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Nutrition apps are effective at initiating and supporting dietary changes. Many researchers in the field of digital health technologies consider these apps to be an easily accessible, readily available and inexpensive option for individual nutrition management. Yet usage rates for these apps fall far short of their potential. The reasons for this are numerous and wide-ranging, and they have been explored in the past using a variety of methods. Researchers at the University of Konstanz, the University of Bayreuth, Chemnitz University of Technology and the University of Lübeck have completed a systematic literature review summarizing the reasons for (non-)usage of nutrition apps. The corresponding article has now been published in the Journal of Medical Internet Research - mHealth and uHealth.

More than 300 barriers and motivators identified
In the systematic literature review, researchers identified 28 articles that provided the basis for mapping the current state of research on usage barriers and motivators for using nutrition apps. “Our findings suggest that many commercially available nutrition apps are poorly aligned with the needs of users, and therefore motivation to continue to use them can quickly be lost. At the same time, our article shows that the factors that motivate initial or continued use often parallel potential weaknesses. For example, the implementation of a specific software feature such as a trusted food database is perceived as a motivator, while its absence is perceived as a barrier,” says Dr Laura König, who began the project at the University of Konstanz in the Health Psychology research team led by Professor Renner and is now continuing it as a junior professor at the University of Bayreuth. The research is performed in collaboration with engineering psychologists Christiane Attig (Chemnitz University of Technology) and Professor Thomas Franke (University of Lübeck). “We were able to extract over 300 individual barriers and motivators from the articles, which were summarized in a framework model,” König adds.

This model shows that usage barriers and motivators can be divided into four broad areas. The first area includes factors related to the (potential) users of nutrition apps. These involve, for example, users’ interest in these apps or how well the use of such apps is compatible with their everyday lives. The second area comprises factors related directly to the technology itself. Here, the model shows, among other things, that the trustworthiness of the databases on which the apps are based is crucial for their use. Some databases are curated by the apps' creators while other databases allow any user to add foods and recipes. This can, for example, make nutritional information less precise.

The third area focusses on the interaction between apps and their users and, in particular, the potential positive and negative consequences for well-being and health. On the one hand, the use of a nutrition app can lead to users developing the desired healthier diet. However, the constant examination of one's own eating behaviour can also trigger feelings of guilt in users, if unhealthier food is eaten than desired. These consequences can, in turn, influence the motivation to continue using the app. Finally, the fourth area, social environment, also plays a role. For example, app users in the family or circle of friends as well as medical professionals can motivate others to use nutrition apps.

There is no one perfect nutrition app
In addition to summarizing the current state of research, the research team explains the significance of the findings for app manufacturers. “The literature clearly demonstrates how varied the reasons are, why many people choose to use or not to use nutrition apps. And it has become clear that there does not seem to be just one perfect nutrition app – instead, users need to have options for individualizing the apps to address different needs,” says Britta Renner.

The research of the two lead authors, Laura König and Christiane Attig, was supported by the Health Psychology Division of the German Psychological Society (DGPs), by the Smartact project funded by the German Federal Ministry of Education and Research (BMBF), and by the Collaborative Research Centre (CRC) Hybrid Societies at Chemnitz University of Technology, which is funded by the German Research Foundation (DFG).

Key facts:

• Original publication: König, L. M., Attig, C., Franke, T., & Renner, B. (2021). Barriers to and facilitators for using nutrition apps: a systematic review and conceptual framework. JMIR mHealth and uHealth, 9(6), e20037. doi: 10.2196/20037
• The collaborative study was completed by health psychologists Junior Professor Laura König (University of Konstanz/University of Bayreuth) and Professor Britta Renner (University of Konstanz), and engineering psychologists Christiane Attig (Chemnitz University of Technology) and Professor Thomas Franke (University of Lübeck)
• Funding for the project was provided by the Peer Mentoring Team Programme of the Division of Health Psychology at the German Psychological Society (DGPs) It received additional financial support from the Smartact project, funded by the German Federal Ministry of Education and Research (BMBF), and from the Collaborative Research Centre (CRC) Hybrid Societies at Chemnitz University of Technology, funded by the German Research Foundation (DFG)