Electronic health apps: exploring the evidence

Spectrum’s Transform Research Alliance publishes Rapid Reviews on diverse topics. This month, we’re taking a look at the evidence analysing e-Health interventions for Physical Health.

October’s Rapid Review outlines a variety of different e-health interventions for physical health indicators (obesity, diet and smoking status) and analyses their effectiveness. Using data collected from 70 articles across a total of 394 research papers, we found that:

e-Health for weight loss

  • Although a majority of the e-Health studies reported the intervention group losing more weight than the control group, this finding was not universal. Smartphone-enabled mobile apps appeared to be more effective than PDA-enabled or armband apps
  • e-Health interventions around obesity mainly targeted lifestyle behaviours related to diet, physical activity, and sedentary behaviour
  • 80% of the studies demonstrated decreased calorie intake and almost all recorded increased levels of exercise
  • However, in young people, use of an electronic app did not result in any significance changes in body mass index (BMI) or waist circumference

The studies reviewed point to a growing body of evidence regarding the positive impact of particular app features. These features include: sending encouraging messages between friends, sharing progress, and posting leader board scores related to nutrition and physical activity.

e-Health for smoking cessation

The effectiveness of e-Health interventions in supporting smoking cessation was less evident than for weight loss and dietary change. Key findings from a review of 158 articles identified only six electronic apps which were supported by a strong evidence base – and only three of these are currently available to consumers. Presently, it would be difficult for consumers to find and use these applications for smoking support and they are likely to remain underutilised.

Summary and Key Recommendations

The current evidence base is still emerging for the effectiveness of e-Health interventions. The key recommendations to inform service provision are as follows:

Do:

  • Signpost to apps that are underpinned by an evidence-based behaviour change theory with goal setting functions, information regarding health consequences, facilities for both self-monitoring of behaviour and social support
  • Be aware that effectiveness is only demonstrated in the short-term, therefore ongoing motivational support may be required
  • Be aware that whilst acceptability is generally high, many have not been evaluated for clinical effectiveness
  • Ensure that in recommending use to young people that apps with peer or parental support to address obesity, are those with the most robust evidence base.

Do Not:

  • Offer instead of social support to young people
  • Exclude children and teenagers from e-health interventions
  • Recommend commercial apps that are not underpinned by the evidence base.