods used. A simple taxonomy to categorize the privacy assessments of mHealth apps based on component evaluation is also proposed.MethodsWe followed the methodology defined by Arksey and O'Malley to conduct a scoping review. Included studies were categorized based on the privacy component, which was assessed using the proposed taxonomy.ResultsThe database searches retrieved a total of 710 citations-24 of them met the defined selection criteria, and data were extracted from them. Even though the inclusion criteria considered articles published since 2009, all the studies that were ultimately included were published from 2014 onward. Although 12 papers out of 24 (50%) analyzed only privacy, 8 (33%) analyzed both privacy and security. Moreover, 4 papers (17%) analyzed full apps, with privacy being just part of the assessment. The evaluation criteria used by authors were heterogeneous and were based on their experience, the literature, and/or existing legal frameworks. Regarding the set of items used for the assessments, each article defined a different one. Items included app permissions, analysis of the destination, analysis of the content of communications, study of the privacy policy, use of remote storage, and existence of a password to access the app, among many others. Most of the included studies provided a scoring method that enables the comparison of privacy among apps.ConclusionsThe privacy assessment of mHealth apps is a complex task, as the criteria used by different authors for their evaluations are very heterogeneous. Although some studies about privacy assessment have been conducted, a very large set of items to evaluate privacy has been used up until now. In-app information and privacy policies are primarily utilized by the scientific community to extract privacy information from mHealth apps. The creation of a scale based on more objective criteria is a desirable step forward for privacy assessment in the future.
| S-EPMC7367524 | biostudies-literature
Project description:BackgroundDigital health apps are among the most visible facets of the ongoing digital transition in health care, with mental health-focused apps as one of the main therapeutic areas. However, concerns regarding their scientific robustness drove regulators to establish evaluation procedures, with Germany's Digitale Gesundheitsanwendungen program pioneering in app prescription with costs covered by statutory health insurance. Portugal gathers a set of conditions and requirements that position it as an excellent test bed for digital health apps. Its daunting mental health landscape reinforces the potential interest in new interventions. To understand if they would be acceptable, we need to understand the supply side's attitudes and perceptions toward them, that is, those of psychiatrists and psychologists.ObjectiveThis study aims to understand the attitudes and expectations of psychiatrists and psychologists toward digital mental health apps (DMHAs) in the Portuguese context, as well as perceived benefits, barriers, and actions to support their adoption.MethodsWe conducted a 2-stage sequential mixed methods study. Stage 1 consisted of a cross-sectional web survey adapted to the Portuguese context that was delivered to mental health professionals and psychologists. Stage 2 complemented the insights of the web survey results with a key opinion leader analysis.ResultsA total of 160 complete survey responses were recorded, most of which were from psychologists. This is the most extensive study on mental health professionals' attitudes and perceptions of DMHAs in Portugal. A total of 87.2% (136/156) of the respondents supported the opportunity to prescribe DMHAs. Increased health literacy (139/160, 86.9%), wider adherence to treatment (137/160, 85.6%), and proper disease management (127/160, 79.4%) were the most frequently agreed upon benefits of DMHAs. However, only less than half (68/156, 43.6%) of the respondents planned to prescribe or recommend DMHAs, with psychologists being more favorable than psychiatrists. Professionals faced substantial barriers, such as a lack of information on DMHAs (154/160, 96.3%), the level of initial training effort (115/160, 71.9%), and the need for adjustments of clinical processes and records (113/160, 70.6%). Professionals reported that having more information on the available apps and their suitability for health objectives (151/160, 94.4%), more scientific evidence of the validity of the apps as a health intervention (147/160, 91.9%), and established recommendations of apps by specific clinical guidelines or professional societies (145/160, 90.6%) would be essential to foster adoption.ConclusionsMore information about DMHAs regarding their clinical validity and how they work is necessary so that such an intervention can be adopted in Portugal. Recommendations from professional and scientific societies, as well as from governmental bodies, are strongly encouraged. Although the benefits of and the barriers to using these apps are consensual, more evidence, along with further promotion of mental health professionals' digital literacy, is needed.International registered report identifier (irrid)RR2-10.2196/41040.
| S-EPMC10276319 | biostudies-literature
Project description:BackgroundMobile health applications (mHealth apps) have been widely used for various purposes for mitigating the COVID-19 pandemic, such as self-assessment, contact tracing, disseminating information, minimizing exposure, and reducing face-to-face health consultation. The objective of this study is to systematically review COVID-19 related mHealth apps and highlight gaps to inform the development of future mHealth initiatives in Indonesia.MethodsA systematic search strategy using a PRISMA flowchart was used to identify mHealth apps available in Google Play and Apple Play stores. We searched mHealth apps using certain specific terms related to COVID-19 outbreaks. The inclusion criteria were apps-based smartphone users related to COVID-19 using local language, free of cost, available in the Google Play and Apple Play Stores, and supported by the Indonesian government. We excluded games, apps on infectious diseases unrelated to COVID-19 specifically, and apps with non-Bahasa Indonesia (Indonesian language). The selected mHealth apps were assessed based on two measures: (1) the WHO guidelines on digital health intervention and (2) the four dimensions of the mHealth technology fit framework. In addition, user feedback from experienced and non-experienced users was conducted to evaluate four dimensions of the apps.ResultsA total of 339 mHealth apps were generated from the initial search, remaining seven selected apps that met inclusion criteria. The results highlighted that mHealth apps reviewed had still not been widely used by the general public. The applications were purposed to disseminate information, conduct a self-risk assessment, provide an online community forum, and telemedicine or teleconsultation regarding COVID-19. Data services, including data storage, aggregation, and data exchange, are available in most apps. The rarest function found was contact tracing and assisting health management and health workers, such as the availability of testing facilities, reporting test results, and prescribing medication. The main issues reported were the lack of data security and data privacy protection, integration and infrastructures, usability, and usefulness.ConclusionOur study highlighted the necessity to improve mHealth apps' functions related to assisting health workers and the function of digital contact tracing. An effort to increase public awareness regarding the use of mHealth is also necessary to streamline the function of this innovation. Policymakers must consider usefulness, usability, integration, and infrastructure issues to improve their mHealth function.
| S-EPMC9114306 | biostudies-literature
Project description:BackgroundThe importance of mobile health (mHealth) apps is growing. Independent of the technologies used, mHealth apps bring more functionality into the hands of users. In the health context, mHealth apps play an important role in providing information and services to patients, offering health care professionals ways to monitor vital parameters or consult patients remotely. The importance of confidentiality in health care and the opaqueness of transport security in apps make the latter an important research subject.ObjectiveThis study aimed to (1) identify relevant security concerns on the server side of mHealth apps, (2) test a subset of mHealth apps regarding their vulnerability to those concerns, and (3) compare the servers used by mHealth apps with servers used in all domains.MethodsServer security characteristics relevant to the security of mHealth apps were assessed, presented, and discussed. To evaluate servers, appropriate tools were selected. Apps from the Android and iOS app stores were selected and tested, and the results for functional and other backend servers were evaluated.ResultsThe 60 apps tested communicate with 823 servers. Of these, 291 were categorized as functional backend servers, and 44 (44/291, 15.1%) of these received a rating below the A range (A+, A, and A-) by Qualys SSL Labs. A chi-square test was conducted against the number of servers receiving such ratings from SSL Pulse by Qualys SSL Labs. It was found that the tested servers from mHealth apps received significantly fewer ratings below the A range (P<.001). The internationally available apps from the test set performed significantly better than those only available in the German stores (alpha=.05; P=.03). Of the 60 apps, 28 (28/60, 47%) were found using at least one functional backend server that received a rating below the A range from Qualys SSL Labs, endangering confidentiality, authenticity, and integrity of the data displayed. The number of apps that used at least one entirely unsecured connection was 20 (20/60, 33%) when communicating with functional backend servers. It was also found that a majority of apps used advertising, tracking, or external content provider servers. When looking at all nonfunctional backend servers, 48 (48/60, 80%) apps used at least one server that received a rating below the A range.ConclusionsThe results show that although servers in the mHealth domain perform significantly better regarding their security, there are still problems with the configuration of some. The most severe problems observed can expose patient communication with health care professionals, be exploited to display false or harmful information, or used to send data to an app facilitating further damage on the device. Following the recommendations for mHealth app developers, the most regularly observed security issues can be avoided or mitigated.
| S-EPMC6364205 | biostudies-literature