Use of a mobile health application in wellness : an assessment of needs, perceptions, usability and efficacy in changing dietary choices in a university student population

Date
2019-12
Journal Title
Journal ISSN
Volume Title
Publisher
Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: Introduction: It is essential to promote wellness in order to improve the health of the population and reduce the cost of healthcare. This study aimed to explore the use of mobile health (mHealth) applications (apps) as dietary self-monitoring tools for wellness purposes, as well as their possible role in the improvement of food choices. One specific app, MyFitnessPal, is explored in greater depth. Methods: This descriptive, cross-sectional study consisted of two phases, each entailing a corresponding self-administered electronic survey. Undergraduate students (aged 18 to 25 years) served as the sample population. The Phase 1 survey aimed to assess the need for and perceptions of mobile health applications to serve as dietary assessment tools for wellness purposes, and to analyse mobile health app use and various demographic characteristics. The Phase 2 survey was conducted after a three-week period of using MyFitnessPal and aimed to assess the usability of this mobile health app, as well as its perceived efficacy in changing dietary choices. Data was analysed using Stata SE version 15.1. Descriptive statistics were used to describe participant demographic variables. Dietary Instrument for Nutrition Education (DINE) scores were compared using a paired t-test. Mean change in scores was calculated with a 95% confidence interval. Results: The first phase survey was completed by 991 students. The majority of participants indicated that they wanted to improve their diet in order to be healthier and to improve their weight, and that they actively searched for information on how to accomplish this. More than three-quarters (79.31%, n=786) of the participants indicated that they were aware of mobile health apps that allow for diet tracking, with less than half of these (42.79%, n=423) having made use of any such app. MyFitnessPal was the most popular diet-tracking app that participants had used previously (67.45%, n=286). The second phase survey was completed by 61 students. MyFitnessPal was found to be relatively easy to use, with some issues experienced in selecting the right food item from the database, and ensuring the correct portion sizes. Users reported that MyFitnessPal helped them to change their dietary intake and advance towards their personal weight and health goals. Dietary data reflects a significant reduction in high-sugar food intake after the use of MyFitnessPal (p=0.030). No change was found in the intake of high-fat foods (p=0.910) or fruit and vegetables (p=0.980). Conclusion: Findings demonstrate that a need for diet-tracking health apps exists and that users find them effective in changing their dietary choices. These apps are widely used, perceived as helpful tools by users, and may play a contributing role by increasing individuals’ awareness of their eating habits together with providing information on how to optimise food choices. Despite their popularity, there are concerns about the quality and evidence base of the information provided by popular health apps. The use of these types of apps with the guidance of a trained nutrition professional may prove valuable in improving their efficacy.
AFRIKAANSE OPSOMMING: Inleiding: Welstandsbevordering is noodsaaklik ten einde die gesondheid van die bevolking te verbeter en die koste van gesondheidsorg te verminder. In hierdie studie is die gebruik van mobiele gesondheidstoepassings as dieet-selfmonitoringshulpmiddels vir welsynsdoeleindes, asook hul moontlike rol in die verbetering van voedselkeuses, ondersoek. Een spesifieke toepassing ("app"), MyFitnessPal, is in meer diepte ondersoek. Metodes: Hierdie beskrywende, deursnee-studie het uit twee fases bestaan, elk met 'n ooreenstemmende self-geadministreerde elektroniese opname. Voorgraadse studente (tussen 18 en 25 jaar oud) het as steekproefpopulasie gedien. Die fase 1-opname het ten doel gehad om die behoefte aan en persepsie van mobiele toepassings te evalueer om as dieet-assesseringsinstrumente vir welstanddoeleindes te dien, en om die gebruik van mobiele gesondheidstoepassings en verskeie demografiese eienskappe te analiseer. Die fase 2-opname is uitgevoer na drie weke van die gebruik van MyFitnessPal en was daarop gemik om die bruikbaarheid van hierdie mobiele gesondheidstoepassing, asook die waargenome doeltreffendheid daarvan in die verandering van dieetkeuse te evalueer. Data is geanaliseer met behulp van Stata SE weergawe 15.1. Beskrywende statistiek is gebruik om deelnemer-demografiese veranderlikes te beskryf. Dietary Instrument for Nutrition Education (DINE) tellings is vergelyk met 'n gepaarde t-toets. Mediaanverandering in tellings is bereken met 'n 95% vertrouensinterval. Resultate: Die eerstefase-opname is voltooi deur 991 studente. Die meerderheid van die deelnemers het aangedui dat hulle hul dieet wil verbeter om gesonder te wees en om hul gewig te verbeter, en dat hulle aktief gesoek het na inligting oor hoe om hierdie doelwitte te bereik. Meer as driekwart (79.31%, n=786) het aangedui dat hulle bewus was van mobiele toepassings wat dit moontlik maak om rekord te hou van dieetkeuses, met minder as die helfte van hierdie groep (42.79%, n=423) wat al ooit gebruik gemaak het van so tipe toepassing. MyFitnessPal was die gewildste dieetopname-toepassing wat deelnemers voorheen gebruik het (67,45%, n=286). Die tweedefase-opname is voltooi deur 61 studente. Daar is bevind dat MyFitnessPal relatief maklik is om te gebruik, met sommige probleme wat ervaar is om die regte voedselitem uit die databasis te kies en om die korrekte porsiegroottes te verseker. Gebruikers het berig dat MyFitnessPal hulle gehelp het om hul dieetinname te verander en vordering te maak te maak wat betref hul persoonlike gewigs- en gesondheidsdoelwitte. Dieetdata weerspieel 'n beduidende vermindering in suikerinname na die gebruik van MyFitnessPal (p=0,030). Geen verandering is gevind in die inname van vetterige kosse (p=0.910) of vrugte en groente (p=0.980) nie. Gevolgtrekking: Bevindinge toon dat 'n behoefte aan dieet-opname gesondheidstoepassings bestaan en dat gebruikers dit effektief vind in die verandering van hul dieetkeuses. Hierdie toepassings word algemeen gebruik, beskou as nuttige hulpmiddels deur gebruikers, en kan 'n bydraende rol speel deur individue se bewustheid van hul eetgewoontes te verhoog, tesame met die verskaffing van inligting oor hoe om hierdie bewustheid te optimaliseer. Ten spyte van hul gewildheid is daar kommer oor die gehalte en bewysebasis van die inligting wat deur populere gesondheidstoepassings verskaf word. Die doeltreffendheid van hierdie tipe toepassings kan verbeter word indien dit onder die leiding van 'n opgeleide voedingskundige gebruik word.
Description
Thesis (MNutr)--Stellenbosch University, 2019.
Keywords
Wireless communication systems in medical care, Health services administration, Health promotion, UCTD
Citation