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Beliefs About Using Smartphones for Health Behavior Change: an Elicitation Study with Overweight and Obese Rural Women


Despite increased interest in developing mobile technology-based interventions, little research has examined preferences and beliefs about using smartphones for psychosocial or health behavior change interventions, particularly among women with overweight/obesity residing in rural communities. The aims of this study were to examine the beliefs of pre- and inter-conceptional women about using smartphones and to examine the extent to which women’s preferences for using smartphones changed as a result of participating in study interviews. Forty women (M age = 28.2 years; M BMI = 31.4; 50% obese) participated in one-time 90-min interviews and completed questionnaires before and after the interviews. Descriptive statistics were used to examine the frequency of women’s preferences for using smartphones and applications. Interviews were downloaded and transcribed; principles of thematic analysis were used to code the interviews and identify themes. Women identified advantages of using smartphones for behavioral interventions, including being convenient, useful, and able to provide social support. Primary disadvantages were annoyances and needing technology support for phone problems. Participating in interviews also resulted in significant improvements in participant willingness to use smartphones in health behavior change interventions. The study findings highlight the importance of understanding beliefs about using smartphones before designing effective smartphone-based interventions, especially for use with pre- and inter-conceptional women with overweight/obesity who may have unique challenges with study adherence. These findings also suggest beliefs about smartphone utility can be improved over the course of a brief interview that taps into technology-related preferences. Identifying advantages/disadvantages of smartphone use can inform intervention design. Future research should explore how to capitalize on strategies that enable the benefits of technology (e.g., convenience, social support) while minimizing participant barriers (e.g., distractions) to promote behavior change and facilitate intervention compliance.

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We would like to thank the contributions of Franny Wales and the Family Health Council of Central Pennsylvania in assisting with data collecteion for this project.


This project was supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1 TR002014. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Funding to support the first author in preparing this work was also provided by the National Heart, Lung,and Blood Institute (NHLBI) of the National Institutes of Health through grant R01HL119245-01.

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Correspondence to Danielle Symons Downs.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This study was approved by the Institutional Review Board of the participating University. Informed consent was obtained from all individual participants included in this study.

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Downs, D.S., Smyth, J.M., Heron, K.E. et al. Beliefs About Using Smartphones for Health Behavior Change: an Elicitation Study with Overweight and Obese Rural Women. J. technol. behav. sci. 4, 33–41 (2019).

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  • Preconception
  • Intervention
  • Mobile phone technology