Health, Fitness Apps for Consumers Show Limited User Engagement

The user engagement approaches of the popular “health and wellness” mobile apps in the Apple iTunes Store are limited, but present an opportunity to improve the effectiveness of the technology.


Americans are increasingly using mobile health applications to monitor their overall wellness, particularly diet and exercise apps. With literally tens of thousands of health and fitness apps now available in the marketplace for download on their smartphones and tablets, consumers in growing numbers are turning to these mHealth apps to manage their weight by tracking their caloric intake and physical activities--the most popular uses for these apps.

According to a recent report by mobile engagement vendor Mobiquity, 70 percent of people use health and fitness apps daily or several times a day. In addition, 63 percent plan to use these apps even more over the next five years. Likewise, a new study by researchers from Duke University School of Medicine found that the most popular mHealth apps in the “health and wellness” category of the Apple iTunes Store are focused on fitness and self-monitoring.

However, the Duke study published in the Journal of Medical Internet Research's mHealth and uHealth concluded that "the approaches to user engagement utilized by these applications are limited and present an opportunity to improve the effectiveness of the technology." Though mHealth apps have the potential for greater patient engagement, researchers found only two major methods of engagement in their sample population of apps. 

Self-monitoring was the most common method of engagement used in 299 apps out of 400 surveyed in the study, while a total of 83 apps out of 400 used two or more approaches, with self-monitoring and progress tracking being the most frequent combination. At the same time, the apps that deployed self-monitoring beyond fitness/exercising training were limited.

The authors of the study argue that it is unknown whether mHealth approaches to behavior change improve self-monitoring, engagement, or have greater influence on outcomes than traditional models of intervention. And, they assert that the lack of data from these apps that can be analyzed for scientific outcomes further limits opportunities to guide developers in refining their offerings for maximal impact and increased market share.

"Investments in scientific and developer communities together, and incentives to draw users into specific apps, could alter the dynamics of the market and have a significant impact on health outcomes," as well as "have profound application in the prevention of cardiovascular disease or in the treatment of patients with chronic disease such as diabetes and congestive heart failure," states the study. "Further work will be required to develop this technology to the point where it is most likely to have an impact on patient outcomes."