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A scientific audit of smartphone applications for the management of obesity

A scientific audit of smartphone applications for the management of obesity Overweight and obesity now affects 68% of Australian adult males and 55% of Australian females, and about 40% of patients visiting a general practitioner (GP) report attempts to lose weight. Apart from advice from health practitioners, self‐help weight management information is readily available through television, magazine articles, newspaper, books, radio and, more recently, the Internet. However, a systematic review of quality assessment studies of health‐related websites reported that 70% were inaccurate. Smartphone applications are emerging as another feasible form of support, with high consumer satisfaction reported. We recently undertook a systematic analysis of the available weight management applications, with information concerning nutrition, physical activity and behavioural modification, with respect to their scientific accuracy, the accountability of authors, and applicability to the Australian population. Weight management applications for iPad,® iPhone® and iPod Touch® were searched on iTunes® using the combination of keywords “weight loss or weight management” and “diet or nutrition” and “exercise or physical activity”. For inclusion, the applications had to have been intended for assisting adults in weight loss, been written in English and contain tailored information with interactive features to help the user monitor their weight loss process. Electronic books, videos, audio, news, blogs, podcasts and magazines were excluded. A pro forma with a clear criteria for rating was developed a priori for the assessment of identified applications. Accountability was assessed using Silberg's scale, which includes authors’ affiliations and credentials, referenced sources of information and their currency as well as financial disclosures. Five key weight loss topic areas with 12 elements were identified by using the Dietitians Association of Australia's (DAA) Best Practice Guidelines for the Treatment of Overweight and Obesity in Adults and the National Health and Medical Research Council's (NHMRC) Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults. These were used to determine adequate coverage of the relevant material and then the scientific accuracy of this information. The NHMRC's Australian Guide to Healthy Eating (AGHE), Compendium of Physical Activities , the Nutrient Reference Values (NRVs) and The United States Department of Agriculture (USDA) National Nutrient Database were also consulted. The applicability to Australian adults was scored according to whether Australian food databases, standards and units of measure (or conversion) were used and if the intended sociodemographic target was similar to Australia. Applications were scored as user‐friendly if the description of the application in iTunes® matched the content, the information was easily comprehended, and the application easily navigated. A composite score with a maximum total of 33 was calculated for each application. The scoring system weighted each domain as follows: coverage (10 points), accuracy (8 points), applicability (6 points), user‐friendliness (6 points) and accountability (3 points). The final composite score for each application was converted to a percentage with applications scored as good (≥70%), fair (50–69%) or poor (≤49%). Of the 403 applications located, 92 met inclusion criteria for downloading, but 35 did not meet the inclusion criteria on closer examination and three had technical problems. Overall, eight applications were rated as good. They were five “calorie and physical activity counters” and three “BMI or weight trackers”. Thirty‐two of the applications were rated as fair and 14 were rated as poor. The applications that were rated as good had better coverage and accuracy scores compared to those rated as fair or poor. Less than a third of all applications had complete accuracy. All applications scored well for user‐friendliness, but scored poorly for author's accountability. The USDA Nutrient Database of Foods was used in all applications and energy intake was tracked with “calories” instead of “kilojoules”, the measure used in Australia. As many manufactured and takeaway foods consumed in the US differ to those commonly eaten in Australia the applicability for Australians is limited. Thus, while the majority of applications did not score well, those rated as good may be a useful adjunct treatment to health professionals’ advice to assist their patients’ weight loss efforts. The assessment tool devised to rate the applications may be useful for future use with new applications and some customisation of the good applications, such as the use of Australian food databases, is indicated. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

A scientific audit of smartphone applications for the management of obesity

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Publisher
Wiley
Copyright
© 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1753-6405.2011.00707.x
pmid
21627732
Publisher site
See Article on Publisher Site

Abstract

Overweight and obesity now affects 68% of Australian adult males and 55% of Australian females, and about 40% of patients visiting a general practitioner (GP) report attempts to lose weight. Apart from advice from health practitioners, self‐help weight management information is readily available through television, magazine articles, newspaper, books, radio and, more recently, the Internet. However, a systematic review of quality assessment studies of health‐related websites reported that 70% were inaccurate. Smartphone applications are emerging as another feasible form of support, with high consumer satisfaction reported. We recently undertook a systematic analysis of the available weight management applications, with information concerning nutrition, physical activity and behavioural modification, with respect to their scientific accuracy, the accountability of authors, and applicability to the Australian population. Weight management applications for iPad,® iPhone® and iPod Touch® were searched on iTunes® using the combination of keywords “weight loss or weight management” and “diet or nutrition” and “exercise or physical activity”. For inclusion, the applications had to have been intended for assisting adults in weight loss, been written in English and contain tailored information with interactive features to help the user monitor their weight loss process. Electronic books, videos, audio, news, blogs, podcasts and magazines were excluded. A pro forma with a clear criteria for rating was developed a priori for the assessment of identified applications. Accountability was assessed using Silberg's scale, which includes authors’ affiliations and credentials, referenced sources of information and their currency as well as financial disclosures. Five key weight loss topic areas with 12 elements were identified by using the Dietitians Association of Australia's (DAA) Best Practice Guidelines for the Treatment of Overweight and Obesity in Adults and the National Health and Medical Research Council's (NHMRC) Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults. These were used to determine adequate coverage of the relevant material and then the scientific accuracy of this information. The NHMRC's Australian Guide to Healthy Eating (AGHE), Compendium of Physical Activities , the Nutrient Reference Values (NRVs) and The United States Department of Agriculture (USDA) National Nutrient Database were also consulted. The applicability to Australian adults was scored according to whether Australian food databases, standards and units of measure (or conversion) were used and if the intended sociodemographic target was similar to Australia. Applications were scored as user‐friendly if the description of the application in iTunes® matched the content, the information was easily comprehended, and the application easily navigated. A composite score with a maximum total of 33 was calculated for each application. The scoring system weighted each domain as follows: coverage (10 points), accuracy (8 points), applicability (6 points), user‐friendliness (6 points) and accountability (3 points). The final composite score for each application was converted to a percentage with applications scored as good (≥70%), fair (50–69%) or poor (≤49%). Of the 403 applications located, 92 met inclusion criteria for downloading, but 35 did not meet the inclusion criteria on closer examination and three had technical problems. Overall, eight applications were rated as good. They were five “calorie and physical activity counters” and three “BMI or weight trackers”. Thirty‐two of the applications were rated as fair and 14 were rated as poor. The applications that were rated as good had better coverage and accuracy scores compared to those rated as fair or poor. Less than a third of all applications had complete accuracy. All applications scored well for user‐friendliness, but scored poorly for author's accountability. The USDA Nutrient Database of Foods was used in all applications and energy intake was tracked with “calories” instead of “kilojoules”, the measure used in Australia. As many manufactured and takeaway foods consumed in the US differ to those commonly eaten in Australia the applicability for Australians is limited. Thus, while the majority of applications did not score well, those rated as good may be a useful adjunct treatment to health professionals’ advice to assist their patients’ weight loss efforts. The assessment tool devised to rate the applications may be useful for future use with new applications and some customisation of the good applications, such as the use of Australian food databases, is indicated.

Journal

Australian and New Zealand Journal of Public Health – Wiley

Published: Jun 1, 2011

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