Juan Mata, Richard Garfinkle, Teodora Dumitra, Mohsen Alhashemi, Tara Landry, Lawrence Lee, Gerald M Fried, Carmen Muller, Julio F Fiore Jr., Liane S Feldman. Mcgill University
Introduction: Globally, an estimated 500 million smartphone users have tried mobile applications (apps) to improve health and support health behavior changes. Apps specifically targeting surgical patients are increasingly available.The purpose of this study was to identify features and mechanisms of apps that were effective in eliciting a behavioral change in patients, in order to inform evidence-based app development in surgery.
Methods and procedures: We conducted a comprehensive literature search between January 2007 and April 2017 to identify trials investigating the impact of a mobile app intervention on a health behavior in adults. Articles were identified through MEDLINE, Embase, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, and CENTRAL registry of controlled trials. References of the included articles were screened for additional relevant publications.The behavior change techniques used in each app were classified using the Abraham and Michie taxonomy. Each study was further defined as “successful” or “non-successful” according to whether there was a statistically significant impact on the health behavior of interest.
Results:The literature search identified a total of 1521 articles. After full-text review, a total of 81 articles describing 81 apps targeting 31 different aspects of health were identified. Of those, 50 (62%) reported no impact of the app on the health behavior of interest, while 31 (38%)reported statistically significant effects. Of these, 29 (93%) studies reported using behavior change techniques compared to 41 (82%) of the non successful studies (p=0.049).The behavior change techniques more often applied in successful compared to non-successful trials were tailored feedback (19 (61%) vs 3 (6%) studies, p<0.001), and goal-setting (8 (22%) vs 4 (8%) studies, p=0.02). There were no differences in successful and non successful studies in the use of self-monitoring (18 (58%) vs 38 (76%) studies, p=0.09), gamification (6 (19%) vs 6 (12%) studies, p=0.11) and social comparison (3 (10%) vs 6 (12%) studies p=0.76). Only 5 studies specifically targeted surgical patients.
Conclusions: Most healthcare applications are not successful in modifying patient behavior, and this review provides insights into the properties of health care apps that were successful. Providing personalized and specific feedback was the most frequently employed behavior change technique in successful trials. With an increasing number of apps targeting surgical patients, this information should inform evidence based app development.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88316
Program Number: P485
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster