Mobile App Intervention for Obese and Overweight Patients in General Practice: User Engagement Analysis (Preprint)

BACKGROUND The Health eLiteracy for Prevention in General Practice (HeLP-GP) trial is a primary healthcare-based behavior change intervention for weight loss in overweight and obese Australians from lower socioeconomic areas. Individuals from these areas are known to have low levels of health literacy and are particularly at risk for chronic conditions, including diabetes and cardiovascular disease. The intervention comprised health check visits with a practice nurse, a purpose-built patient-facing mobile app (mysnapp) and referral to telephone coaching OBJECTIVE This study aimed to assess the mysnapp app use within the HeLP-GP trial and its effects on study outcomes. METHODS In 2018, we recruited 22 general practices from 2 Australian states and randomized them by cluster to the intervention or usual care. Patients who met the main eligibility criteria (i.e. BMI > 28 in previous 12 months and aged 40-74 years) were identified through the clinical software. The practice staff then provided the patients with details about the study. The intervention consisted of a health check with a practice nurse and a lifestyle app, a telephone coaching program, or both depending on the participants' choice. We collected data directly through the app and combined it with data from the 6-week health check with the practice nurses, the telephone coaching, and the participants' questionnaires at baseline, and 6-month follow-up. The analyses comprised descriptive and inferential statistics. RESULTS Of the 120 participants who received the intervention, 62 (52%) participants chose to use the app. The two groups did not differ significantly in demographics or recent hospital admissions. The median time between first and last app use was 52 (IQR 4-95) days, with a median of 5 (IQR 2-10) active days. App users were significantly more likely to attend the 6-week health check (χ21=6.4, P=.010) and participate in the telephone coaching (χ22=25.0, P<.001) than non-app users. CONCLUSIONS There seemed to be no differences in demographics or recent hospital admissions between those who chose to use the app and those who did not. App users were more likely to attend the 6-week health check and participate in telephone coaching. These finding suggest that participants who opted for several intervention components felt more committed to the study. CLINICALTRIAL ANZCTR.org.au ACTRN12617001508369 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2018-023239