title: The use of smartphone health apps and other mobile health (mHealth) technologies in dietetic practice: a three country study.
abstract: Smartphone health applications (apps) and other mobile health (mHealth) technologies may assist dietitians in improving the efficiency of patient care. The present study investigated the use of health apps and text messaging in dietetic practice and formulated intervention recommendations for supporting app uptake by dietitians based on the behavioural 'COM-B' system, where interactions between capability, opportunity and motivation influence behaviour.
  
  
  
  A 52-item online survey tool, taking 20 min to complete, was developed and piloted, with questions exploring the use of health apps and text messaging in dietetic practice, types of apps dietitians recommended and that patients used, and barriers and enablers to app use in dietetic practice. The Australian, New Zealand and British dietetic associations distributed the survey to their members.
  
  
  
  A 5% response rate was achieved internationally, with 570 completed responses included for further analysis. Health apps, namely nutrition apps, were used by 62% of dietitians in their practice, primarily as an information resource (74%) and for patient self-monitoring (60%). The top two nutrition apps recommended were MyFitnessPal®(62%) and the Monash University Low FODMAP Diet®(44%). Text messaging was used by 51% of respondents, mainly for appointment-related purposes (84%).
  
  
  
  Although the reported use of smartphone health apps in dietetic practice is high, health apps and other mHealth technologies are not currently being used for behaviour change, nor are they an integral part of the nutrition care process. Dietetic associations should provide training, education and advocacy to enable the profession to more effectively engage with and implement apps into their practice.
authors.affiliation: School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: J
authors.initials: J
authors.lastname: Lieffers
authors.affiliation: School of Public Health and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Bauman
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Hanning
authors.affiliation: School of Life and Environmental Sciences and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Allman-Farinelli
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D004032:Diet; D004046:Dietetics; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D009520:New Zealand; D064686:Nutritionists; D010865:Pilot Projects; D000068997:Smartphone; D012958:Societies, Scientific; D017216:Telemedicine; D060145:Text Messaging; D006113:United Kingdom; D055815:Young Adult
keywords: behaviour change; dietetics; education; mHealth; smartphone applications