Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial

Abstract BackgroundMobile health (mHealth) interventions offer a promising way to support healthy lifestyle habits, but effectiveness depends on user engagement. Maintaining high user engagement in app-based interventions is important, yet challenging. ObjectiveWe...

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Main Authors: Linnea Sjoblom, Freja Stenbeck, Ylva Trolle Lagerros, Essi Hantikainen, Stephanie E Bonn
Format: Article
Language:English
Published: JMIR Publications 2025-05-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e71408
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author Linnea Sjoblom
Freja Stenbeck
Ylva Trolle Lagerros
Essi Hantikainen
Stephanie E Bonn
author_facet Linnea Sjoblom
Freja Stenbeck
Ylva Trolle Lagerros
Essi Hantikainen
Stephanie E Bonn
author_sort Linnea Sjoblom
collection DOAJ
description Abstract BackgroundMobile health (mHealth) interventions offer a promising way to support healthy lifestyle habits, but effectiveness depends on user engagement. Maintaining high user engagement in app-based interventions is important, yet challenging. ObjectiveWe aimed to examine the association between user engagement with an app-based dietary education for people with type 2 diabetes and changes in diet quality, dietary intake, and clinical measures. MethodsIn this randomized clinical trial, people with type 2 diabetes were recruited within primary care and randomized 1:1 to a 12-week smartphone-delivered app-based dietary education or control group. Participants were followed up after 3, 6, and 12 months. Dietary intake was assessed using a food frequency questionnaire. The control group received the app at the 3-month follow-up. User engagement was analyzed among all participants. Categories of high (100%), moderate (50%‐99.9%), and low (<50%) user engagement were created based on the percentage of activities completed in the app. We used paired t ResultsData from 119 participants (60.5%, 72/119 men) were analyzed. The mean age at baseline was 63.2 (SD 10.3) years and mean BMI was 30.1 (SD 5.1) kg/m2P ConclusionsUser engagement was generally high for the smartphone-based dietary education, suggesting that an app targeting dietary habits is feasible to use. Those with higher user engagement seem to maintain healthier dietary behaviours over time, compared to those with low user engagement. Future mHealth interventions should focus on ways to engage those with low interest.
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spelling doaj-art-799ec7eb8d5e41569725668ecba7c1dd2025-08-20T03:24:59ZengJMIR PublicationsJMIR Formative Research2561-326X2025-05-019e71408e7140810.2196/71408Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled TrialLinnea Sjoblomhttp://orcid.org/0000-0003-1740-6675Freja Stenbeckhttp://orcid.org/0009-0001-5394-1950Ylva Trolle Lagerroshttp://orcid.org/0000-0001-6816-7577Essi Hantikainenhttp://orcid.org/0000-0002-4155-2894Stephanie E Bonnhttp://orcid.org/0000-0002-2219-7970 Abstract BackgroundMobile health (mHealth) interventions offer a promising way to support healthy lifestyle habits, but effectiveness depends on user engagement. Maintaining high user engagement in app-based interventions is important, yet challenging. ObjectiveWe aimed to examine the association between user engagement with an app-based dietary education for people with type 2 diabetes and changes in diet quality, dietary intake, and clinical measures. MethodsIn this randomized clinical trial, people with type 2 diabetes were recruited within primary care and randomized 1:1 to a 12-week smartphone-delivered app-based dietary education or control group. Participants were followed up after 3, 6, and 12 months. Dietary intake was assessed using a food frequency questionnaire. The control group received the app at the 3-month follow-up. User engagement was analyzed among all participants. Categories of high (100%), moderate (50%‐99.9%), and low (<50%) user engagement were created based on the percentage of activities completed in the app. We used paired t ResultsData from 119 participants (60.5%, 72/119 men) were analyzed. The mean age at baseline was 63.2 (SD 10.3) years and mean BMI was 30.1 (SD 5.1) kg/m2P ConclusionsUser engagement was generally high for the smartphone-based dietary education, suggesting that an app targeting dietary habits is feasible to use. Those with higher user engagement seem to maintain healthier dietary behaviours over time, compared to those with low user engagement. Future mHealth interventions should focus on ways to engage those with low interest.https://formative.jmir.org/2025/1/e71408
spellingShingle Linnea Sjoblom
Freja Stenbeck
Ylva Trolle Lagerros
Essi Hantikainen
Stephanie E Bonn
Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
JMIR Formative Research
title Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
title_full Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
title_fullStr Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
title_full_unstemmed Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
title_short Engagement With a Smartphone-Delivered Dietary Education Intervention and Its Relation to Dietary Intake and Cardiometabolic Risk Markers in People With Type 2 Diabetes: Secondary Analysis of a Randomized Controlled Trial
title_sort engagement with a smartphone delivered dietary education intervention and its relation to dietary intake and cardiometabolic risk markers in people with type 2 diabetes secondary analysis of a randomized controlled trial
url https://formative.jmir.org/2025/1/e71408
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