Do physical activity and dietary smartphone applications incorporate evidence-based behaviour change techniques?

BACKGROUND: There has been a recent proliferation in the development of smartphone applications (apps) aimed at modifying various health behaviours. While interventions that incorporate behaviour change techniques (BCTs) have been associated with greater effectiveness, it is not clear to what extent smartphone apps incorporate such techniques. The purpose of this study was to investigate the presence of BCTs in physical activity and dietary apps and determine how reliably the taxonomy checklist can be used to identify BCTs in smartphone apps.

METHODS: The top-20 paid and top-20 free physical activity and/or dietary behaviour apps from the New Zealand Apple App Store Health & Fitness category were downloaded to an iPhone. Four independent raters user-tested and coded each app for the presence/absence of BCTs using the taxonomy of behaviour change techniques (26 BCTs in total). The number of BCTs included in the 40 apps was calculated. Krippendorff's alpha was used to evaluate interrater reliability for each of the 26 BCTs.

RESULTS: Apps included an average of 8.1 (range 2-18) techniques, the number being slightly higher for paid (M = 9.7, range 2-18) than free apps (M = 6.6, range 3-14). The most frequently included BCTs were "provide instruction" (83% of the apps), "set graded tasks" (70%), and "prompt self-monitoring" (60%). Techniques such as "teach to use prompts/cues", "agree on behavioural contract", "relapse prevention" and "time management" were not present in the apps reviewed. Interrater reliability coefficients ranged from 0.1 to 0.9 (Mean 0.6, SD = 0.2).

CONCLUSIONS: Presence of BCTs varied by app type and price; however, BCTs associated with increased intervention effectiveness were in general more common in paid apps. The taxonomy checklist can be used by independent raters to reliably identify BCTs in physical activity and dietary behaviour smartphone apps.

Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications

BACKGROUND: Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. OBJECTIVES: The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. METHODS: Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. RESULTS: There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found. CONCLUSIONS: This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure.

A systematic mapping study of mobile application testing techniques

The importance of mobile application specific testing techniques and methods has been attracting much attention of software engineers over the past few years. This is due to the fact that mobile applications are different than traditional web and desktop applications, and more and more they are moving to being used in critical domains. Mobile applications require a different approach to application quality and dependability and require an effective testing approach to build high quality and more reliable software. We performed a systematic mapping study to categorize and to structure the research evidence that has been published in the area of mobile application testing techniques and challenges that they have reported. Seventy nine (79) empirical studies are mapped to a classification schema. Several research gaps are identified and specific key testing issues for practitioners are identified: there is a need for eliciting testing requirements early during development process; the need to conduct research in real-world development environments; specific testing techniques targeting application life-cycle conformance and mobile services testing; and comparative studies for security and usability testing.

Tracking and tracing applications of 3G for SMEs

With dynamic growth and acceptance of mobile devices, many innovative business applications are beginning to emerge. Tracking and tracing seems to be one of the popular applications which many organisations have initiated, often facilitated by location based services provided by mobile network operators. However, there are many issues associated with the provisioning of this application with current technologies and business models. Small and Medium-size Enterprises (SMEs) that make up a significant segment of businesses worldwide do not yet seem able to benefit widely from these services. In this chapter, we initially review current technologies/ applications and the issues associated with them, drawing from research and the experiences of a long term ongoing action research project with SMEs in the trade sector. Subsequently, we explore the opportunities offered by 3G services/business applications to SMEs, and provide a broad critical outlook on future opportunities for SMEs to benefit from 3G services.

Novel applications and research problems for sensor-clouds

Recent developments in sensor networks and cloud computing saw the emergence of a new platform called sensor-clouds. While the proposition of such a platform is to virtualise the management of physical sensor devices, we foresee novel applications being created based on a new class of social sensors. Social sensors are effectively a human-device combination that sends torrents of data as a result of social interactions. The data generated appear in different formats such as photographs, videos, or short texts, etc. Unlike other sensor devices, social sensors operate on the control of individuals via their mobile devices like smart phones, tablets or laptops. Further, they do not generate data at a constant rate or format like other sensors do. Instead, data from social sensors are spurious and varied, often in response to social events, or a news announcement of interests to the public. This collective presence of social data creates opportunities for novel applications never experienced before. This paper discusses three such applications utilising social sensors within a sensor-cloud environment. Consequently, the associated research problems are also presented.

A comparison of mobile learning attitudes among university students in four nations

This paper contains findings based on administering a Likert-type mobile learning attitude survey to 261 university students from four nations, China, Lebanon, the UAE and the USA. Students were asked to provide attitudes and perceptions toward the use of mobile technologies in education. The results of the survey indicate that students in different regions of the world tend to agree that mobile learning could empower informal learning and could enhance teaching and learning. Lebanon students were most similar to those from the USA, while students from China were more similar to those from the UAE. Similarities and differences in results among nations and implications of these findings are discussed.

Great 'app-eal' but not there yet: a review of iPhone nutrition applications relevant to child weight management

Aims: There is increasing interest in the use of smartphone applications (apps) for delivering child obesity management interventions and supporting lifestyle behaviour change; however, there has been very little academic research on their development. Our aim is to review nutrition-related apps designed for children currently available in Australia for their usefulness in education or support behavioural interventions for child obesity. Methods: Apps available for download in iTunes Australia between 2 April and 3 June 2013 which were suitable for children >12 years were identified. Key words were chosen to identify apps applicable to children, focusing on nutrition. Results: A total of 27 apps were included. Most apps (24/27) were not based on evidence-informed recommendations. A third of apps were developed in the USA (n = 10; 37%) and were free (67%), nine apps required upfront payment, with a mean cost of $A2.80 (range $A0.99-$A7.49). The most common nutrition features were the promotion of energy balance (n = 12 apps) and guidance on appropriate portion size (n = 15). The most common behaviour change feature was goal setting (n = 15). The five apps that scored most highly against the characteristics reviewed were: Calorie Counter Pro by My Net Diary, Weight Watchers, Swap It Don't Stop It, Control My Weight by CalorieKing and Rate What I Ate-Photo Diet Tracker. Conclusions: Very few apps were identified that could be used in education or support behavioural interventions for child obesity. There is a need to harness this technology and evaluate the applicability and use within childhood obesity research interventions.

Mobile phone app aimed at improving iron intake and bioavailability in premenopausal women: a qualitative evaluation

BACKGROUND: Low iron intake can lead to iron deficiency, which can result in impaired health and iron-deficiency anemia. A mobile phone app, combining successful dietary strategies to increase bioavailable iron with strategies for behavior change, such as goal setting, monitoring, feedback, and resources for knowledge acquisition, was developed with the aim to increase bioavailable iron intake in premenopausal women.

OBJECTIVE: To evaluate the content, usability, and acceptability of a mobile phone app designed to improve intake of bioavailable dietary iron.

METHODS: Women aged 18-50 years with an Android mobile phone were invited to participate. Over a 2-week period women were asked to interact with the app. Following this period, semistructured focus groups with participants were conducted. Focus groups were audio recorded and analyzed via an inductive open-coding method using the qualitative analysis software NVivo 10. Themes were identified and frequency of code occurrence was calculated.

RESULTS: Four focus groups (n=26) were conducted (age range 19-36 years, mean 24.7, SD 5.2). Two themes about the app's functionality were identified (frequency of occurrence in brackets): interface and design (134) and usability (86). Four themes about the app's components were identified: goal tracker (121), facts (78), photo diary (40), and games (46). A number of suggestions to improve the interface and design of the app were provided and will inform the ongoing development of the app.

CONCLUSIONS: This research indicates that participants are interested in iron and their health and are willing to use an app utilizing behavior change strategies to increase intake of bioavailable iron. The inclusion of information about the link between diet and health, monitoring and tracking of the achievement of dietary goals, and weekly reviews of goals were also seen as valuable components of the app and should be considered in mobile health apps aimed at adult women.

A framework for programmatically designing user interfaces in javascript

Purpose – The purpose of this paper is to investigate the feasibility of creating a declarative user interface language suitable for rapid prototyping of mobile and Web apps. Moreover, this paper presents a new framework for creating responsive user interfaces using JavaScript. Design/methodology/approach – Very little existing research has been done in JavaScript-specific declarative user interface (UI) languages for mobile Web apps. This paper introduces a new framework, along with several case studies that create modern responsive designs programmatically. Findings – The fully implemented prototype verifies the feasibility of a JavaScript-based declarative user interface library. This paper demonstrates that existing solutions are unwieldy and cumbersome to dynamically create and adjust nodes within a visual syntax of program code. Originality/value – This paper presents the Guix.js platform, a declarative UI library for rapid development of Web-based mobile interfaces in JavaScript.

Mobile application testing in industrial contexts: an exploratory multiple case-study

Recent empirical studies in the area of mobile application testing indicate the need for specific testing techniques and methods for mobile applications. This is due to mobile applications being significantly different than traditional web and desktop applications, particularly in terms of the physical constraints of mobile devices and the very different features of their operating systems. In this paper, we presented a multiple case-study involving four software development companies in the area of mobile and smartphones application. We aimed to identify testing techniques currently being applied by developers and challenges that they are facing. Our principle results are that many industrial teams seem to lack sufficient knowledge on how to test mobile applications, particularly in the areas of mobile application life-cycle conformance, context-awareness, and integration testing. We also found that there is no formal testing approach or methodology that can facilitate a development team to systematically test a critical mobile application.

Remotely delivered exercise-based cardiac rehabilitation: design and content development of a novel mHealth platform

BACKGROUND: Participation in traditional center-based cardiac rehabilitation exercise programs (exCR) is limited by accessibility barriers. Mobile health (mHealth) technologies can overcome these barriers while preserving critical attributes of center-based exCR monitoring and coaching, but these opportunities have not yet been capitalized on.

OBJECTIVE: We aimed to design and develop an evidence- and theory-based mHealth platform for remote delivery of exCR to any geographical location.

METHODS: An iterative process was used to design and develop an evidence- and theory-based mHealth platform (REMOTE-CR) that provides real-time remote exercise monitoring and coaching, behavior change education, and social support.

RESULTS: The REMOTE-CR platform comprises a commercially available smartphone and wearable sensor, custom smartphone and Web-based applications (apps), and a custom middleware. The platform allows exCR specialists to monitor patients' exercise and provide individualized coaching in real-time, from almost any location, and provide behavior change education and social support. Intervention content incorporates Social Cognitive Theory, Self-determination Theory, and a taxonomy of behavior change techniques. Exercise components are based on guidelines for clinical exercise prescription.

CONCLUSIONS: The REMOTE-CR platform extends the capabilities of previous telehealth exCR platforms and narrows the gap between existing center- and home-based exCR services. REMOTE-CR can complement center-based exCR by providing an alternative option for patients whose needs are not being met. Remotely monitored exCR may be more cost-effective than establishing additional center-based programs. The effectiveness and acceptability of REMOTE-CR are now being evaluated in a noninferiority randomized controlled trial.

Smartphone malware based on synchronisation vulnerabilities

Smartphones are mobile phones that offer processing power and features like personal computers (PC) with the aim of improving user productivity as they allow users to access and manipulate data over networks and Internet, through various mobile applications. However, with such anywhere and anytime functionality, new security threats and risks of sensitive and personal data are envisaged to evolve. With the emergence of open mobile platforms that enable mobile users to install applications on their own, it opens up new avenues for propagating malware among various mobile users very quickly. In particular, they become crossover targets of PC malware through the synchronization function between smartphones and computers. Literature lacks detailed analysis of smartphones malware and synchronization vulnerabilities. This paper addresses these gaps in literature, by first identifying the similarities and differences between smartphone malware and PC malware, and then by investigating how hackers exploit synchronization vulnerabilities to launch their attacks.

ipreps on ipads : exploring the visual/audio nexus of techno-literacy learners in an Australian classroom

This presentation reports on findings from a qualitative study on the use of iPads to support the literacy learning of a group of children who had just commenced their formal schooling in a regional Australian preparatory classroom. Specifically it looks at the affordances the iPad offered to enhance the oral-aural-visual communication of children not yet fluent in print based literacies. The children were interviewed about their techno-literacy learning and observed as they engaged with applications (apps). The researchers were able to video them as they demonstrated high levels of interest, energised learning and a range of independently acquired techno- literacy skills.
There is as yet little research on the use of portable personal computing devices such as the iPad in early years’ classrooms. The children in this study are shown as capable and articulate regarding their iPad use. Beyond the traditionally conceived struggle with passive print decoding when using iPads they become active creators of sophisticated multimodal artefacts that they consider worthy of acclaim, “I’m really proud of myself.” Findings from this study suggest the visual/listening nexus of popular apps potentially challenges print based literacy education approaches and existing paradigms of research and teaching/learning practice in Australian early years’ literacy education.

Remote monitoring system enabling cloud technology upon smart phones and inertial sensors for human kinematics

Stroke is a common neurological condition which is becoming increasingly common as the population ages. This entails healthcare monitoring systems suitable for home use, with remote access for medical professionals and emergency responders. The mobile phone is becoming the easy access tool for self-evaluation of health, but it is hindered by inherent problems including computational power and storage capacity. This research proposes a novel cloud based architecture of a biomedical system for a wearable motion kinematic analysis system which mitigates the above mentioned deficiencies of mobile devices. The system contains three subsystems: 1. Bio Kin WMS for measuring the acceleration and rotation of movement 2. Bio Kin Mobi for Mobile phone based data gathering and visualization 3. Bio Kin Cloud for data intensive computations and storage. The system is implemented as a web system and an android based mobile application. The web system communicates with the mobile application using an encrypted data structure containing sensor data and identifiable headings. The raw data, according to identifiable headings, is stored in the Amazon Relational Database Service which is automatically backed up daily. The system was deployed and tested in Amazon Web Services.

Towards localisation with Doppler radar

In this thesis the author introduces a novel method for Geo Localisation via Doppler Radar. The area of research is in the three dimensional space using amplitude and magnitude measurements. Geo Localisation in mobile applications is a useful technology that enables monitoring and gathering information about objects of interest.