A particular opportunity for health apps to make a real impact is in driving healthy lifestyle changes. By virtue of being on a smartphone, they are generally always “on.” And for kids who are growing up with these devices, there should be a particular opportunity.

With over 1/3 of children and adolescents now overweight and obese, apps that promote healthier diets, more activity, and other behavioral changes could have a big impact.

A group of researchers from the University of Kansas took a myriad of apps aimed at pediatric obesity and how well they adhered to best practices. And what they found suggests that there is a real opportunity here still for clinicians interested in using these tools for the benefit of their patients.

Approximately 46% of children have a cell phone by the age of 12 but that figure is probably an underestimate of how children interact with these devices. For example, two thirds of children between the age of 4 to 7 years get to use their parents smartphones and tablets.

To evaluate the landscape of what’s available for children and adolescents, the researchers looked at apps available in iTunes using search terms including kids fitness, kids nutrition, and kids exercise. Using this search strategy, 237 apps were returned but all but 64 were excluded due mostly to irrelevance to the topic. The average cost was $1.09. However, it is worth noting that the highest costing app at $9.99 also had one of the lowest ratings.

On the whole, the researchers found that the included apps did a pretty poor job of incorporating recommended behavior recommendations and even worse on behavioral change strategies. For example, about half of the apps included recommendations to get an hour of physical activity, eat five servings of fruit and vegetables per day. Less than a quarter of apps recommended limiting consumption of sugary beverages and fast food. Only 1.6% of apps mentioned limiting screen time to less than two hours per day.

One interesting finding was that ~40% of apps were formatted as games, demonstrating the popularity of using gaming in health apps. It also reminds us that simply being a game is not enough to make an app good. Also of interest, several apps (about 20%) used the accelerometer to try to drive movement by getting kids to do things like jog in place to drive actions of avatars in virtual words.

The highest rated apps included:

  • Iron Kids – $3.99
  • WakeMyMojo – Free
  • Eat-and-Move-O-Matic – Free

Iron Kids, from the American Academy of Pediatrics, is a personal training aid for children to help promote exercise. In the evaluation, it was rated leaps and bounds beyond the other apps.

For clinicians who deal with pediatric obesity, these findings suggest that a real opportunity remains to be realized in the use of apps to drive healthy behavior change in overweight and obese children. In this study, the researchers have outlined several key recommendations and behavior strategies that should be used – not only can this be an evaluative tool, but it could also serve as a great roadmap for developers and clinicians going forward.

Wearing JR, Nollen N, Befort C, Davis AM, Agemy CK. iPhone App Adherence to Expert-Recommended Guidelines for Pediatric Obesity Prevention. Child Obes. 2014 Mar 21.