TY - JOUR
T1 - SNapp, a Tailored Smartphone App Intervention to Promote Walking in Adults of Low Socioeconomic Position
T2 - Development and Qualitative Pilot Study
AU - Vos, Anne L
AU - de Bruijn, Gert-Jan
AU - Klein, Michel C A
AU - Lakerveld, Jeroen
AU - Boerman, Sophie C
AU - Smit, Edith G
N1 - Funding Information:
The authors acknowledge the support from the Netherlands Cardiovascular Research Initiative, an initiative supported by the Dutch Heart Foundation (CVON2016–04) and ZonMw (531003001). Funders had no role in the design of the study and collection, analysis, and interpretation of data in writing the manuscript. The authors would like to thank Ognjan Denkovski and Ege de Bruin for their contributions to the development and usability testing of SNapp. The authors would also like to thank Maaike Klomp for assisting with the pilot study. Finally, the authors would like to acknowledge the digital agency Doing Things Together for their development work supporting this project.
Publisher Copyright:
© Anne L Vos, Gert-Jan de Bruijn, Michel C A Klein, Jeroen Lakerveld, Sophie C Boerman, Edith G Smit.
PY - 2023/4/17
Y1 - 2023/4/17
N2 - BACKGROUND: Adults of low socioeconomic position (SEP) are generally less physically active than those who are more socioeconomically advantaged, which increases their cardiovascular disease incidence risk. Moreover, individuals of low SEP are often less easily reached with physical activity (PA) interventions than individuals of higher SEP. Smartphone apps have been presented as a promising platform for delivering PA interventions to difficult-to-reach individuals of low SEP. Although PA apps are widely available, they are rarely based on health behavior theories and most predominantly offer generic PA advice. Consequently, it is unlikely that available apps are the most effective PA intervention tools.OBJECTIVE: To respond to these areas for improvement, we developed SNapp, an app-based intervention encouraging adults of low SEP to increase PA by providing tailored coaching messages targeting walking behavior. This study aimed to describe SNapp's stepwise development and pilot evaluation process.METHODS: We applied a stepwise approach: analyzing the health problem, developing a program framework, developing tailoring assessments, writing tailored messages, automating the tailoring process, and implementing and evaluating the program in a qualitative pilot study (11 participants).RESULTS: SNapp consisted of several elements. First, an app was developed to collect step count and geolocation data using smartphone sensor functionalities. In addition, a survey measure was created to assess users' behavior change technique (BCT) preferences. These 3 data types were used to tailor SNapp's coaching messages to stimulate walking. This allows SNapp to offer feedback on performance levels, contextually tailored prompts when users are near green spaces, and coaching content that aligns with individual BCT preferences. Finally, a server-based Python program that interacts with databases containing user data and tailored messages was built using Microsoft Azure to select and automatically send messages to users through Telegram messenger. Pilot study findings indicated that SNapp was rated positively, with participants reporting that its design, technical functioning, and message content were acceptable. Participants suggested additional functionalities that are worth considering for future updates.CONCLUSIONS: SNapp is an app-based intervention that aims to promote walking in adults of low SEP by offering tailored coaching messages. Its development is theory based, and it is among the first to incorporate contextualized feedback and content tailored to individual BCT preferences. The effectiveness of SNapp will be evaluated in a 12-month real-life parallel cluster-randomized controlled trial.
AB - BACKGROUND: Adults of low socioeconomic position (SEP) are generally less physically active than those who are more socioeconomically advantaged, which increases their cardiovascular disease incidence risk. Moreover, individuals of low SEP are often less easily reached with physical activity (PA) interventions than individuals of higher SEP. Smartphone apps have been presented as a promising platform for delivering PA interventions to difficult-to-reach individuals of low SEP. Although PA apps are widely available, they are rarely based on health behavior theories and most predominantly offer generic PA advice. Consequently, it is unlikely that available apps are the most effective PA intervention tools.OBJECTIVE: To respond to these areas for improvement, we developed SNapp, an app-based intervention encouraging adults of low SEP to increase PA by providing tailored coaching messages targeting walking behavior. This study aimed to describe SNapp's stepwise development and pilot evaluation process.METHODS: We applied a stepwise approach: analyzing the health problem, developing a program framework, developing tailoring assessments, writing tailored messages, automating the tailoring process, and implementing and evaluating the program in a qualitative pilot study (11 participants).RESULTS: SNapp consisted of several elements. First, an app was developed to collect step count and geolocation data using smartphone sensor functionalities. In addition, a survey measure was created to assess users' behavior change technique (BCT) preferences. These 3 data types were used to tailor SNapp's coaching messages to stimulate walking. This allows SNapp to offer feedback on performance levels, contextually tailored prompts when users are near green spaces, and coaching content that aligns with individual BCT preferences. Finally, a server-based Python program that interacts with databases containing user data and tailored messages was built using Microsoft Azure to select and automatically send messages to users through Telegram messenger. Pilot study findings indicated that SNapp was rated positively, with participants reporting that its design, technical functioning, and message content were acceptable. Participants suggested additional functionalities that are worth considering for future updates.CONCLUSIONS: SNapp is an app-based intervention that aims to promote walking in adults of low SEP by offering tailored coaching messages. Its development is theory based, and it is among the first to incorporate contextualized feedback and content tailored to individual BCT preferences. The effectiveness of SNapp will be evaluated in a 12-month real-life parallel cluster-randomized controlled trial.
KW - behavior change techniques
KW - cardiovascular disease
KW - intervention development
KW - mHealth
KW - mobile app
KW - mobile health
KW - mobile phone
KW - physical activity
KW - smartphone
KW - socioeconomic position
KW - tailoring
KW - walking
UR - http://www.scopus.com/inward/record.url?scp=85154572974&partnerID=8YFLogxK
U2 - 10.2196/40851
DO - 10.2196/40851
M3 - Article
C2 - 37067890
SN - 2561-326X
VL - 7
SP - e40851
JO - JMIR formative research
JF - JMIR formative research
M1 - e40851
ER -