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App aimed at preventing diabetes brings promising results

The health app has the potential to reduce waistlines and improve food habits.

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Users can select healthy actions from a lifestyle library. Image: THL

Preliminary research on mobile health app Pienet Teot, known in English as StopDia, which aims to reduce type 2 diabetes risk through changes in diet and exercise habits, has yielded promising results.

The app, which was developed by the University of Eastern Finland in collaboration with the state-owned VTT Technical Research Centre of Finland, is designed to help users take small, everyday steps to improve their lifestyle. The app seeks to encourage the formation of new, lasting healthy habits, with the ultimate aim of preventing or delaying the onset of type 2 diabetes.

Results of the Stop Diabetes research project indicate that the app helped slim waists and improve eating habits and was most effective when used in conjunction with group coaching. StopDia has been tested on approximately 3,000 people who were at risk for diabetes in the healthcare districts of Päijät-Häme, North Savo and South Karelia.

"Using nothing but the app is sufficient for approximately one third of people, but for the remaining two thirds, the app can be used in conjunction with other methods," said Jussi Pihlajamäki, nutrition professor and lead researcher of Stop Diabetes. "The app can make a difference in certain target groups’ diets, exercise habits and to an extent, waist circumference," he said.

First study to examine effectiveness

Health apps have been rapidly gaining popularity. Public health centres and healthcare districts offer digital services and apps. However, there have been no similar studies monitoring the impact of these services, according to Pihlajamäki.

"The key concern was fully integrating the research into the healthcare system. Risk identification was directly linked to risk assessment, which included lab testing, digital applications that continue to be offered and the control group. That way we could measure the effect," he said.

Three steps to better health

The basic principle of the StopDia app is simple: after opening the app, the user selects small, easy lifestyle changes from a lifestyle library and incorporates these changes into his or her everyday life.

The app, which is aimed at promoting the automatic development of healthy habits, is based on the habit formation theory. According to this theory, the formation of healthy habits involves three components: a familiar context where the new behaviour is introduced, repeating the behaviour in the same context and a meaningful reward for the behaviour. If the behaviour becomes systematic, a permanent habit is formed.

Users can select a suitable healthy action from the list and mark it done once completed. For instance, one healthy habit the app suggests is taking a nutritious snack to work to prevent unhealthy choices and fatigue in the evening.

"We have compiled a lifestyle library of small actions, which people can select from freely according to their own requirements. The action is then carried out every day," said VTT Senior Scientist Marja Harjumaa.

Unexpected number of male and elderly users

The preliminary results of the study subverted expectations, as researchers were surprised by the high number of active male users. "Surprisingly, male users were more active than female users," said Harjumaa.

Researchers were similarly surprised that the app was more actively used by the slightly older age group. "The reasons behind this are yet to be analysed," said Pihlajamäki.

According to Harjumaa, the results of the study did not indicate differences between various regions or individuals, but demonstrated differences in the operations of healthcare districts.

"Some places have been implementing preventive measures and these places provide more fertile ground to work with. Similarly, work communities for whom preventive measures are not new provide much better results," she noted.

Not for everyone

"An important lesson related to the app’s usage is that clearly over half of users are motivated to use the app for a long time, but around a third do not use it at all," Pihlajamäki said. "The final outcome should be targeting the right people with the right app."

The next step for researchers is to determine which active users benefit from the app and which do not. Following this, researchers can gain a more in-depth solution to reach the missing risk group.

StopDia will continue to be developed after the end of the project. However, the open access application has not yet reached this point. Healthcare provider HUS plans to use the model to treat patients on the waiting list for surgery.

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