Awareness, Usage and Perceived Benefits of Mobile Appsfor Health and Fitness among the Interns and PostgraduateStudents of a Medical College in Bengaluru city

INTRODUCTION

India has a strong background in Information and technology (IT) and the integrated health information system serves by contributing approximately 8 percent to the GDP. Hence, The Ministry of Health and Family Welfare has initiated eHealth division in India primarily due to the rapid rate of progress in mobile technology, easy accessibility, quality of healthcare, affordability, efficient monitoring and significant reduction in disease burden. Benefits are described in the form of 10 e’s in “e-Health” viz. Efficiency, Enhancing Quality, Evidence based, Empowerment of consumers and patients, Encouragement Education, Enabling information exchange, Extending, Ethics and Equity. However, the population who do not have money, skills, and access to computers and networks are least likely to benefit from advances, unless political measures ensure equitable access for all.¹ Apps are created to help solve a problem that users are experiencing, and have a clear purpose and goal. Health apps aim to help peopletracking day-todaycondition, staying on track withmedication, athome testing, information sharing with care teams andself-education which could help themavoid emergencies, long-term problemsandreduce the high cost of healthcare.² Out of 3,017,514 apps in the android market 90,591 apps are categorized as health and fitness, of which 85,752 are free of cost and 4,839 are paid apps.³ Several studies also has been done on these health apps depending on the types, uses and necessity among the users.^4-11

Apart from these apps, several apps are created for Health information for medical professionals and everyone else which helps us keep a track on the latest global health information at our fingertips like that of WHO. In this modern world of technology, where smartphone plays a major part of our everyday life, health care service through smartphones can be improved by various means. To facilitate this, studies in this area is the need of the day to gain knowledge about proportion of users and to further identify the necessities of additional features as recommended by the users. Hence the study was taken to determinethe proportion of health app users among medical interns and postgraduates and to assess the effectiveness of Health apps among them on nutrition, physical activity and weight loss.

Materials and Methods: The study is crosssectional study, conducted in a Private medical college, Bangalore from July to August 2018. Study population were Medical interns and post graduate students studying in a Private Medical College, Bengaluru

Inclusion criteria

a) Persons willing to participate in the studyand Persons having Smartphones

Exclusion criteria:

Persons absent during the period of study

Sample size: Based on Bol N’s study the prevalence of health app users is 36.5% so the sample size was calculated using formulaand N=181

Sampling method:

STEP 1: Medical interns and postgraduates present in the select Private Medical college were listed.

STEP 2: Permission was obtained from the department.

STEP 3: 181 randomly selected medical interns and postgraduateswereasked to fill a pretested self-administered questionnaire

Method of data collection

After ethical clearance from the Institute Ethical Committee, data was collected from the eligible participants. After explaining the details of the study, data was collected using an interviewer administered pretested, semi-structured questionnaire. Health app categories included for the study were health, fitness and nutrition mobile apps. The questionnaire includes the usage of app, lifestyle, food log, health goals, barriers, influence of app rewards on fitness and health.

PROCEDURE: Participants who met the inclusion criteria werescheduled for a confidential interview at their convenience.

Results were compared among males/ females, different age group, types of phone apps, types of smart phones, activity details including exercise and diet on the pillars of nutrition, physical activity and weight loss.

Statistical Analysis: Data was entered and analyzed using Epi Info Version 7.2.1. Data was presented in percentages, mean and standard deviation. Chi-square test, independent t test was used to test relationship between various variables. P value <0.05 was considered as statistically significant.

Results

Postgraduates and interns were randomly asked if they are interested in participating in the study. Out of which, 181 valid and completely answered questionnaire were taken for the study.

Out of the total study subjects (n=181), 69(38%) were males and 112(62%) were females and 94(52%) were postgraduate students and 87(48%) were intern doctors.

Discussion

Out of 181 respondents in our study, 58.39% were users and 41.61% were not non users. Among the users (n=87), 57(65.52%) were females which suggests more use of health apps among females as compared to males. Mary Gowin et al performed a study on 27 college students aged 18-30 years, to explain usage of health and fitness apps for behavioral change among college students showed that 78% were females.⁹ Similar results were seen in study by David Bakker et al which showed 81% were females.¹⁰

Our study showed the respondents used health apps for fitness, nutrition, self-care, vitals, sleep, mindfulness and reproductive health. In Bol’s study the various used health app categories included fitness, nutrition, self-care, vitals, sleep, mindfulness, reproductive health, health information, and health dashboards.⁴ In our study, 45(24.86%) were used for fitness and exercise, 14(7.73%) for nutrition or nutrition goals, 8(4.41%) for sleep, 4(2.2%) for mindfulness, 3(1.65%) for reproductive health, 9(4.97%) for health related informations, 5(2.76%) others. Allover 30 different types of apps were used by the respondents in this study.

Other studies have shown that 80% uses internet and various apps for Health Information in United States, including sexual health information (Eleuteri et al., 2017).¹¹ In our study it was observed that uses of smartphone apps was quite frequent and a higher percentage used it on a daily basis. However, other studies by Eleuteri et al showed that smartphone apps, are used to facilitate health information seeking or health-related apps are infrequently downloaded and rarely used.¹¹ Similar study by N bol et al showed that 28.7% users actually used their health apps while 7.8% had health apps installed but never used. On an average the app users had 3 apps on their device of which two were used.⁴ Similar study by Mary Gowin et al showed that 37% used apps for more than a year. She said that the participants used health apps to adopt a healthy lifestyle or meet a goal or support an established behavior and the apps helped them by their free availability, ease of use, audio and visual cues and game like rewards.⁹

Conclusion

This study showed that only 82.32% were aware of presence of apps related to health of which, 58.39% used them. With the advancement in technology and easier, more updated and better access to health-related knowledge, awareness should be spread regarding usage of health apps, especially among medical professionals. As for certain health goals requiring long term consistency like diet and exercise, following health apps for prolonged period of time or till achievement of goal can be suggested. Apps may be developed with more game like rewards to motivate the users in maintaining consistency. Alarm based daily notifications can be developed in the app to remind the user about the app. Mandatory feedbacks can be used as pop up window to know the deficiencies in the apps for those who discontinue the usage of health apps and thus welcoming ideas for improvement of the app further.