JMIR Publications

ABSTRACT

Background:

Behavioral change interventions using smartphone applications (apps) have rapidly increased worldwide to prevent non-communicable diseases. However, most previous studies on the use and effectiveness of apps have been conducted in the OECD countries, and rarely in the developing countries.

Objective:

This study aimed to compare adherence to use and effects of using the app (NOOM) between users in the developing and OECD countries. We also compared weight changes over time and weight loss of users of paid and free versions of the app.

Methods:

A secondary data analysis was conducted with repeated measures. The data were collected from users in the developing countries (N=312) and OECD countries (N=8041) who used the app for 12 months. The app provided programs for self-monitoring of physical activity, dietary intake, and body weight. Descriptive statistics, independent T-tests, chi-square tests, and linear mixed models were used for analysis.

Results:

Body weight of all users significantly decreased over time (-1.79kg, P<.001); however, no statistically significant differences in the change of body weight for 12 months were observed between users from the developing and OECD countries (β= -.16, P=.189). The users who frequently monitored their lunch (β= -0.1, P<.001), dinner (β= -0.1, P<.001), body weight (β= -0.1, P<.001), evening snack (β= -0.1, P<.001), and exercise (β= -0.03, P<.001) showed a significant weight loss over time. There were no significant differences in body weight changes between users who used free and paid versions of app.

Conclusions:

We found that the users who entered more data into the app lost more body weight. However, there were no differences in weight change between users in the developing and OECD countries. Similarly, no differences in body weight changes between users of paid and free versions of the app were observed.