Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback

Retrospective cohort study

Elina Helander (Corresponding Author), Kirsikka Kaipainen, Ilkka Korhonen, Brian Wansink

Research output: Contribution to journalArticleScientificpeer-review

41 Citations (Scopus)

Abstract

Background: Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations. Objective: The aim of the study was to assess the factors related to sustained use of a free mobile app ("The Eatery") that promotes healthy eating through photographic dietary self-monitoring and peer feedback. Methods: A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as "Users" and people with one or no pictures as "Dropouts". Users who had taken at least 10 pictures and used the app for at least one week were classified as "Actives", Users with 2-9 pictures as "Semi-actives", and Dropouts with one picture as "Non-actives". The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives. Results: Overall adherence was low-only 2.58% (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28% (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34% (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31%, 900/6291) than those who had not defined any diet (3.99%, 742/18,590), said they ate everything (9.47%, 3040/32,090), or reported some other diet (11.85%, 213/1798). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives. Feedback beyond ratings was relatively infrequent: 3.83% (15,247/398,228) of pictures received comments and 15.39% (61,299/398,228) received "likes" from other users. Actives were more likely to have at least one comment or one "like" for their pictures than Semi-actives or Non-actives. Only 9.89% (481/4863) of Active users had a positive trend in their average healthiness ratings. Conclusions: Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.
Original languageEnglish
Number of pages13
JournalJournal of Medical Internet Research
Volume16
Issue number4
DOIs
Publication statusPublished - 2014
MoE publication typeA1 Journal article-refereed

Fingerprint

Mobile Applications
Photography
Cohort Studies
Retrospective Studies
Diet
Population
Healthy Diet

Keywords

  • healthy eating
  • food journaling
  • food photographing
  • adherence
  • mobile app
  • self-monitoring
  • peer feedback
  • control theory

Cite this

@article{1232d7c135b14a958947c805e39bf185,
title = "Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback: Retrospective cohort study",
abstract = "Background: Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations. Objective: The aim of the study was to assess the factors related to sustained use of a free mobile app ({"}The Eatery{"}) that promotes healthy eating through photographic dietary self-monitoring and peer feedback. Methods: A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as {"}Users{"} and people with one or no pictures as {"}Dropouts{"}. Users who had taken at least 10 pictures and used the app for at least one week were classified as {"}Actives{"}, Users with 2-9 pictures as {"}Semi-actives{"}, and Dropouts with one picture as {"}Non-actives{"}. The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives. Results: Overall adherence was low-only 2.58{\%} (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28{\%} (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34{\%} (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31{\%}, 900/6291) than those who had not defined any diet (3.99{\%}, 742/18,590), said they ate everything (9.47{\%}, 3040/32,090), or reported some other diet (11.85{\%}, 213/1798). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives. Feedback beyond ratings was relatively infrequent: 3.83{\%} (15,247/398,228) of pictures received comments and 15.39{\%} (61,299/398,228) received {"}likes{"} from other users. Actives were more likely to have at least one comment or one {"}like{"} for their pictures than Semi-actives or Non-actives. Only 9.89{\%} (481/4863) of Active users had a positive trend in their average healthiness ratings. Conclusions: Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.",
keywords = "healthy eating, food journaling, food photographing, adherence, mobile app, self-monitoring, peer feedback, control theory",
author = "Elina Helander and Kirsikka Kaipainen and Ilkka Korhonen and Brian Wansink",
note = "Project code: 72578",
year = "2014",
doi = "10.2196/jmir.3084",
language = "English",
volume = "16",
journal = "Journal of Medical Internet Research",
issn = "1439-4456",
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}

Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback : Retrospective cohort study. / Helander, Elina (Corresponding Author); Kaipainen, Kirsikka; Korhonen, Ilkka; Wansink, Brian.

In: Journal of Medical Internet Research, Vol. 16, No. 4, 2014.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Factors related to sustained use of a free mobile app for dietary self-monitoring with photography and peer feedback

T2 - Retrospective cohort study

AU - Helander, Elina

AU - Kaipainen, Kirsikka

AU - Korhonen, Ilkka

AU - Wansink, Brian

N1 - Project code: 72578

PY - 2014

Y1 - 2014

N2 - Background: Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations. Objective: The aim of the study was to assess the factors related to sustained use of a free mobile app ("The Eatery") that promotes healthy eating through photographic dietary self-monitoring and peer feedback. Methods: A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as "Users" and people with one or no pictures as "Dropouts". Users who had taken at least 10 pictures and used the app for at least one week were classified as "Actives", Users with 2-9 pictures as "Semi-actives", and Dropouts with one picture as "Non-actives". The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives. Results: Overall adherence was low-only 2.58% (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28% (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34% (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31%, 900/6291) than those who had not defined any diet (3.99%, 742/18,590), said they ate everything (9.47%, 3040/32,090), or reported some other diet (11.85%, 213/1798). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives. Feedback beyond ratings was relatively infrequent: 3.83% (15,247/398,228) of pictures received comments and 15.39% (61,299/398,228) received "likes" from other users. Actives were more likely to have at least one comment or one "like" for their pictures than Semi-actives or Non-actives. Only 9.89% (481/4863) of Active users had a positive trend in their average healthiness ratings. Conclusions: Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.

AB - Background: Healthy eating interventions that use behavior change techniques such as self-monitoring and feedback have been associated with stronger effects. Mobile apps can make dietary self-monitoring easy with photography and potentially reach huge populations. Objective: The aim of the study was to assess the factors related to sustained use of a free mobile app ("The Eatery") that promotes healthy eating through photographic dietary self-monitoring and peer feedback. Methods: A retrospective analysis was conducted on the sample of 189,770 people who had downloaded the app and used it at least once between October 2011 and April 2012. Adherence was defined based on frequency and duration of self-monitoring. People who had taken more than one picture were classified as "Users" and people with one or no pictures as "Dropouts". Users who had taken at least 10 pictures and used the app for at least one week were classified as "Actives", Users with 2-9 pictures as "Semi-actives", and Dropouts with one picture as "Non-actives". The associations between adherence, registration time, dietary preferences, and peer feedback were examined. Changes in healthiness ratings over time were analyzed among Actives. Results: Overall adherence was low-only 2.58% (4895/189,770) used the app actively. The day of week and time of day the app was initially used was associated with adherence, where 20.28% (5237/25,820) of Users had started using the app during the daytime on weekdays, in comparison to 15.34% (24,718/161,113) of Dropouts. Users with strict diets were more likely to be Active (14.31%, 900/6291) than those who had not defined any diet (3.99%, 742/18,590), said they ate everything (9.47%, 3040/32,090), or reported some other diet (11.85%, 213/1798). The average healthiness rating from peers for the first picture was higher for Active users (0.55) than for Semi-actives (0.52) or Non-actives (0.49). Actives wrote more often a textual description for the first picture than Semi-actives or Non-actives. Feedback beyond ratings was relatively infrequent: 3.83% (15,247/398,228) of pictures received comments and 15.39% (61,299/398,228) received "likes" from other users. Actives were more likely to have at least one comment or one "like" for their pictures than Semi-actives or Non-actives. Only 9.89% (481/4863) of Active users had a positive trend in their average healthiness ratings. Conclusions: Most people who tried out this free mobile app for dietary self-monitoring did not continue using it actively and those who did may already have been healthy eaters. Hence, the societal impact of such apps may remain small if they fail to reach those who would be most in need of dietary changes. Incorporating additional self-regulation techniques such as goal-setting and intention formation into the app could potentially increase user engagement and promote sustained use.

KW - healthy eating

KW - food journaling

KW - food photographing

KW - adherence

KW - mobile app

KW - self-monitoring

KW - peer feedback

KW - control theory

U2 - 10.2196/jmir.3084

DO - 10.2196/jmir.3084

M3 - Article

VL - 16

JO - Journal of Medical Internet Research

JF - Journal of Medical Internet Research

SN - 1439-4456

IS - 4

ER -