Search

BackgroundSmartphones have allowed for the development and use of apps. There is now a proliferation of mobile health interventions for physical activity, healthy eating, smoking and alcohol cessation or reduction, and improved mental well-being. However, the strength or potential of these apps to lead to behavior change remains uncertain. ObjectiveThe aim of this study was to review a large sample of healthy lifestyle apps at a single point in time (June to July 2018) to determine their potential for promoting health-related behavior change with a view to sharing this information with the public. In addition, the study sought to test a wide range of apps using a new scale, the App Behavior Change Scale (ABACUS). MethodsApps focusing on 5 major modifiable lifestyle behaviors were identified using a priori key search terms across the Australian Apple iTunes and Google Play stores. Lifestyle behavior categories were selected for their impact on health and included smoking, alcohol use, physical activity, nutrition, and mental well-being. Apps were included if they had an average user rating between 3 and 5, if they were updated in the last 18 months, if the description of the app included 2 of 4 behavior change features, and if they were in English. The selected behavior change apps were rated in 2 ways using previously developed rating scales: the Mobile App Rating Scale (MARS) for functionality and the ABACUS for potential to encourage behavior change. ResultsThe initial search identified 212,352 apps. After applying the filtering criteria, 5018 apps remained. Of these, 344 were classified as behavior change apps and were reviewed and rated. Apps were given an average MARS score of 2.93 out of 5 (SD 0.58, range 1.42-4.16), indicating low-to-moderate functionality. Scores for the ABACUS ranged from 1 to 17, out of 21, with an average score of 7.8 (SD 2.8), indicating a low-to-moderate number of behavior change techniques included in apps. The ability of an app to encourage practice or rehearsal, in addition to daily activities, was the most commonly identified feature across all apps (310/344, 90.1%), whereas the second most common feature was the ability of the user to easily self-monitor behavior (289/344, 84.0%). ConclusionsThe wide variety of apps included in this 2018 study and the limited number of behavior change techniques found in many apps suggest an opportunity for improvement in app design that will promote sustained and significant lifestyle behavior change and, therefore, better health. The use of the 2 scales for the review and rating of the apps was successful and provided a method that could be replicated and tested in other behavior change areas.

BackgroundUsing mobile phone apps to promote behavior change is becoming increasingly common. However, there is no clear way to rate apps against their behavior change potential. ObjectiveThis study aimed to develop a reliable, theory-based scale that can be used to assess the behavior change potential of smartphone apps. MethodsA systematic review of all studies purporting to investigate app’s behavior change potential was conducted. All scales and measures from the identified studies were collected to create an item pool. From this item pool, 3 health promotion exerts created the App Behavior Change Scale (ABACUS). To test the scale, 70 physical activity apps were rated to provide information on reliability. ResultsThe systematic review returned 593 papers, the abstracts and titles of all were reviewed, with the full text of 77 papers reviewed; 50 papers met the inclusion criteria. From these 50 papers, 1333 questions were identified. Removing duplicates and unnecessary questions left 130 individual questions, which were then refined into the 21-item scale. The ABACUS demonstrates high percentage agreement among reviewers (over 80%), with 3 questions scoring a Krippendorff alpha that would indicate agreement and a further 7 came close with alphas >.5. The scale overall reported high interrater reliability (2-way mixed interclass coefficient=.92, 95% CI 0.81-0.97) and high internal consistency (Cronbach alpha=.93). ConclusionsThe ABACUS is a reliable tool that can be used to determine the behavior change potential of apps. This instrument fills a gap by allowing the evaluation of a large number of apps to be standardized across a range of health categories.

Introduction Food insecurity (FI), an inadequate access to healthy, affordable food, is a public health concern primarily driven by material hardship. Optimal antenatal nutrition promotes best health outcomes for the mother and baby. Pregnant women experiencing FI are less able to access healthy foods, increasing the risk of complications such as gestational diabetes and preterm labour. Little is known about the experiences of food-insecure pregnant women in obtaining sufficient, nutritious food, their perceptions regarding antenatal nutrition and how this contributes to their food choices. Methods This qualitative study conducted from August to November 2020, during the COVID-19 pandemic, examined the experiences and coping strategies of food-insecure pregnant women, and the factors influencing their food choices. Seven English-speaking food-insecure pregnant women participated in semi-structured interviews. Interview transcripts were thematically analysed, informed by grounded theory methodology. Results Three themes were identified through analysis of the interviews related to strategies that managed household food supply, factors that influenced food choices, and experiences of pregnancy during the COVID-19 pandemic. As a result of a limited food budget, pregnancy symptoms, the cognitive overload that attends the FI experience, and the acute yet significant impact of the pandemic, food-insecure pregnant women in this study defaulted to cheap and convenient food choices despite acknowledging the importance of eating well for pregnancy. Conclusion FI during pregnancy is burdensome, relentless and undermines women's wellbeing. Supportive strategies within antenatal healthcare settings are urgently required to deliver an equitable health response for vulnerable women., Author(s): Julia Zinga [sup.1] , Fiona H. McKay [sup.2] , Rebecca Lindberg [sup.3] , Paige van der Pligt [sup.3] Author Affiliations: (1) grid.416259.d, 0000 0004 0386 2271, Royal Women's Hospital, [...]

International students in Australia risk financial insecurity and as a result, may make suboptimal health decisions. Limited research has explored the experiences of international students' health-related financial decision making. In-depth interviews were conducted with 31 international students to explore how financial situation influences their decisions in Australia. Data were thematically analysed. Findings highlight that limited income can impact overall wellbeing and health-related decision making. When making financial health-related decisions, participants prioritised urgent health needs and education. Participants who perceived their financial situation limited were less willing to spend money on mental health services, social activities, and food. This study suggests that students may consider the long-term financial benefits of studying abroad when making decisions, but they do not consider the long-term health implications of stress and wellbeing. Enabling students to improve their financial situation and lower their expenses could enhance wellbeing and facilitate health-related decision making. [ABSTRACT FROM AUTHOR]

The provision of mobility exercises through a smartphone application (app) for people undertaking neurological rehabilitation may improve mobility outcomes. However, it is difficult for clinicians and consumers to select high-quality, appropriate apps. This review aimed to identify (1) which mobile health (mHealth) apps are suitable for prescribing mobility exercises for adults with neurological health conditions, (2) how well these apps incorporate telehealth strategies, and (3) how well these apps rate in terms of quality and capacity for behaviour change. The Australian Apple iTunes Store was systematically searched, by using a search code and manually, for apps suitable for training mobility in neurological rehabilitation. Additional searches were conducted in known app repositories and for web-based apps. Trained reviewers extracted data from the included apps, including population-specific characteristics; quality, by using the Mobile App Rating Scale (MARS); and behaviour change potential, by using the App Behaviour Change Scale (ABACUS). The included apps (n = 18) provided <50 to >10,000 exercises, many incurred a subscription fee (n = 13), and half included telehealth features. App quality was moderate (mean MARS score of 3.2/5 and SD of 0.5), and potential for behaviour change was poor (mean ABACUS score of 5.7/21 and SD of 2.1). A limited number of high-quality apps are available for the prescription of mobility exercises in people with neurological conditions. [ABSTRACT FROM AUTHOR]

Aim: To explore the nutritional content of meal kits from two main Australian companies over a 6‐week period against healthy eating guidelines for pregnancy. Method: Across the 6‐week period, weekly meal kits from both Provider 1 and Provider 2 were purchased, 36 individual meals were assessed. All data were analysed for the development of a macronutrient and micronutrient profile of meals. Extracted data were macronutrient, vitamin, and mineral composition, which were compared against the healthy eating guidelines for pregnant women in Australia and New Zealand. Results: Meal kits include higher levels of sodium, and lower levels of dietary fibre, calcium, magnesium, zinc, iron, thiamin, riboflavin, grains, and dairy when compared against the guidelines for healthy eating for pregnant women in Australia and New Zealand. Conclusions and implications: Meal kits may increase meals prepared and consumed in the home, and thanks to the clear instructions and pre‐portioned ingredients, may reduce stress related to food preparation. They have the potential to provide nutritionally adequate meals to pregnant women as a way to mitigate food insecurity or hunger during pregnancy and may provide some nutritional benefits and have the potential to remove some of the challenges with maintaining an adequate diet when pregnant. [ABSTRACT FROM AUTHOR]