How can weight‐loss app designers' best engage and support users? A qualitative investigation

Tang, Jason; Abraham, Charles; Stamp, Elena; Greaves, Colin

doi:10.1111/bjhp.12114

Cited by 152Mobile Health and mHealth ApplicationsDigital Mental Health InterventionsInnovative Human-Technology Interaction

How can weight‐loss app designers' best engage and support users? A qualitative investigation

Tang, Jason, Abraham, Charles, Stamp, Elena, Greaves, Colin·2015·British Journal of Health Psychology

DOI 10.1111/bjhp.12114

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Abstract

Objectives: This study explored young adults' experiences of using e‐health internetbased computer or mobile phone applications (apps) and what they valued about those apps. Design and methods: A qualitative design was used. Semi‐structured interviews were conducted with a community sample of 19 young adults who had used a publicly available phone or internet‐based application. Transcripts were analysed using thematic analysis. Results: Participants valued an attractive user interface. Structure, ease of use, personalised features and accessibility (including dual phone‐computer access) were all important to participants and users indicated that continued use depended on these design features. Many believed that a focus on calorie counting was too limiting. Some users mentioned behaviour change strategies and known behaviour change techniques utilised by apps including; self‐monitoring, goal setting and behavioural feedback. Only a few users reported positive changes in physical activity levels. Conclusions: Use of particular design features and application of evidence‐based behaviour change techniques could optimise continued use and the effectiveness of internet/smart phone interventions. Statement of contribution: What is already known on this subject? E‐health is increasingly used to deliver weight loss/control programs. Most e‐health programs have not been founded on evidence‐based designs and it is unclear what features and functions users find useful or not so useful. What does this study add? Weight loss app users valued structure, ease of use, personalised features and accessibility. Goal setting and feedback on calorie intake/energy balance were the most widely used behaviour change techniques. Designers should consider an extensive food database, a food scanner, and provision of diaries.

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Users valued available statistical information, which was a visual or numerical summary of progress or a trend in their behavior.
“Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E).”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Being able to check their progress helped users better monitor their behavior.
“Being able to check their progress helped users better monitor their behavior (Q10) [37-39,71,72], and for some individuals, a positive trajectory acted as a behavioral reinforcement (Q11) [46,67].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Reminders positively affected behavioral regulation by prompting engagement with self-monitoring and the tracking features of the app.
“Reminders positively affected behavioral regulation by prompting engagement with self-monitoring and the tracking features of the app (Q14) [37,39,40,51,54,62,67,69-71] as well as reinforcing the users by reminding them about their positive progress [40,48,51].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Additional functions that decrease the time spent on a task using an app were highly appreciated.
“Additional functions that decrease the time spent on a task using an app were highly appreciated [37,39,48,50,54,56,71,72,75].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Automatization of data collection, for example by linking apps to wearables or by using the camera function to scan barcodes to input calories, was found to be particularly useful in physical activity and weight management apps.
“The automatization of data collection, for example, by linking apps to wearables [37] or by using the camera function to scan the barcodes to input calories [71] was found to be particularly useful in physical activity and weight management apps.”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]

Such an app often would be deleted or replaced with another app that is perceived to be easier to use.
“Such an app often would be deleted or replaced with another app that is perceived to be easier to use [46,48,56,66,71].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Self-monitoring enhanced users' intention to engage with an app, provided self-reinforcement, helped increase self-efficacy, and evoked feelings of control, security, health, empowerment, and autonomy.
“It also enhanced users’ intention to engage with an app [51,52,58], provided self-reinforcement [52], helped increase self-efficacy (Q22) [56,61,71], and evoked feelings of control, security, health, empowerment, and autonomy [54].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Interactivity and positivity of tone may be efficacious for engagement, especially when attempting to change behaviors associated with self-blame (eg, weight management).
“Numerous studies have found that interactivity and positivity of tone may be efficacious for engagement, especially when attempting to change behaviors associated with self-blame (eg, weight management) (Q29) [46,51,57-60,69,71,72].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Unsupportive language would evoke negative emotions (eg, guilt and regret), which would affect the intention to engage with an app.
“It was suggested that unsupportive language would evoke negative emotions (eg, guilt and regret), which would affect the intention to engage with an app [46,59,71].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Lack of flexibility in content created frustration in some cases.
“Personalization to users’ needs and preferences suggested better engagement [58,59,61], whereas lack of flexibility in content was found to be a reason to stop engagement [52], and in some cases, it created frustration [71].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Some users found embedded social media reinforcing.
“Some users found this reinforcing (Q46) [40,61,71,75], whereas others did not want to engage with such features due to social stigma (eg, smoking, alcohol consumption, or weight management; Q46-Q47) [39,48,54,56,58,67,72].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Participants suggested including gamification elements in apps to enhance engagement.
“Participants suggested including gamification elements in apps to enhance engagement [37,56,69,71,75].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]
Some users found intangible rewards (eg, badges) motivating.
“Some users found intangible rewards (eg, badges) motivating (Q57) [46,56,58,59,66,71], whereas others would want to receive tangible rewards instead (eg, free t-shirt, gift cards, cash, reduction in health insurance, or vouchers provided by hospitals or doctor’s office; Q58-Q59) [40,56,58,66].”
From Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review (2020) · cites this paper as [71]

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Authors: Tang, J., Abraham, C., Stamp, E., & Greaves, C.
Affiliations: University of Exeter (GB)
Corresponding author: Tang, Jason
ORCID: Tang, Jason
Abraham, Charles
Greaves, Colin
Venue: British Journal of Health Psychology
Publisher: Wiley
Published: 2014-08-14
Volume: 20
Issue: 1
Pages: 151-171
ISSN: 1359-107X (ISSN-L)
2044-8287
DOI: 10.1111/bjhp.12114
OpenAlex: W1998221668
Cited by: 152
References: 41
Citations by year: 2026: 4 · 2025: 11 · 2024: 10 · 2023: 6 · 2022: 14 · 2021: 15 · 2020: 18 · 2019: 18 · 2018: 22 · 2017: 16 · 2016: 11 · 2015: 6 · 2014: 1
FWCI: 20.52
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: British Journal of Health Psychology (publishedVersion)
PubMed (publishedVersion)
Figshare (submittedVersion)
Open Research Exeter (University of Exeter) (submittedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Funders: UK National Institute for Health Research (NIHR)
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Physical Sciences › Computer Science › Human-Computer Interaction › Innovative Human-Technology Interaction
Keywords: weight loss apps, e-health, mobile health apps, young adults, user engagement, app design features, user interface, ease of use, personalization, calorie counting, behaviour change techniques, self-monitoring, goal setting, physical activity, food database
MeSH terms: Adolescent, Adult, Female, Health Promotion, Humans, Interviews as Topic, Male, Motivation, Health Behavior, Young Adult, Weight Reduction Programs, Mobile Applications

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