Effectiveness of Mobile Health Application Use to Improve Health Behavior Changes: A Systematic Review of Randomized Controlled Trials

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Abstract

Objectives

The purpose of this study was to examine the effectiveness of mobile health applications in changing health-related behaviors and clinical health outcomes.

Methods

A systematic review was conducted in this study. We conducted a comprehensive bibliographic search of articles on health behavior changes related to the use of mobile health applications in peer-reviewed journals published between January 1, 2000 and May 31, 2017. We used databases including CHINAHL, Ovid-Medline, EMBASE, and PubMed. The risk of bias assessment of the retrieved articles was examined using the Scottish Intercollegiate Guidelines Network.

Results

A total of 20 articles met the inclusion criteria. Sixteen among 20 studies reported that applications have a positive impact on the targeted health behaviors or clinical health outcomes. In addition, most of the studies, which examined the satisfaction of participants, showed health app users have a statistically significant higher satisfaction.

Conclusions

Despite the high risk of bias, such as selection, performance, and detection, this systematic review found that the use of mobile health applications has a positive impact on health-related behaviors and clinical health outcomes. Application users were more satisfied with using mobile health applications to manage their health in comparison to users of conventional care.

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Most cited references 20

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Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews

Spyros Kitsiou, Guy Paré, Mirou Jaana … (2017)

Background Diabetes is a common chronic disease that places an unprecedented strain on health care systems worldwide. Mobile health technologies such as smartphones, mobile applications, and wearable devices, known as mHealth, offer significant and innovative opportunities for improving patient to provider communication and self-management of diabetes. Objective The purpose of this overview is to critically appraise and consolidate evidence from multiple systematic reviews on the effectiveness of mHealth interventions for patients with diabetes to inform policy makers, practitioners, and researchers. Methods A comprehensive search on multiple databases was performed to identify relevant systematic reviews published between January 1996 and December 2015. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using AMSTAR. Results Fifteen systematic reviews published between 2008 and 2014 were eligible for inclusion. The quality of the reviews varied considerably and most of them had important methodological limitations. Focusing on systematic reviews that offered the most direct evidence, this overview demonstrates that on average, mHealth interventions improve glycemic control (HbA1c) compared to standard care or other non-mHealth approaches by as much as 0.8% for patients with type 2 diabetes and 0.3% for patients with type 1 diabetes, at least in the short-term (≤12 months). However, limitations in the overall quality of evidence suggest that further research will likely have an important impact in these estimates of effect. Conclusions Findings are consistent with clinically relevant improvements, particularly with respect to patients with type 2 diabetes. Similar to home telemonitoring, mHealth interventions represent a promising approach for self-management of diabetes.

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A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms.

C. Taylor, Josef Ruzek, Donn W. Garvert … (2017)

Posttraumatic stress disorder (PTSD) is highly prevalent in the population, but relatively few affected individuals receive treatment for it. Smartphone applications (apps) could help address this unmet need by offering sound psychoeducational information and evidence-based cognitive behavioral coping tools. We conducted a randomized controlled trial to assess the efficacy of a free, publicly available smartphone app (PTSD Coach) for self-management of PTSD symptoms.

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Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial

Joseph Tighe, Fiona Shand, Rebecca Ridani … (2017)

Objectives Rates of youth suicide in Australian Indigenous communities are 4 times the national youth average and demand innovative interventions. Historical and persistent disadvantage is coupled with multiple barriers to help seeking. Mobile phone applications offer the opportunity to deliver therapeutic interventions directly to individuals in remote communities. The pilot study aimed to evaluate the effectiveness of a self-help mobile app (ibobbly) targeting suicidal ideation, depression, psychological distress and impulsivity among Indigenous youth in remote Australia. Setting Remote and very remote communities in the Kimberley region of North Western Australia. Participants Indigenous Australians aged 18–35 years. Interventions 61 participants were recruited and randomised to receive either an app (ibobbly) which delivered acceptance-based therapy over 6 weeks or were waitlisted for 6 weeks and then received the app for the following 6 weeks. Primary and secondary outcome measures The primary outcome was the Depressive Symptom Inventory—Suicidality Subscale (DSI-SS) to identify the frequency and intensity of suicidal ideation in the previous weeks. Secondary outcomes were the Patient Health Questionnaire 9 (PHQ-9), The Kessler Psychological Distress Scale (K10) and the Barratt Impulsivity Scale (BIS-11). Results Although preintervention and postintervention changes on the (DSI-SS) were significant in the ibobbly arm (t=2.40; df=58.1; p=0.0195), these differences were not significant compared with the waitlist arm (t=1.05; df=57.8; p=0.2962). However, participants in the ibobbly group showed substantial and statistically significant reductions in PHQ-9 and K10 scores compared with waitlist. No differences were observed in impulsivity. Waitlist participants improved after 6 weeks of app use. Conclusions Apps for suicide prevention reduce distress and depression but do not show significant reductions on suicide ideation or impulsivity. A feasible and acceptable means of lowering symptoms for mental health disorders in remote communities is via appropriately designed self-help apps. Trial registration number ACTRN12613000104752.

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Author and article information

Journal

Journal ID (nlm-ta): Healthc Inform Res

Journal ID (iso-abbrev): Healthc Inform Res

Journal ID (publisher-id): HIR

Title: Healthcare Informatics Research

Publisher: Korean Society of Medical Informatics

ISSN (Print): 2093-3681

ISSN (Electronic): 2093-369X

Publication date (Print): July 2018

Publication date (Electronic): 31 July 2018

Volume: 24

Issue: 3

Pages: 207-226

Affiliations

[1 ]School of Nursing, University of Maryland, Baltimore, MD, USA.

[2 ]College of Nursing, Research Institute of Nursing Science, Kyungpook National University, Daegu, Korea.

Author notes

Corresponding Author: Eunjoo Lee, PhD, RN. Department of Nursing, College of Nursing, Research Institute of Nursing Science, Kyungpook National University, 680, Gukchaebosang-ro, Jung-gu, Daegu 41944, Korea. Tel: +82-53-420-4934, jewelee@ 123456knu.ac.kr

Article

DOI: 10.4258/hir.2018.24.3.207

PMC ID: 6085201

PubMed ID: 30109154

SO-VID: 9d78dd9f-cbb6-4570-bb71-5a6a35013815

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 15 March 2018

Date revision received : 07 May 2018

Date accepted : 30 May 2018

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Effectiveness of Mobile Health Application Use to Improve Health Behavior Changes: A Systematic Review of Randomized Controlled Trials

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Most cited references 20

Effectiveness of mHealth interventions for patients with diabetes: An overview of systematic reviews

A randomized controlled trial of a smartphone app for posttraumatic stress disorder symptoms.

Ibobbly mobile health intervention for suicide prevention in Australian Indigenous youth: a pilot randomised controlled trial

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