title: Apps seeking theories: results of a study on the use of health behavior change theories in cancer survivorship mobile apps.
abstract: BACKGROUND
  Thousands of mobile health apps are now available for use on mobile phones for a variety of uses and conditions, including cancer survivorship. Many of these apps appear to deliver health behavior interventions but may fail to consider design considerations based in human computer interface and health behavior change theories.
  
  
  OBJECTIVE
  This study is designed to assess the presence of and manner in which health behavior change and health communication theories are applied in mobile phone cancer survivorship apps.
  
  
  METHODS
  The research team selected a set of criteria-based health apps for mobile phones and assessed each app using qualitative coding methods to assess the application of health behavior change and communication theories. Each app was assessed using a coding derived from the taxonomy of 26 health behavior change techniques by Abraham and Michie with a few important changes based on the characteristics of mHealth apps that are specific to information processing and human computer interaction such as control theory and feedback systems.
  
  
  RESULTS
  A total of 68 mobile phone apps and games built on the iOS and Android platforms were coded, with 65 being unique. Using a Cohen's kappa analysis statistic, the inter-rater reliability for the iOS apps was 86.1 (P<.001) and for the Android apps, 77.4 (P<.001). For the most part, the scores for inclusion of theory-based health behavior change characteristics in the iOS platform cancer survivorship apps were consistently higher than those of the Android platform apps. For personalization and tailoring, 67% of the iOS apps (24/36) had these elements as compared to 38% of the Android apps (12/32). In the area of prompting for intention formation, 67% of the iOS apps (34/36) indicated these elements as compared to 16% (5/32) of the Android apps.
  
  
  CONCLUSIONS
  Mobile apps are rapidly emerging as a way to deliver health behavior change interventions that can be tailored or personalized for individuals. As these apps and games continue to evolve and include interactive and adaptive sensors and other forms of dynamic feedback, their content and interventional elements need to be grounded in human computer interface design and health behavior and communication theory and practice.
authors.affiliation: Texas A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, College Station, TX, TX, United States. Deborahvd@gmail.com.
authors.forename: Deborah
authors.identifier: http://orcid.org/0000-0003-1674-4998
authors.initials: D
authors.lastname: Vollmer Dahlke
authors.forename: Kayla
authors.identifier: http://orcid.org/0000-0002-1487-250X
authors.initials: K
authors.lastname: Fair
authors.forename: Y Alicia
authors.identifier: http://orcid.org/0000-0003-2729-0450
authors.initials: YA
authors.lastname: Hong
authors.forename: Christopher E
authors.identifier: http://orcid.org/0000-0002-6003-1031
authors.initials: CE
authors.lastname: Beaudoin
authors.forename: Jairus
authors.identifier: http://orcid.org/0000-0001-7753-0956
authors.initials: J
authors.lastname: Pulczinski
authors.forename: Marcia G
authors.identifier: http://orcid.org/0000-0001-8036-2383
authors.initials: MG
authors.lastname: Ory
keywords: eHealth; health behavior; health promotion; mobile apps; mobile health; survivorship
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