Barriers to and facilitators for using nutrition apps : systematic review and conceptual framework

Background: Nutrition apps are effective in changing eating behavior and diet-related health risk factors. However, while they may curb growing overweight and obesity rates, widespread adoption is yet to be achieved. Hence, profound knowledge regarding factors motivating and hindering (long-term) nutrition app use is crucial for developing design guidelines aimed at supporting uptake and prolonged use of nutrition apps. Objective: In this systematic review, we synthesized the literature on barriers to and facilitators for nutrition app use across disciplines including empirical qualitative and quantitative studies with current users, ex-users, and nonusers of nutrition apps. Methods: A systematic literature search including 6 databases (PubMed, Web of Science, PsychINFO, PSYNDEX, PsycArticles, and SPORTDiscus) as well as backward and forward citation search was conducted. Search strategy, inclusion and exclusion criteria, and the planned data extraction process were preregistered. All empirical qualitative and quantitative studies published in German or English were eligible for inclusion if they examined adolescents (aged 13-18) or adults who were either current users, ex-users, and nonusers of nutrition apps. Based on qualitative content analysis, extracted individual barriers and facilitators were grouped into categories. Results: A total of 28 publications were identified as eligible. A framework with a 3-level hierarchy was designed which grouped 328 individual barriers and facilitators into 23 subcategories, 12 categories, and 4 clusters that focus on either the individual user (goal setting and goal striving, motivation, routines, lack of awareness of knowledge), different aspects of the app and the smartphone (features, usability of the app or food database, technical issues, data security, accuracy/trustworthiness, costs), positive and negative outcomes of nutrition app use, or interactions between the user and their social environment. Conclusions: The resulting conceptual framework underlines a pronounced diversity of reasons for (not) using nutrition apps, indicating that there is no “one-size-fits-all” approach for uptake and prolonged use of nutrition apps. Hence, tailoring nutrition apps to needs of specific user groups seems promising for increasing engagement.