Effects of an mHealth App (Kencom) With Integrated Functions for Healthy Lifestyles on Physical Activity Levels and Cardiovascular Risk Biomarkers: Observational Study of 12,602 Users

Abstract

Background: Mobile health (mHealth) apps are considered to be potentially powerful tools for improving lifestyles and preventing cardiovascular disease (CVD), although only few have undergone large, well-designed epidemiological research. "kencom" is a novel mHealth app with integrated functions for healthy lifestyles such as monitoring daily health/step data, providing tailored health information, or facilitating physical activity through group-based game events. The app is linked to large-scale Japanese insurance claims databases and annual health check-up databases, thus comprising a large longitudinal cohort.

Objective: We aimed to assess the effects of kencom on physical activity levels and CVD risk factors such as obesity, hypertension, dyslipidemia, and diabetes mellitus in a large population in Japan.

Methods: Daily step count, annual health check-up data, and insurance claim data of the kencom users were integrated within the kencom system. Step analysis was conducted by comparing the 1-year average daily step count before and after kencom registration. In the CVD risk analysis, changes in CVD biomarkers following kencom registration were evaluated among the users grouped into the quintile according to their change in step count.

Results: A total of 12,602 kencom users were included for the step analysis and 5473 for the CVD risk analysis. The participants were generally healthy and their mean age was 44.1 (SD 10.2) years. The daily step count significantly increased following kencom registration by a mean of 510 steps/day (P<.001). In particular, participation in "Arukatsu" events held twice a year within the app was associated with a remarkable increase in step counts. In the CVD risk analysis, the users of the highest quintile in daily step change had, compared with those of the lowest quartile, a significant reduction in weight (-0.92 kg, P<.001), low-density lipoprotein cholesterol (-2.78 mg/dL, P=.004), hemoglobin A_1c (HbA_1c; -0.04%, P=.004), and increase in high-density lipoprotein cholesterol (+1.91 mg/dL, P<.001) after adjustment of confounders.

Conclusions: The framework of kencom successfully integrated the Japanese health data from multiple data sources to generate a large, longitudinal data set. The use of the kencom app was significantly associated with enhanced physical activity, which might lead to weight loss and improvement in lipid profile.

Keywords: app; cardiovascular disease; mHealth; mobile phone; physical activity; smartphone.