National survey of Americans' health app use shows technology's promise and weakness

According to results of an online national survey analyzed by researchers at NYU Langone Medical Center, 58 percent of 1,604 adult smartphone users had downloaded one of the estimated 40,000 available health-related mobile applications, and 42 percent had downloaded five or more. The average age of respondents was 40, and a majority had annual incomes of less than $50,000.

Some 65 percent of those surveyed said the apps had improved their health, and a majority also had a strong degree of faith in health apps' accuracy and effectiveness.

But there were downsides, as well. Forty-six percent reported having downloaded an app they no longer used. In addition, concerns about cost, disinterest over time, and privacy were apparent barriers to wider and more effective use of the apps.

The study, to be published in the Journal of Medical Internet Research mHealth and uHealth online Nov. 3, is believed to be the most in-depth analysis to date of health-related app use in the United States, according to its authors.

"Smartphone applications have tremendous potential to help market healthy lifestyle habits to people who may be harder to reach in other ways, especially minorities, and those with lower incomes and serious health problems," says study senior investigator and NYU Langone epidemiologist Dustin Duncan, ScD. Duncan, an assistant professor at NYU Langone, points out that more research is needed into applying health apps' and their special ability to reach medically underserviced groups to maximize the impact of their app use on their overall health.

Study lead investigator and clinical psychologist Paul Krebs, PhD, says that far more must also be done to test and validate the health benefits of apps. Krebs, an assistant professor at NYU Langone, adds that app developers also need to address consumer concerns about privacy, keeping purchase costs low, and reducing the burden of data entry.

In their report, Krebs and Duncan point out that most downloaded and used health apps are related to personal fitness and nutrition: to track physical activity (53 percent), food consumption (48 percent), weight loss (47 percent), and exercise instruction (34 percent). Some 65 percent of respondents, equally split among men and women, reported using their apps daily.

As part of the survey, conducted in June 2015 by a survey management company, participants from all regions of the country volunteered to answer 36 online questions about their app use, health status, and personal information. All were over the age of 18, spoke English, and owned a smartphone.

Among survey respondents, some 41 percent said they would never pay anything for a health app, 20 percent would pay only up to $1.99, while 23 percent said they pay at most between $2 and $5.99.

According to Krebs, the most common reasons for people not downloading apps were lack of interest, cost, high volume of information that needed to be entered on a daily basis, and concern about apps collecting their personal data.

In the survey population, those most likely to use health apps were overall younger, more educated, of higher income, of Hispanic ethnicity, or obese (with a body mass index of 30 or more).

"Our study suggests that while many Americans have embraced health apps along with their smartphones, there are challenges to keeping users engaged, and many Americans who might benefit are not using them at all," says Krebs. "There is still much more to be learned about how we can broaden the appeal and make best use of the wide variety of health apps now available -- not just for fitness and nutrition, but for other purposes, such as monitoring sleep and scheduling medical appointments."

Duncan also notes the limitations of the study, including the fact that the data were self-reported and a one-time "snapshot" of use, not a long-term analysis of use over weeks, months, or years. Funding support for the survey was provided by a grant from the Verizon Foundation, the philanthropic arm of Verizon Communications.

Reference DOI upon publication: 10.2196/mhealth.4924