JMIR Publications

ABSTRACT

Background:

The increasing prevalence of smartphone applications to help people find different services raises the question of whether apps to help people find physical activity (PA) locations would help better prevent and control overweight/obesity.

Objective:

To determine and quantify the potential impact of a digital health intervention for African American women prior to allocating financial resources towards implementation.

Methods:

We further developed our Virtual Population Obesity Prevention (VPOP) agent-based model of Washington, D.C to simulate the impact of a place-tailored digital health app that provides information about free recreation center classes on PA, BMI and overweight and obesity prevalence among African American women.

Results:

When the app is introduced at the beginning of the simulation, there are 2.43% (95% CI: -4.24% - 9.1%) to 0.05% (95% CI: -8.68%, 8.77%) more women exercising over the 5 years as well as 2.9 (95% CI: -1.4- 17.9) to 7.4 (95% CI: -6.5, 21.4) additional minutes/week of PA at recreation center classes (10%-75% baseline exercise probability). This resulted in average BMI dropping 0.09 (95% CI: -0.56, 0.39) to 0.14 (95% CI: -0.74, -0.46) kg/m2 and obesity prevalence by 0.43% (95% CI: -2.7 - 2.93%) to 0.75% (95% CI: -4.3%–5.8%). When increasing the proportion of women who were aware of the app, downloaded it, and opted into push notifications to 75% weekly PA at recreation center classes increased by 10.7 minutes/week (95% CI: 4.2, 17.2 minutes) and obesity prevalence dropped by an absolute 4.09% (95% CI: 1.2%-7.0%) with 25% baseline probability to exercise. When baseline exercise probability was 25%, Ward Six had the highest percent of women who exercised (72% [71.9%, 72.1%]) and obesity prevalence dropped by as much as 2.6% (95% CI: -2.9%, -2.3%) in Ward Six.

Conclusions:

Simulating the uptake of a digital health app that helps identify recreation center classes indicates the app, if sufficiently downloaded and used (e.g., 75% of population aware, downloading and using the app) has the potential to moderately reduce obesity prevalence over five years. As the app cannot fully overcome lack of access to recreation centers, public health administrators and parks and recreation agencies might consider incorporating this type of technology into multi-level interventions that also target the built environment and other social determinants of health.