Abstract
Mobile health technology plays an important role in improving physical activity (PA). However, commercial healthcare applications for smartphones (apps) have poor retention, and understanding how people adopt and integrate app use in daily life is critical. We investigated the use patterns of PA apps and explored the usage styles that are predictive of continuation and discontinuation of use and of changes in PA levels over time. We analyzed 2-wave longitudinal survey data concerning commercial PA-app use, which included 4465 respondents (mean age = 50.7; 1932 women) identified as PA-app users at baseline. The participants completed a questionnaire regarding how and for what purpose they used the apps. A 6-month follow-up survey was administered that asked participants about their current app use and PA levels. At baseline, 2737 were identified as long-term users of a PA app (ie, use for more than 6 months). Long-term users reported appreciating the lifestyle management aspects (eg, constant accessibility to health information, tracking, and monitoring PA), whereas short-term users indicated that they appreciated their app's distraction and building relationships (eg, finding like-minded peers) aspects. Prospective analyses (logistic regressions) demonstrated that lifestyle management was associated with continuing to use the app and increased PA levels at the 6-month follow-up, whereas distraction predicted discontinuing the use of the app and decreased PA levels. These findings suggest that on-purpose use (ie, using a PA app to improve one's PA) is the key feature of being in an appropriation state, whereas off-purpose use may hinder app use, leading to less active lifestyles. The implications of appropriation theory and practice are also discussed.