Herrmann Lynn Katherine, Kim Jinsook
School of Health Studies, Northern Illinois University, DeKalb, IL, USA.
Mhealth. 2017 Jan 30;3:2. doi: 10.21037/mhealth.2017.01.03. eCollection 2017.
There are thousands of fitness-related smartphone applications ("apps") available for free and purchase, but there is uncertainty if these apps help individuals achieve and maintain personal fitness. Technology usage attrition is also a concern among research studies on health technologies.
Usage of three fitness apps was examined over 5 months to assess adherence and effectiveness. Initially, 64 participants downloaded three free apps available on Android and iOS and 47 remained in the study until posttest. With a one group pre-posttest design and checkpoints at months 1, 3, and 5, exercise and exercise with fitness apps were examined in the framework of the Theory of Planned Behavior (TPB) using a validated survey. Apps were selected based on their function from the Functional Triad. Perceived fitness was also measured. -tests, sign tests, Fisher's exact tests, and linear and logistic regression were used to compare pre to posttests and users to non-users of the apps.
Forty-seven participants completed both pre and posttests. Individual item scores indicated no significant change pre to posttest except for decreases observed in usefulness of using apps for exercise (attitude) (-0.78, P<0.01), peer influence on exercise (subjective norm) (-0.51, P<0.05), peer influence on exercise with apps (subjective norm) (-1.02, P<0.01), perceived difficulties in exercising with apps (perceived behavioral control) (-1.29, P<0.001), and the expected frequency of exercise with apps over the next 2 weeks (behavioral intention) (P<0.0001 in a sign test). Subscale total scores indicated significant decreases in subjective norm regarding exercise (-0.72, P<0.05), subjective norm regarding exercise with apps (-1.72, P<0.01), and perceived behavioral control over exercising with apps (-2.56, P<0.01) between pre and posttest. When comparing app users (n=32) to non-users (n=15), there was only a significant difference in subscale total scores at posttest for attitude toward exercising using apps, which was significantly more favorable among users than non-users (32.3 . 27.6, P<0.05). Fitness perception did not change over 5 months regarding cardiovascular fitness, strength, endurance, flexibility, or body composition. Technology usage attrition was desirable at 31.9%.
App usage and effectiveness appears to have a connection to usefulness (attitude) and to perceived difficulties of exercising using apps (perceived behavioral control). Exercise and exercise using apps are not influenced by peer influence (subjective norm). Intention to exercise using these particular apps decreased (behavioral intention). Those who utilized the apps were more likely to have a positive attitude about the apps. Usefulness and perceived difficulties in particular should be considered with future app development. App usefulness and ease of use may be facilitated by using health behavior theories to guide development.
有成千上万款与健身相关的智能手机应用程序（“应用”）可供免费下载和付费购买，但这些应用是否能帮助个人实现并保持身体健康尚不确定。在关于健康技术的研究中，技术使用损耗也是一个令人担忧的问题。
对三款健身应用的使用情况进行了为期5个月的调查，以评估其依从性和有效性。最初，64名参与者下载了安卓和iOS系统上的三款免费应用，47人留在研究中直至进行后测。采用单组前后测设计，并在第1、3和5个月设置检查点，使用经过验证的调查问卷，在计划行为理论（TPB）的框架内对使用健身应用的锻炼和锻炼情况进行了调查。根据功能三元组中的功能选择应用。还测量了感知到的健康状况。使用t检验、符号检验、费舍尔精确检验以及线性和逻辑回归来比较前后测结果以及应用使用者和非使用者。
47名参与者完成了前后测。单项得分显示，除了使用应用进行锻炼的有用性（态度）下降（-0.78，P<0.01）、同伴对锻炼的影响（主观规范）下降（-0.51，P<0.05）、同伴对使用应用锻炼的影响（主观规范）下降（-1.02，P<0.01）、使用应用锻炼时感知到的困难（感知行为控制）下降（-1.29，P<0.001）以及未来两周内使用应用锻炼的预期频率（行为意图）下降（符号检验中P<0.0001）外，前后测之间没有显著变化。分量表总分显示，前后测之间在锻炼的主观规范方面显著下降（-0.72，P<0.05）、使用应用锻炼的主观规范方面显著下降（-1.72，P<0.01）以及使用应用锻炼的感知行为控制方面显著下降（-2.56，P<0.01）。在比较应用使用者（n=32）和非使用者（n=15）时，后测中在对使用应用锻炼的态度的分量表总分上只有显著差异，使用者的态度明显比非使用者更积极（32.3对27.6，P<0.05）。在5个月内，心血管健康、力量、耐力、柔韧性或身体成分方面的健康感知没有变化。技术使用损耗率为31.9%，这是理想的。
应用的使用和有效性似乎与有用性（态度）以及使用应用锻炼时感知到的困难（感知行为控制）有关。锻炼和使用应用锻炼不受同伴影响（主观规范）的影响。使用这些特定应用锻炼的意图下降了（行为意图）。使用这些应用的人对应用更可能持积极态度。在未来的应用开发中，尤其应考虑有用性和感知到的困难。利用健康行为理论指导开发可能会提高应用的有用性和易用性。
