Did you know that 85% of Americans own a smartphone (12) and nearly 60% of smartphone owners use them for tracking health behaviors? (3) With widespread access to smartphones and the growing popularity of technologies used to support healthy behavioral change, the use of digital interventions such as mobile apps and wearable devices for encouraging behavior change has become a topic of interest in recent years. Research demonstrates how technologies such as computers, desktop apps, smartphones (mobile apps and SMS (mHealth)), the internet, email, wearable sensors, games, social media, and patient portals can provide techniques to influence behavioral change. (18)
How can you harness the power of these technologies to support your patients on their health journeys? Keep reading to learn more about how mobile apps and other technologies can promote positive behavioral change, and view a list of some of the most promising behavior change apps according to recent research.
Did you know? 60% of the global population has access to the internet, 92% of which connect to the internet through their mobile device. (15)
How can mobile health apps promote behavioral change?
Research highlights the potential benefits of using digital interventions such as mobile health apps for promoting behavioral change. According to a 2016 systematic review, digital interventions have been shown to improve multiple facets of health such as diet, physical activity, obesity, tobacco, and alcohol use. These benefits are primarily observed in the first six months; however, small positive effects may last for up to one year. (1)(24) Outlined below are some examples of how apps can promote behavioral change.
1. Diet and physical activity
Mobile apps, wearable devices, and other digital interventions are popular in the physical activity and nutrition space. (14)(18) For example, web-based interventions increased the average daily time spent engaging in moderate to vigorous physical activity by 13.4 minutes and steps by 2,185. (8) In older adults, moderate to vigorous physical activity was increased by 52 minutes per week and sedentary time was reduced by 58 minutes per day according to one study. (17) Research also demonstrates that digital interventions reduced sedentary time by approximately 32 to 41 minutes per day, though effects seem to diminish over time (greater than six months). (7)(16)
Mobile apps have demonstrated small effects on improving nutrition behaviors and nutrition-related health outcomes such as obesity measures, blood pressure, and blood lipids in adults. (21) Wearable devices have also shown effectiveness in improving physical activity levels. Individuals who own wearable technologies self-reported increased moderate physical activity, walking, and total physical activity per week compared to individuals who do not own wearable devices. (25)
Did you know? As of 2019, 21% of Americans reported using a wearable device such as a pedometer or fitness watch. (22)
The top four behavior change techniques most frequently used in mobile applications for improving healthy eating behaviors in adult populations included “feedback on behavior,” “instruction on how to perform the behavior,” “goal setting (behavior),” and “review of behavior goals.” (21) Other successful short-term behavioral change techniques for improving diet and physical activity include “social support (unspecified)” and “adding objects to the environment” (e.g., wearable trackers). (20)
2. Smoking cessation
Digital interventions have been shown to increase the odds of smoking cessation by 29% in the short term (less than six months) and 19% in the long term (greater than six months) in the general population. (10) According to one meta-analysis, technologies offering the greatest likelihood of success included strategies such as “problem solving,” “pros and cons,” “action planning,” “social support (unspecified),” “pharmacological support,” “goal setting (behavior),” and “information about health consequences.” (10)
3. Alcohol consumption
Digital interventions also have been shown to reduce alcohol consumption and improve drinking behaviors. In a meta-analysis of nine randomized controlled trials, adult drinking behaviors slightly reduced for six to nine months post intervention. (13) In college students, digital interventions may also reduce drinking quantities and frequencies as well as other alcohol-related problems with small effects for up to 13 weeks post intervention, but an effect might only be sustained for a reduced alcohol quantity after six months. (5)(6)
4. Treatment adherence
Treatment adherence is essential for achieving desired health outcomes, and research demonstrates that technology may help patients stay on track with their prescribed treatment plans. (2) Specifically, mobile apps or text messages have been shown to increase the likelihood of improving medication adherence and may increase absolute adherence, (4)(19) particularly if reminders are set as part of a schedule (as opposed to in response to a trigger that detects non-adherence over a given timeframe) and when patients can send text messages in reply to the reminder. (2)(23)
Best behavior change apps
There are various popular apps that help promote physical activity, track nutrition, promote mindfulness, and support smoking cessation or alcohol consumption reduction. A 2019 study analyzed a wide range of health apps using two scales: the App Behavior Change Scale (ABACUS), which measures the potential of the mobile phone app to encourage behavior change, and the Mobile App Rating Scale (MARS), which measures functionality.
Outlined below are some of the top-rated apps according to this study. (11)
- Quit Genius (App store, Google Play)
- Smoke Free (App store, Google Play)
- Daybreak (App store, Google Play)
- Drinks Meter (App store, Google Play)
Mindfulness and mental health apps
- HeadGear (App store, Google Play)
- Headspace: Guided Meditation (App store, Google Play)
- Simple Habit: Meditation (App store, Google Play)
- Unwinding Anxiety (App store, Google Play)
- Asana Rebel: Yoga and Fitness (App store, Google Play)
- CARROT Fit (App store)
- Fitbit (App store, Google Play)
- Garmin Connect (App store, Google Play)
- Home Workout – No Equipments (App store, Google Play)
- JEFIT Strength Training Guide (App store, Google Play)
- Map My Fitness by Under Armour (App store, Google Play)
- Map My Walk by Under Armour (App store, Google Play)
- Workout Trainer: fitness coach (App store, Google Play)
Nutrition and hydration
- Beyou – Health Coach & Recipes (App store)
- Lifesum: Food & Macro Tracker (App store, Google Play)
- Drink Water Aquarium (App store, Google Play)
- MyNetDiary PRO Calorie Counter (App store, Google Play)
- MyFitnessPal (App store, Google Play)
For a list of Fullscript practitioner-recommended health apps, visit the Fullscript blog.
The bottom line
Mobile apps and other technologies can be effective tools for promoting behavioral change. Engage your patients by encouraging them to try digital tools like the the behavior change apps discussed in this article to help them stay on track with their goals and to help them reach their desired health outcomes.
Fullscript simplifies supplement dispensingCreate your dispensary today I'm a patient
- Afshin, A., Babalola, D., Mclean, M., Yu, Z., Ma, W., Chen, C., Arabi, M., & Mozaffarian, D. (2016). Information technology and lifestyle: A systematic evaluation of internet and mobile interventions for improving diet, physical activity, obesity, tobacco, and alcohol use. Journal of the American Heart Association, 5(9), e003058.
- Amankwaa, I., Boateng, D., Quansah, D. Y., Akuoko, C. P., & Evans, C. (2018). Effectiveness of short message services and voice call interventions for antiretroviral therapy adherence and other outcomes: A systematic review and meta-analysis. PLOS ONE, 13(9), e0204091.
- Arigo, D., Jake-Schoffman, D. E., Wolin, K., Beckjord, E., Hekler, E. B., & Pagoto, S. L. (2019). The history and future of digital health in the field of behavioral medicine. Journal of Behavioral Medicine, 42(1), 67–83.
- Armitage, L. C., Kassavou, A., & Sutton, S. (2020). Do mobile device apps designed to support medication adherence demonstrate efficacy? A systematic review of randomised controlled trials, with meta-analysis. BMJ Open, 10(1), e032045.
- Carey, K. B., Scott-Sheldon, L. A., Elliott, J. C., Bolles, J. R., & Carey, M. P. (2009). Computer-delivered interventions to reduce college student drinking: a meta-analysis. Addiction (Abingdon, England), 104(11), 1807–1819.
- Carey, K. B., Scott-Sheldon, L. A., Elliott, J. C., Garey, L., & Carey, M. P. (2012). Face-to-face versus computer-delivered alcohol interventions for college drinkers: A meta-analytic review, 1998 to 2010. Clinical Psychology Review, 32(8), 690–703.
- Curran, F., Blake, C., Cunningham, C., Perrotta, C., van der Ploeg, H., Matthews, J., & O’Donoghue, G. (2021). Efficacy, characteristics, behavioural models and behaviour change strategies, of non-workplace interventions specifically targeting sedentary behaviour; a systematic review and meta-analysis of randomised control trials in healthy ambulatory adults. PLOS ONE, 16(9), e0256828.
- Jahangiry, L., Farhangi, M. A., Shab-Bidar, S., Rezaei, F., & Pashaei, T. (2017). Web-based physical activity interventions: A systematic review and meta-analysis of randomized controlled trials. Public Health, 152, 36–46.
- Li, R., Liang, N., Bu, F., & Hesketh, T. (2020). The effectiveness of Self-Management of hypertension in adults using mobile health: Systematic review and Meta-Analysis. JMIR mHealth and uHealth, 8(3), e17776.
- McCrabb, S., Baker, A. L., Attia, J., Skelton, E., Twyman, L., Palazzi, K., McCarter, K., Ku, D., & Bonevski, B. (2018). Internet-Based programs incorporating behavior change techniques are associated with increased smoking cessation in the general population: A systematic review and meta-analysis. Annals of Behavioral Medicine, 53(2), 180–195.
- McKay, F. H., Wright, A., Shill, J., Stephens, H., & Uccellini, M. (2019). Using health and Well-Being apps for behavior change: A systematic search and rating of apps. JMIR mHealth and uHealth, 7(7), e11926.
- Pew Research Center. (2021). Mobile fact sheet. Pew Research Center: Internet, Science & Tech. https://www.pewresearch.org/internet/fact-sheet/mobile/
- Riper, H., Spek, V., Boon, B., Conijn, B., Kramer, J., Martin-Abello, K., & Smit, F. (2011). Effectiveness of E-Self-help interventions for curbing adult problem drinking: A meta-analysis. Journal of Medical Internet Research, 13(2), e42.
- Schoeppe, S., Alley, S., van Lippevelde, W., Bray, N. A., Williams, S. L., Duncan, M. J., & Vandelanotte, C. (2016). Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: A systematic review. International Journal of Behavioral Nutrition and Physical Activity, 13(1), 127.
- Statista. (2022). Worldwide digital population April 2022. https://www.statista.com/statistics/617136/digital-population-worldwide/
- Stephenson, A., McDonough, S. M., Murphy, M. H., Nugent, C. D., & Mair, J. L. (2017). Using computer, mobile and wearable technology enhanced interventions to reduce sedentary behaviour: A systematic review and meta-analysis. International Journal of Behavioral Nutrition and Physical Activity, 14(1), 105.
- Stockwell, S., Schofield, P., Fisher, A., Firth, J., Jackson, S. E., Stubbs, B., & Smith, L. (2019). Digital behavior change interventions to promote physical activity and/or reduce sedentary behavior in older adults: A systematic review and meta-analysis. Experimental Gerontology, 120, 68–87.
- Taj, F., Klein, M. C. A., & van Halteren, A. (2019). Digital health behavior change technology: Bibliometric and scoping review of two decades of research. JMIR mHealth and uHealth, 7(12), e13311.
- Thakkar, J., Kurup, R., Laba, T. L., Santo, K., Thiagalingam, A., Rodgers, A., Woodward, M., Redfern, J., & Chow, C. K. (2016). Mobile telephone text messaging for medication adherence in chronic disease. JAMA Internal Medicine, 176(3), 340.
- van Rhoon, L., Byrne, M., Morrissey, E., Murphy, J., & McSharry, J. (2020). A systematic review of the behaviour change techniques and digital features in technology-driven type 2 diabetes prevention interventions. Digital Health, 6, 205520762091442.
- Villinger, K., Wahl, D. R., Boeing, H., Schupp, H. T., & Renner, B. (2019). The effectiveness of app‐based mobile interventions on nutrition behaviours and nutrition-related health outcomes: A systematic review and meta‐analysis. Obesity Reviews, 20(10), 1465–1484.
- Vogels, E. A. (2020). About one-in-five Americans use a smart watch or fitness tracker. Pew Research Center. https://www.pewresearch.org/fact-tank/2020/01/09/about-one-in-five-americans-use-a-smart-watch-or-fitness-tracker/
- Wald, D. S., Butt, S., & Bestwick, J. P. (2015). One-way versus two-way text messaging on improving medication adherence: Meta-analysis of randomized trials. The American Journal of Medicine, 128(10), 1139.e1-1139.e5.
- Webb, T. L., Joseph, J., Yardley, L., & Michie, S. (2010). Using the internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. Journal of Medical Internet Research, 12(1), e4.
- Yen, H. Y., & Huang, H. Y. (2021). Comparisons of physical activity and sedentary behavior between owners and non-owners of commercial wearable devices. Perspectives in Public Health, 141(2), 89–96.