A Group-based mobile application to increase adherence in exercise and nutrition programs: A factorial design feasibility study

Abstract

Background: Novel methods of promoting self-monitoring and social support are needed to ensure long-term maintenance of behavior change. In this paper, we directly investigate the effects of group support in an exercise and nutrition program delivered by an mHealth application called Fittle. Objective: Our first specific study aim was to explore whether social support improved adherence in wellness programs. Our second specific study aim was to assess whether media types (ePaper vs mobile) were associated with different levels of compliance and adherence to wellness programs. The third aim was to assess whether the use of an mHealth application led to positive changes to participants' eating behavior, physical activity, and stress level, compared to traditional paper-based programs. Methods: A 2 × 2 (eg, Media: Mobile vs ePaper × Group Type: Team vs Solo) factorial design feasibility study was conducted. A sample of 124 volunteers who were interested in improving eating behavior, increasing physical activity, or reducing stress participated in this study. The study duration was 8 weeks. All groups were self-directed with no ongoing human input from the research team. Results: Participants in ePaper conditions had higher attrition rates compared to participants in Mobile conditions, χ32=9.96, P=.02 (N=124). Participants in Mobile conditions reported their compliance with a much higher frequency closer to the time of challenge activity completion (2-sample Kolmogorov-Smirnov test comparing distributions was highly significant - KS=0.33, P