Practical Apps 12: Changing Behaviour with Apps

author

Dr. Payal Agarwal
Toronto, Ontario

Bio
Dr. Payal Agarwal is a practicing family physician in Toronto. She holds an undergraduate degree in Systems Design Engineering from the University of Waterloo, where she refined her software design and development skills while working at several technology companies. During her medical studies at the University of Toronto, Payal’s research efforts focused on the development of novel technologies to improve health care delivery and education. As an Innovation Fellow at WIHV, Payal is currently focused on the creation of new models of care by adapting proven methodologies from the design, technology and entrepreneurship fields, with a specific focus on virtual care. She also consults for several healthcare startups around product design and usability and will be starting a Masters in Health Service Research at the University of Toronto in September 2016.

Apps Reviewed:

Patient Experiences

 

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Carrot Rewards

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Carrot Rewards provides Canadians in B.C., Ontario and Newfoundland with rewards points for completing educational quizzes and improving their activity levels. Created with a unique public-private partnership, Carrot Rewards works with health agencies, including the Public Health Agency of Canada, to encourage priority health behaviours among the population. Users earn real points on one of several popular reward programs for common items like gas, movies and flights by tracking activity levels and completing educational quizzes.

The app syncs with common fitness trackers and rewards users for meeting challenges to increase their step count. While there are no studies showing positive impact on activity levels, it is evident that the company uses known behaviour change concepts to drive healthy behaviours. The app is well designed, with a pleasant and intuitive interface. It has broad appeal and will be relevant to all but the most motivated and knowledgeable patients. Overall, despite the lack of clear evidence of effectiveness, this app has few drawbacks and can be a tool regularly recommended by primary care providers as part of an ongoing partnership to promote healthy behaviours in their patients.

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EaTracker

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EaTracker was created by the Dieticians of Canada with support from the B.C. Ministry of Health. The app’s main feature is its ability to track detailed nutritional intake based on meals entered by the user. This requires users to find meals from a long – but culturally limited – list or manually enter each ingredient into a meal. Activity can be tracked, but must be entered manually with no integration into popular fitness trackers. The app is actively support by the dieticians at EatRight Ontario who can provide some guidance for Ontario-based users. The app was generally reliable with a clear privacy statement. Unfortunately, clumsy manual entry of diet and fitness information and a lack of culturally diverse meals means the usefulness of the app is limited for some patients. Motivated patients who desire a detailed understanding of nutrition might find this app helpful in their quest for a healthier lifestyle.
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My Food Guide

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This simple app created by Health Canada enables users to review Canada’s Food Guide and explore food options in each category. While it has a relatively limited feature set, its bright visuals and easy navigation make it enjoyable to use. The app focuses on understanding nutrition using food groups and not calories, as most apps do. This is likely better for some patients. Users can add foods they enjoy to each food group. There is no way to track daily intake. The app collects minimal health information and is being actively updated. Overall, this app is likely too basic for many patients motivated to improve their health but would be helpful for those who need to learn the basics of nutrition and require a simple, easy-to-use app to get them started.

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References:

1. Douglas G. Manuel, R.P., Carol Bennett, Seven More Years: The impact of smoking, alcohol, diet, physical activity and stress on health and life expectancy in Ontario. 2012, Institute of Clinical Evaluative Sciences, Public Health Ontario.
2. Cohen, D.J., et al., Implementing Health Behavior Change in Primary Care: Lessons From Prescription for Health. Annals of Family Medicine, 2005. 3(Suppl 2): p. s12-s19.
3. Eric C. Schneider, D.O.S., David Squires, Arnav Shah, Michelle M. Doty, Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better U.S. Health Care. 2017, The Commonwealth Fund.
4. K. Singh, K.D., L. P. Newmark et al., Developing a Framework for Evaluating the Patient Engagement, Quality, and Safety of Mobile Health Applications. 2016, The Commonwealth Fund.
5. Mitchell, M., et al., Uptake of an Incentive-Based mHealth App: Process Evaluation of the Carrot Rewards App. JMIR Mhealth Uhealth, 2017. 5(5): p. e70.
6. Build a healthy meal: use the Eat Well Plate. 2016 Sept 1, 2016 [cited 2017 Aug 8, 2017]; Available from: http://www.healthycanadians.gc.ca/eating-nutrition/healthy-eating-saine-alimentation/tips-conseils/interactive-tools-outils-interactifs/eat-well-bien-manger-eng.php.

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