mHealth apps targeted toward weight loss must leverage strong educational features to help frame patient attitudes regarding healthy eating to drive patient behavior change and motivation, according to a study published in the Journal of Medical Internet Research.

Many healthcare professionals recommend mHealth apps for their overweight or obese patient populations working to adopt healthier eating habits. Research has suggested that these apps are effective in driving patient behavior change and motivating patients. However, little information exists about the mechanisms by which diet and nutrition apps drive patient behavior change.

“Health apps have the potential to decrease some barriers to traditional prescriptions for behavior change, including expense, patient burden, and variable adherence,” a research team out of Brigham Young University said. “Specifically, how engaging, convenient, and easy to use the app is can be a mechanism for reducing barriers and increasing adherence. However, none of the leading weight loss apps have been evaluated in a clinical trial.”

The researchers issued surveys to 217 adult patients about their experiences with diet and nutrition mHealth apps, asking patients about their history using the apps. Questions included details about app engagement, likability, and patient-reported changes in dietary habits.

Ninety-six percent of respondents agreed or strongly agreed that using a diet or nutrition app helped drive positive behavior change and healthy eating habits, the survey revealed. Fifty-eight percent of patients said apps increased goal-setting. Over half of patients said that using a diet or nutrition app helped increase the frequency and consistency at which they ate healthier foods.

“The results of this study demonstrate that the use of diet/nutrition apps is associated with diet-related behavior change,” the investigators reported. “In addition, this study showed that behavior change theory was positively associated with actual behavior change related to the use of diet/nutrition apps.”

Patient engagement with and likability of the app, frequent app use, and app educational quality predicted more noticeable behavior change, the survey showed. These predictors helped drive the key indicators of patient behavior change, including a better knowledge of health improvement, stronger self-efficacy, and an overall better attitude toward one’s own health.

“Results from this study indicate that attitudes related to the importance of eating healthy and the subsequent behavioral intentions of doing so are mechanisms for behavior change when using diet- and nutrition-related apps,” the research team explained.

The team suggested that strong educational content on the app is a strong driver of patient behavior change. However, researchers cautioned against arbitrary educational content.

“Though general knowledge alone is often an insufficient change agent, this study demonstrates that knowledge specifically related to ways in which one can improve dietary behavior and the benefits of making such improvements are mechanisms for change when using diet- and nutrition-related apps,” the team pointed out.

Generally, mHealth app developers must ensure that educational content is put into real-life context. New information should pertain to how patients can improve their own health, ranging in topics from the importance of healthy eating to how patients can incorporate a healthier diet into their current lifestyles.

These findings did have some limitations, the researchers acknowledged. Researchers did not collect the full extent of participant data that they ideally wished for due to funding and other restrictions. For example, the researchers may have benefitted from collecting body mass index information about the patients to determine the clinical effectiveness of diet apps.

Additionally, the participant pool was limited to mostly white patients within a limited age range. The study also asked for patient-reported outcomes on behavior change, which may have had an implicit bias.

Those limitations notwithstanding, the researchers contended that their findings could help frame future mHealth app development.

“Moving forward, developers of diet/nutrition apps may consider design configurations that emphasize the provision of knowledge to shape attitudes and beliefs, followed by attempts to influence actual skill development in app users,” the researchers concluded. “Elements of gamification or other such paradigms may be useful to maintain user motivation and the desire to be persistent in making weight loss efforts.”