A Theory-Based Exercise App to Enhance Exercise Adherence: A Pilot Study

BACKGROUND: Use of mobile health (mHealth) technology is on an exponential rise. mHealth apps have the capability to reach a large number of individuals, but until now have lacked the integration of evidence-based theoretical constructs to increase exercise behavior in users. OBJECTIVE: The purpose of this study was to assess the effectiveness of a theory-based, self-monitoring app on exercise and self-monitoring behavior over 8 weeks. METHODS: A total of 56 adults (mean age 40 years, SD 13) were randomly assigned to either receive the mHealth app (experimental; n=28) or not to receive the app (control; n=28). All participants engaged in an exercise goal-setting session at baseline. Experimental condition participants received weekly short message service (SMS) text messages grounded in social cognitive theory and were encouraged to self-monitor exercise bouts on the app on a daily basis. Exercise behavior, frequency of self-monitoring exercise behavior, self-efficacy to self-monitor, and self-management of exercise behavior were collected at baseline and at postintervention. RESULTS: Engagement in exercise bouts was greater in the experimental condition (mean 7.24, SD 3.40) as compared to the control condition (mean 4.74, SD 3.70, P=.03, d=0.70) at week 8 postintervention. Frequency of self-monitoring increased significantly over the 8-week investigation between the experimental and control conditions (P<.001, partial η(2)=.599), with participants in the experimental condition self-monitoring significantly more at postintervention (mean 6.00, SD 0.93) in comparison to those in the control condition (mean 1.95, SD 2.58, P<.001, d=2.10). Self-efficacy to self-monitor and perceived self-management of exercise behavior were unaffected by this intervention. CONCLUSIONS: The successful integration of social cognitive theory into an mHealth exercise self-monitoring app provides support for future research to feasibly integrate theoretical constructs into existing exercise apps. In addition, findings provide preliminary support for theory-based apps to increase self-monitoring and exercise behavior in comparison to a control, no-app condition.