Identification of the Most Suitable Mobile Apps to Support Dietary Approaches to Stop Hypertension (DASH) Diet Self-Management: Systematic Search of App Stores and Content Analysis

Ghadah Alnooh; Tourkiah Alessa; Essra Noorwali; Salwa Albar; Elizabeth Williams; Luc P de Witte; Mark S Hawley

doi:10.3390/nu15153476

Identification of the Most Suitable Mobile Apps to Support Dietary Approaches to Stop Hypertension (DASH) Diet Self-Management: Systematic Search of App Stores and Content Analysis

Nutrients. 2023 Aug 6;15(15):3476. doi: 10.3390/nu15153476.

Authors

Ghadah Alnooh^{1

2}, Tourkiah Alessa³, Essra Noorwali⁴, Salwa Albar⁵, Elizabeth Williams⁶, Luc P de Witte⁷, Mark S Hawley¹

Affiliations

¹ Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield S1 2NU, UK.
² Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia.
³ Department of Biomedical Technology, College of Applied Medical Science, King Saud University, Riyadh 11433, Saudi Arabia.
⁴ Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
⁵ Food and Nutrition Department, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 21589, Saudi Arabia.
⁶ Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield S1 2NU, UK.
⁷ Research Group Technology for Healthcare, Centre of Expertise Health Innovation, The Hague University of Applied Science, 2521 EN Den Haag, The Netherlands.

Abstract

Smartphone apps might provide an opportunity to support the Dietary Approaches to Stop Hypertension (DASH) diet, a healthy diet designed to help lower blood pressure. This study evaluated DASH diet self-management apps based on their quality, likely effectiveness, and data privacy/security to identify the most suitable app(s). A systematic search and content analysis were conducted of all DASH diet apps available in Google Play and the Apple App Store in the UK in November 2022. Apps were included if they provided DASH diet tracking. A previous systematic literature review found some commercial apps not found in the app store search, and these were also included in this review. Three reviewers used the App Quality Evaluation Tool (AQEL) to assess each app's quality across seven domains: knowledge acquisition, skill development, behaviour change, purpose, functionality, and appropriateness for adults with hypertension. Domains with a score of 8 or higher were considered high-quality. Two reviewers assessed the apps' data privacy and security and then coded Behaviour change techniques (BCTs) linked to the Theoretical Domain Framework (TDF) underpinning the likely effectiveness of the apps. Seven DASH diet apps were assessed, showing the limited availability of apps supporting DASH diet self-management. The AQEL assessment showed that three apps scored higher than eight in most of the AQEL domains. Nineteen BCTs were used across the apps, linked to nine TDF action mechanisms that may support DASH diet self-management behaviours. Four apps met standards for privacy and security. All seven apps with self-monitoring functionality had sufficient theoretical basis to demonstrate likely effectiveness. However, most had significant quality and data security shortcomings. Only two apps, NOOM and DASH To TEN, were found to have both adequate quality and security and were thus deemed suitable to support DASH diet self-management.

Keywords: DASH diet; behaviour change techniques; hypertension; mHealth; quality; self-management; smartphone app.

Publication types

Review

MeSH terms

Behavior Therapy / methods
Diet
Dietary Approaches To Stop Hypertension*
Humans
Mobile Applications*
Self-Management* / methods

Grants and funding

This research received no external funding.