Tracking physical activity using smart phone apps: assessing the ability of a current app and systematically collecting patient recommendations for future development

J Murphy, T Uttamlal, K A Schmidtke, I Vlaev, D Taylor, M Ahmad, S Alsters, P Purkayastha, S Scholtz, R Ramezani, A R Ahmed, H Chahal, A Darzi, A I F Blakemore, J Murphy, T Uttamlal, K A Schmidtke, I Vlaev, D Taylor, M Ahmad, S Alsters, P Purkayastha, S Scholtz, R Ramezani, A R Ahmed, H Chahal, A Darzi, A I F Blakemore

Abstract

Background: Within the United Kingdom's National Health System (NHS), patients suffering from obesity may be provided with bariatric surgery. After receiving surgery many of these patients require further support to continue to lose more weight or to maintain a healthy weight. Remotely monitoring such patients' physical activity and other health-related variables could provide healthworkers with a more 'ecologically valid' picture of these patients' behaviours to then provide more personalised support. The current study assesses the feasibility of two smartphone apps to do so. In addition, the study looks at the barriers and facilitators patients experience to using these apps effectively.

Methods: Participants with a BMI > 35 kg/m2 being considered for and who had previously undergone bariatric surgery were recruited. Participants were asked to install two mobile phone apps. The 'Moves' app automatically tracked participants' physical activity and the 'WLCompanion' app prompted participants to set goals and input other health-related information. Then, to learn about participants' facilitators and barriers to using the apps, some participants were asked to complete a survey informed by the Theoretical Domains Framework. The data were analysed using regressions and descriptive statistics.

Results: Of the 494 participants originally enrolled, 274 participants data were included in the analyses about their activity pre- and/or post-bariatric surgery (ages 18-65, M = 44.02, SD ± 11.29). Further analyses were performed on those 36 participants whose activity was tracked both pre- and post-surgery. Participants' activity levels pre- and post-surgery did not differ. In addition, 54 participants' survey responses suggested that the main facilitator to their continued use of the Moves app was its automatic nature, and the main barrier was its battery drain.

Conclusions: The current study tracked physical activity in patients considered for and who had previously undergone bariatric surgery. The results should be interpreted with caution because of the small number of participants whose data meet the inclusion criteria and the barriers participants encountered to using the apps. Future studies should take note of the barriers to develop more user-friendly apps.

Trial registration: ClinicalTrials.gov- NCT01365416 on the 3rd of June 2011.

Keywords: Obesity; Physical activity monitoring; Smartphone app; Surgery.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1.
Fig. 1.
Flow of participants through the study
Fig. 2.
Fig. 2.
Daily average walking time from pre-surgery to >3-years post-surgery (Error bars = 1 Standard Error)

References

    1. UK and Ireland Prevalence and Trends. In: Public Health England Obesity Knowledge and Intelligence Team. . Accessed 6 Jan 2017.
    1. National Institute for Health and Care Excellence. Managing overweight and obesity in adults. In: . Accessed 26 July 2016.
    1. Avenell A, Robertson C, Skea Z, Jacobsen E, Boyers D, Cooper D, et al. Bariatric surgery, lifestyle interventions and orlistat for severe obesity: the REBALANCE mixed-methods systematic review and economic evaluation. Health Technol Assess. 2018;22(68):1–246. doi: 10.3310/hta22680.
    1. Karmali S, Brar B, Shi X, Sharma AM, de Gara C, Birch DW. Weight recidivism post-bariatric surgery: a systematic review. Obes Surg. 2013;23(11):1922–1933. doi: 10.1007/s11695-013-1070-4.
    1. Sjöström CD, Lissner L, Wedel H, Sjöström L. Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS intervention study. Obes Res. 1999;7(5):477–484. doi: 10.1002/j.1550-8528.1999.tb00436.x.
    1. Bond DS, Phelan S, Wolfe LG, Evans RK, Meador JG, Kellum JM, et al. Becoming physically active after bariatric surgery is associated with improved weight loss and health-related quality of life. Obes. 2009;17(1):78–83. doi: 10.1038/oby.2008.501.
    1. Jacobi D, Ciangura C, Couet C, Oppert JM. Physical activity and weight loss following bariatric surgery. Obes Rev. 2011;12(5):366–377. doi: 10.1111/j.1467-789X.2010.00731.x.
    1. Livhits M, Mercado C, Yermilov I, Parikh JA, Dutson E, Mehran A, et al. Exercise following bariatric surgery: systematic review. Obes Surg. 2011;20(5):657–665. doi: 10.1007/s11695-010-0096-0.
    1. Egberts K, Brown WA, Brennan L, O’Brien PE. Does exercise improve weight loss after bariatric surgery?: a systematic review. Obes Surg. 2012;22(2):335–341. doi: 10.1007/s11695-011-0544-5.
    1. Department of Health. Physical Activity Guidelines for Adults (19-64 Years). In: Accessed 26 July 2016.
    1. Bouchard C, Blair SN, Haskell W. Why study physical activity and health? In: Bouchard C, Blair SN, Haskell WL, editors. Physical activity and health. Champaign: Human Kinetics; 2007. pp. 4–19.
    1. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin JW, Smith BK, et al. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41:459–471. doi: 10.1249/MSS.0b013e3181949333.
    1. Herring LY, Stevinson C, Davies MJ, Biddle S, Sutton C, Bowrey D, et al. Changes in physical activity behaviour and physical function after bariatric surgery: a systematic review and meta-analysis. Obes Rev. 2016;17(3):250–261. doi: 10.1111/obr.12361.
    1. King WC, Hsu JY, Belle SH, Courcoulas AP, Eid GM, Flum DR, et al. Pre- to postoperative changes in physical activity: report from the longitudinal assessment of bariatric surgery-2 (LABS-2) Surg Obes Relat Dis. 2012;8:522–532. doi: 10.1016/j.soard.2011.07.018.
    1. O'Kane M, Parretti HM, Hughes CA, Sharma M, Woodcock S, Puplampu T, et al. Guidelines for the follow-up of patients undergoing bariatric surgery. Clin Obes. 2016;6(3):210–224. doi: 10.1111/cob.12145.
    1. Pew Research Centre. Smartphone Ownership Is Growing Rapidly Around the World, but Not Always Equally In: . Accessed 13 Aug 2019.
    1. Ross KM, Wing RR. Impact of newer self-monitoring technology and brief phone-based intervention on weight loss: a randomized pilot study. Obes. 2016;24(8):1653–1659. doi: 10.1002/oby.21536.
    1. Svetkey LP, Batch BC, Lin PH, Intille SS, Corsino L, Tyson CC, et al. Cell phone intervention for you (CITY): a randomized, controlled trial of behavioral weight loss intervention for young adults using mobile technology. Obes. 2015;23(11):2133–2141. doi: 10.1002/oby.21226.
    1. Godino JG, Merchant G, Norman GJ, Donohue MC, Marshall SJ, Fowler JH, et al. Using social and mobile tools for weight loss in overweight and obese young adults (project SMART): a 2 year, parallel-group, randomised, controlled trial. Lancet Diabetes Endocrinol. 2016;4(9):747–755. doi: 10.1016/S2213-8587(16)30105-X.
    1. Althoff T, Sosič R, Hicks JL, King AC, Delp SL, Leskovec J. Large-scale physical activity data reveal worldwide activity inequality. Send Nat. 2017;547(7663):336–339. doi: 10.1038/nature23018.
    1. Hood MM, Corsica J, Bradley L, Wilson R, Chirinos DA, Vivo A. Managing severe obesity: understanding and improving treatment adherence in bariatric surgery. J Behav Med. 2016;39(6):1092–1103. doi: 10.1007/s10865-016-9772-4.
    1. Jennings N, Boyle M, Mahawar K, Balupuri S, Small P. The relationship of distance from the surgical centre on attendance and weight loss after laparoscopic gastric bypass surgery in the United Kingdom. Clin Obes. 2013;3(6):180–184. doi: 10.1111/cob.12031.
    1. Bond DS, Thomas JG, Ryder BA, Vithiananthan S, Pohl D, Wing RR. Ecological momentary assessment of the relationship between intention and physical activity behavior in bariatric surgery patients. Int J Behav Med. 2013;20(1):82–87. doi: 10.1007/s12529-011-9214-1.
    1. Thomas JG, Bond DS, Ryder BA, Leahey TM, Vithiananthan S, Roye GD, et al. Ecological momentary assessment of recommended postoperative eating and activity behaviors. Surg Obes Relat Dis. 2011;7(2):206–212. doi: 10.1016/j.soard.2010.10.007.
    1. Mundi MS, Lorentz PA, Grothe K, Kellogg TA, Collazo-Clavell ML. Feasibility of smartphone-based education modules and ecological momentary assessment/intervention in pre-bariatric surgery patients. Obes Surg. 2015;25(10):1875–1881. doi: 10.1007/s11695-015-1617-7.
    1. Birkhoff SD, Smeltzer SC. Perceptions of smartphone user-centered mobile health tracking apps across various chronic illness populations: an integrative review. J Nurs Scholarsh. 2001;49(4):371–378. doi: 10.1111/jnu.12298.
    1. Thomas JG, Bond DS, Sarwer DB, Wing RR. Technology for behavioral assessment and intervention in bariatric surgery. Surg Obes Relat Dis. 2011;7(4):548–557. doi: 10.1016/j.soard.2011.02.009.
    1. Bradley LE, Thomas JG, Hood MM, Corsica JA, Kelly MC, Sarwer DB. Remote assessments and behavioral interventions in post-bariatric surgery patients. Surg Obes Relat Dis. 2018;14(10):1632–1644. doi: 10.1016/j.soard.2018.07.011.
    1. Bondaronek P, Alkhaldi G, Slee A, Hamilton FL, Murray E. Quality of publicly available physical activity apps: review and content analysis. JMIR Mhealth Uhealth. 2018;6(3):e53. doi: 10.2196/mhealth.9069.
    1. Penedo FJ, Dahn JR. Exercise and well-being: a review of mental and physical health benefits associated with physical activity. Curr Opin Psychol. 2005;18(2):189–193. doi: 10.1097/00001504-200503000-00013.
    1. Fox KR. The influence of physical activity on mental well-being. Pub Heal Nutri. 1999;2(3a):411–418. doi: 10.1017/S1368980099000567.
    1. Atkinson G, Davenne D. Relationships between sleep, physical activity and human health. Physiol Behav. 2007;90(2-3):229–235. doi: 10.1016/j.physbeh.2006.09.015.
    1. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behavior change and implementation research. Implement Sci. 2012;7(1):37. doi: 10.1186/1748-5908-7-37.
    1. Michie S, Atkins L, West R. The behaviour change wheel. A guide to designing interventions. 1st ed. Great Britain: Silverback Publishing; 2014.
    1. Phillips CJ, Marshall AP, Chaves NJ, Jankelowitz SK, Lin IB, Loy CT, et al. Experiences of using the theoretical domains framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc. 2015;18(8):139–146.
    1. Bond DS, Jakicic JM, Unick JL, Vithiananthan S, Pohl D, Roye GD, et al. Pre- to postoperative physical activity changes in bariatric surgery patients: self-report vs. objective measures. Obes. 2010;18:2395–2397. doi: 10.1038/oby.2010.88.
    1. Norman D. The design of everyday things. New York: Basic Books; 2013.
    1. Helfer SG, Elhai JD, Geers AL. Affect and exercise: positive affective expectations can increase post-exercise mood and exercise intentions. Ann Behav Med. 2015;49:269–279. doi: 10.1007/s12160-014-9656-1.
    1. Orr K, Howe HS, Omran J, Smith KA, Palmateer TM, Ma AE, et al. Validity of smartphone pedometer applications. BMC Res Notes. 2015;8(1):733. doi: 10.1186/s13104-015-1705-8.
    1. Gould JC, Beverstein G, Reinhardt S, Garren MJ, et al. Surg Obes Relat Dis. 2007;3(6):627–630. doi: 10.1016/j.soard.2007.07.005.
    1. Toussi R, Fujioka K, Coleman KJ. Pre-and postsurgery behavioral compliance, patient health, and postbariatric surgical weight loss. Obes. 2009;17(5):996–1002. doi: 10.1038/oby.2008.628.
    1. Laing BY, Mangione CM, Tseng CH, Leng M, Vaisberg E, Mahida M, et al. Effectiveness of a smartphone application for weight loss compared with usual care in overweight primary care patients: a randomized, controlled trial. Ann Intern Med. 2014;161(10_Supplement):S5–12. doi: 10.7326/M13-3005.
    1. Mateo GF, Granado-Font E, Ferré-Grau C, Montaña-Carreras X. Mobile phone apps to promote weight loss and increase physical activity: a systematic review and meta-analysis. J Med Internet Res. 2015;17(11):e253. doi: 10.2196/jmir.4836.
    1. Wang JB, Cadmus-Bertram LA, Natarajan L, White MM, Madanat H, Nichols JF, et al. Wearable sensor/device (Fitbit one) and SMS text-messaging prompts to increase physical activity in overweight and obese adults: a randomized controlled trial. Telemed E Health. 2015;21(10):782–792. doi: 10.1089/tmj.2014.0176.
    1. Zhang T, Klein DA, Walsh T, Lu J, Sazonov ES. Android TWEETY—A wireless activity monitoring and biofeedback system designed for people with anorexia nervosa. In: 2014 IEEE international symposium on medical measurements and applications (MeMeA): IEEE. p. 1–5.

Source: PubMed

3
Se inscrever