App-Based Interventions Can’t Do It All

Anxiety, obesity, diabetes — there’s apps for all that and more. But which risk factors and outcomes actually respond to smartphone-based interventions? A new paper in The Lancet Digital Health separates helpful software from homescreen clutter. 

Mountains of data went into this study. The umbrella review and meta-analysis covered 78 systematic reviews, 496 primary studies, and over 177k participants. 

Apps came out looking pretty good. They made a dent in 21 of 31 outcomes. 

  • Users got moving, adding to their step counts and exercise time. 
  • BMI, weight, and waist size (but somehow not body fat percentage) fell.
  • On the mental health front, anxiety, mindfulness, and stress saw the most positive movement, with depression and wellbeing just behind.
  • Glucose levels improved — more than any other metric, at that. 

But the study was a heartbreaker for cardiovascular disease apps (and a grab bag of other categories)

  • Blood pressure was the only CV outcome that responded to apps.
  • Cholesterol, triglycerides, and CV disease mortality didn’t budge.
  • Fruit and veggie intake, smoking, and hospitalization were also unchanged. 

Here’s where the lessons on better building and deploying apps come in. Researchers, clinicians, developers, and policymakers, take note.

  • Tracking and monitoring were most useful when it came to physical activity, glucose management, nutrition, and medication adherence. 
  • Educational content went a long way for mental health. 
  • Support from healthcare professionals or a community was broadly helpful. 
  • Goal-setting and behavioral planning were generally underused. 

Some outcomes might just be harder to achieve, though. 

  • The researchers theorize that apps are good at short-term behavioral changes, but struggle with conditions that require intensive, multifaceted care.

The Takeaway

App-based interventions are cheap, non-invasive, and low commitment, but this study shows they’re not useful for all conditions. Take that how you will, either as a sign to ditch smartphones for some types of care or double down with better features. 

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