Barriers to and facilitators for using nutrition apps: a scoping review and conceptual framework (Preprint)

BACKGROUND Nutrition apps are a prototypical mobile health (mHealth) technology supporting healthy eating behavior that are seen as promising tools for health promotion by policy makers. Although nutrition apps are increasingly popular, wide-spread adoption is yet to be achieved. Hence, profound knowledge regarding factors motivating and hindering (long-term) nutrition app use is crucial for developing design guidelines aiming at supporting uptake and prolonged use of nutrition apps. OBJECTIVE In this scoping review, we synthesized the literature on barriers to and facilitators for nutrition app use across disciplines including empirical qualitative and quantitative studies with current users, ex-users, and/or non-users of nutrition apps. METHODS A systematic literature search including six databases as well as backward and forward citation search was conducted. Search strategy, inclusion and exclusion criteria, and the planned data extraction process were preregistered. All empirical qualitative and quantitative studies published in German or English were eligible for inclusion if they examined adults or adolescents (aged 13 to 18) who were either current users, ex-users and/ or non-users of nutrition apps. Based on qualitative content analysis, extracted individual barriers and facilitators were grouped into categories. RESULTS Twenty-eight publications were identified as eligible. A framework with a three-level hierarchy was designed which grouped 326 individual barriers and facilitators into 21 sub-categories, twelve categories, and four clusters that focus on either the individual user (goals, goal attainment, goal abandonment, personal living conditions, lack of knowledge or skill, lack or loss of motivation, habit), different aspects of the app and the smartphone (features, usability of the app or food database, technical issues, data security, accuracy/trustworthiness, costs), positive and negative outcomes of nutrition app use, or interactions between the user and their social environment. CONCLUSIONS The resulting conceptual framework underlines a pronounced diversity of reasons for (not) using nutrition apps indicating that there is no “one-size-fits-all” approach for uptake and prolonged use of nutrition aps. Hence, tailoring nutrition apps to needs of specific user groups seems promising for increasing engagement.