Web or app: What’s best for your mobile behavioral intervention?

As the world becomes more mobile, so do the ways we reach people to help them improve their health. In this blog, based on our article recently published in Translational Behavioral Medicine we take a look at what provides the best outcomes for health, web or app.

This is a guest blog by Brie Turner-McGrievy.

As a behavioral scientist, my work has used technology to scale up effective behavioral interventions from face-to-face delivery to delivery via digital and mobile technologies. Technology moves fast and science can sometimes move a little slower, so it can be a challenge making sure you’re using the most effective technology to assist people with making healthy behavior changes.

Websites vs mobile apps

When researchers delve into the world of mobile health (mHealth), they often first think of smartphone apps. While apps can be an effective way to collect data and deliver behavioral interventions, they are not always the most cost and time efficient delivery platform.

After working in the area of mHealth for the past 17 years, I’ve seen many times researchers that I’ve collaborated with, unsure about what technology they need to deliver their behavioral health interventions. For example, many feel that they need an app for their intervention when they actually could use a responsive-design website (a website that works well across different mobile and non-mobile platforms). It’s because of this misconception that our team decided to share some lessons learned and guidance in choosing between mobile responsive-design websites vs. mobile apps for research interventions.

Case studies

Our paper also walks readers through the benefits and challenges of using two different mobile modalities for behavioral interventions.

Our paper provides an overview of four case studies: two studies that chose a mobile app and two that chose a mobile website. The Motivating Families with Interactive Technology (mFIT) study used a mobile web approach to allow parents and their children to help each other improve their healthy eating and physical activity. Cost and time were the primary drivers of using this approach, but an additional benefit was the use of the site across all mobile and non-mobile platforms. A single log-in for families, with the ability to toggle between parent and child interfaces, made the intervention more accessible to families and also provided tailored information for each parent-child dyad in the study.

The Social Pounds Off Digitally (Social POD) study used a mobile app programmed for Android devices. This weight loss intervention for adults required an app-based solution in order to provide built-in notifications to remind participants to self-monitor behaviors and to send supportive messages to other users. App-based notifications were used in place of text-messaging, which allowed users participate in the study without a text-messaging plan.

The Healthy Eating and Physical Activity Mobile (HEPAm) study took a paper-based assessment tool and converted it to an electronic format to be used by afterschool program staff. A web approach was chosen for several reasons. Staff completing the assessment accessed the tool from a wide variety of personal devices (including both Android and iOS) and a web approach allowed for delivery across different (and older) smartphones and tablets. In addition, the interface could be regularly updated without the need for staff to re-download an app.

Last, the Inflammation Management System (IMAGINE) study aimed to assess risk of inflammation via use of a modified Dietary Inflammatory Index scale. The study, which was funded by an NIH Small Business Innovation Research (SBIR) grant, required a mobile solution that could be quickly scaled up, delivered via mobile repositories, and have the potential to charge users for downloads. A mobile app approach allowed the team to meet those goals.

These four case studies demonstrate reasons why a responsive design website or mobile app may be most appropriate for a particular study. Our paper also walks readers through the benefits and challenges of using two different mobile modalities for behavioral interventions.

As technology moves forward, we will continue to have even more options to choose from—a prospect which is both exciting and intimidating.

We discuss the list of pros and cons of each approach, including cost, targeted population, compatibility across multiple platforms, data security and privacy, user notification requirements, and integration with other platforms or sensors to help users decide what approach is best before investing time and money into a project—both of which are resources that are in limited supply among researchers.

As technology moves forward, we will continue to have even more options to choose from—a prospect which is both exciting and intimidating. We’d love to hear about your experiences using either mobile responsive web design or mobile apps for your intervention research and what influenced your choice. Comment below and share some tips for others that can help with this decision process.

About the author: Brie Turner-McGrievy, PhD, MS, RD is an assistant professor at the University of South Carolina in the Department of Health Promotion, Education, and Behavior in the Arnold School of Public health. Her research focuses on the use of emerging technologies for weight loss and promotion of healthy eating. She heads up the Behavioral Research in Eating Lab at U of SC: www.brie.net.

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