JMIR Publications

ABSTRACT

Background:

Cardiovascular disease and type 2 diabetes mellitus are 2 of the most prevalent chronic conditions worldwide. An unhealthy lifestyle greatly contributes to someone’s risk of developing the conditions. Mobile health is an emerging technology that can help deliver health promotion interventions to the population, for example, in the form of health apps.

Objective:

To test the feasibility of an app-based intervention for cardiovascular and diabetes risk awareness and prevention by measuring non-usage, drop-out, adherence to app use, and usability of the app over 3 months.

Methods:

Participants were eligible if they were aged 45 years or older, resided in Australia, were free of cardiovascular disease and diabetes, were fluent in English, and owned a smartphone. In the beginning, participants received an email with instructions on how to install the app and a user guide. After 3 months, they received an email with an invitation to an end-of-study survey. The survey included questions about general smartphone use and the user version of the Mobile Application Rating Scale. We analyzed app-generated and survey data using descriptive and inferential statistics as well as thematic analysis for open-text comments.

Results:

Recruitment took place between September and October 2021. Of the 46 participants who consented to the study, 20 participants never used the app (44%) and 15 participants dropped out (33%). The median age of app users at baseline was 62 years (IQR 56‒67). Adherence to app use, that is, using the app at least once a week over 3 months, was 17% (8/46) of the total sample and 31% (8/26) of all app users. The mean app quality rating on the user version of the Mobile Application Rating Scale was 3.5 of 5 points (SD 0.6). The app scored highest for the information section and lowest for the engagement section of the scale.

Conclusions:

Non-usage and drop-out were too high and the adherence too low to consider the intervention in its current form feasible. Potential barriers we identified include the research team not actively engaging with participants early in the study to verify that all participants could install the app, that the intervention did not involve direct contact with healthcare professionals, and that the app did not have enough interactive interaction features.