Abstract running, swimming or at the gym,

AbstractmHealthApplications are the center of attention with changing lifestyles and increaseuser’s motivation. Users became more self-educated about nutrition, fitness andgeneral wellbeing. The available technology facilitates achieving this goaleither through mobile apps or smart watches and activity trackers that cancapture the most personal activities like heart rate, heart rate data can becaptured all the time during working hours, while exercising either running,swimming or at the gym, even while sleeping.mHealthapplications are facing some challenges, some of these challenges are relate tocontinuity, security and privacy and data quality which leads users to stopusing the mHealth application and abandon the application.  1. IntroductionTheadoption rate of Smartphones and mobile apps overpass the adoption rate ofpersonal computer.

That’s due to its portability, enriched connectivity,efficiency, feasibility and the amount of miniature sensors attached to them.Smartphoneshave evolved from the essential usage like making and receiving calls andmessages, smartphones have become a portal camera, video recorder, soundrecorder, organizer, and lately they become bank cards through Near FieldCommunication (NFC).Theselittle portal devices have more connectivity sensors than modern laptops, likeGPS, Bluetooth, LTE, 4G and Wi-Fi; even your smartphone can react as a hotspotand provide internet connectivity your laptop or other devices.Peoplefound to use mobile applications more than traditional websites or webapplications, and that led also the wide use and involvement of mobileapplications.

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These days’smartphones have embedded miniature sensors, sensors that can be found intraditional Healthcare clinics and Hospitals to capturing the most personalactivities, such as heart rate, step counters, walking distance or sleepdisturbance.2. SmartphoneEvolvementsThesmartphone has rapidly gotten evolved and developed; they have gone from oldstyle phones that have a tiny screen with buttons and a chunky sized, to atouch screen technology and the nearly edge to edge display size.Nowsmartphones are rich in features and capabilities, thanks to the tiny sensorsthat are embedded in the phones.

Connectivity sensors: like Wi-Fi, GPS, 3G, 4G, LTE andNFCCamera sensors: sensors that can capture high quality images,image stabilizers, front and back images, even some phones have dual camera nowfor taking best images Security sensors: finger print sensors, face and eye detectionsActivity and Health Sensors: Barometer, Geometer, Heart Rate,AccelerometerOther sensors: Proximity sensor, light sensor, GyroscopeThesesensors are useless if they are not backed up by mobile applications. Mobileapplications interact with these sensors and feedback to the user the data orinformation they captured.  Then camethe era of Smart-Watches and Activity trackers wearable that extended the possibilitiesof activity tracking in areas where mobile applications cannot be used to reached,like activities happens while user is exercising in the Gym or outdoor, duringswimming time, or even sleeping. Here the smart watch or the activity trackercomes in handy to continue monitoring activities and report back to the mHealthapplication as connectivity is enabled.3. mHealthApplicationsTheGuardian has stated that Mobile Applications have become more popular than webapplications. And estimated that individuals spend an average of 3 hours perday on mobile applications (Arthur,2014).

A study hasbeen made using Self Determination Theory (SDT) to test the efficacy ofmotivational aid used in various mobile applications. This theory has beenconducted on the two most mobile apps (i.e. electronic periodic promts) usedfeatures, First Automated daily reminders, and Second Promoting an oft-repeatedcanard as fact (i.e. “It takes 21 days to form a habit”). The result of thistheory will help towards understanding the mechanisms underlying motivationalapps (Austin and Kwapisz, 2016). Mobile Appshave the potential for helping people increase their physical activity,nutrition awareness, scheduled alerts and notifications, such as reminders todrink water, break and move.

There arecurrently over 100,000 mHealth apps in major mobile apps store like Apple AppStore and Google Play Store (Xu, and Liu, 2015).These appshave helped people to self-monitor and educate themselves towards nutrition,fitness, weight management that had a great effect in reducing obesity, quitsmoking, lose weight and get fit among young people. Fitness and general wellbeing applications:Samsunghave provided a good example mHealth application called Health Application,this application comes pre-installed in most of Samsung’s latest smartphones.This application can automatically detects movement activities and record them,so for example it detects when you start to walk for more than two minutes andrecord how many steps you achieved, the distance and map location. This is theleast feature of the application, it can capture more activities like measuresyour heart rate, set goals, and social activities. This app can also beoperated through the smart watch or the activity tracker for maximum activitytracking and capturing. Other companies like Google have developed a similarapp called Google Fit, and Apple the Health App.    Weight Management Apps:Unhealthydietary habits can cause weight gain and thus to obesity and other dieses thatcan affect the heart, the bones.

And can cause other mental dieses that canlead to depression. Many of these dieses can be avoided by dietaryself-monitoring mobile application.Studieshave revealed that individuals who have used mHealth applications for dietaryself-monitoring had a significantly higher adherence and completion ratescompared to a paper diary. As it has been suggested that younger generations,prefer to use mobile applications for dietary and weight loss interventionscompared to other web-based tools (Sarcona,Kovacs, Wright, and Williams, 2017). Sarcona’sand his team have declared that participants in their studies have revealedthat they felt much healthier, motivated and improved self-monitoring whileusing the mHealth application.And that’strue as mobile technology and applications are a leading innovation incommunication and cutting edge technologies. Smartphones are in user’s pocketsand are used most of the time.

Weight loss is the key in prevention of chronicdisease and therefore mHealth application can help achieving the goal ofdisease prevention. Diabetes Apps:DiabetesMellitus (DM) is a chronic disease. A study was conducted to evaluate theefficacy of mHealth application through a systematic review and Meta dataanalysis to facilitate treatment for this disease. The result on 1263participants stated using the mHealth application can significantly improvecontrol of glycated hemoglobin (HbA1c), and this can be done using theperception of self-care contribution and health education to patients. Also,the studies have indicated that patients become more self-confident to dealwith their diabetes (Bonoto et al.

, 2017). 4. Challengesthat are facing mHealth AppsAlthoughmHealth apps are growing as people are towards healthy lifestyles and startedto look after their nutrition, diets, fitness activities and working in ahealthy environment. mHealth app development is facing some crucialchallenging’s, that leads people to stop using the apps after a brief period oftime and abandon the application.

Thesechallenges can be categories into these areas:§  Application Design: There is a lack of standardized design process. A study conducted by Svensson, Magnusson and Larsson toexperience using a mobile phone dietary assessment application over 198participants, they have found that participants are having technicaldifficulties if they are not familiar with the application platform usage, e.g.if they were iPhone users they would have used the application more easily.Other difficulties were reported the design of the application, unnecessaryfunctions and unclear reminders to record (Svensson,Magnusson, and Larsson, 2016).  §  Medication Management for older adults:There are a number of mHealth applications available to help users, rememberand educate about their medication therapy. Studies have revealed that patientswith chronic diseases stop taking a medication as prescribed within the first yearand for other psychiatric diseases by 3 to 6 month.There is a potential need and use for people aged 50 and above.

Elderlypeople have claimed that mHealth applications are frustrating, overwhelming andchallenging to use, as the design is somehow complicated for them to use (Grindrod, Li and Gates, 2014). §  Continuity:Mobile applications got abandoned and people stop using them, which can besummarized in the following points.1.     Some people are not aware of the health application2.     Lack of application literacy3.

     Lack of motivation and discipline §  Quality Concerns: 1.     Sometimes there is a lack of engagement of qualified professionals whiledeveloping the application. 2.     There is an absence of feedback of evidence indicating the clinicaleffectiveness of the application after publishing.3.     Lack of peer review after application publishing.

 §  Security and Privacy: Although most of the mHealth applications are free to download and use,what happens to the data and information being collected and captured whileusing the application? Where are they stored and how are they used? How theapplication generates revenue and who funds the application development?Perhaps these data are used towards targeted marketing, or data arepassed into other third parties for other purposes than the main purpose of theapplication. 5. Somesuggested solutionsDesign Challenges:Mobileapplication developers should have some Human Computer Interaction (HCI)background or studies to enable them to design a more user friendlyapplications. Some organizations started to apply User-Centered-Design coursessuch as the course organized by IDEO.org and +Acumen (NovoEd , 2018), to enable developers to capturenot just functional requirements, but also to capture behavior requirements.

This course passes through several iterations and phases, such as investigationphase, ideation phase, prototyping phase and finally the implementation phase.One of the positive impacts that can be extracted from this course is thatdevelopers or designers are in direct communication with the end user tocapture detailed usage of the system or what expected to be developed. Thisprocess facilitates the development and testing process, and ensures that developersdeliver the expected solution from the end-user perspective.

As statedand suggested by Hevner applying the Information Systems Research (ISR)framework, which consist of three cycles (Hevner,2007). 1.      Relevance Cycle: In this cycle userenvironment to be identified and requirements are generated.2.      Rigor Cycle: In this cycle atheories and artifacts are evaluated. 3.      Design Cycle: In this cycleartifacts were produced and tested.

 Centralized Database Repository:Looking atthe two major mobile application stores (Apple App Store and Google PlayStore), users have to download the application on their own devices, test themto see if they meet their requirements, or read through each applicationprevious users shared feedback, experience and the given rating for theapplication. This is a very time consuming process and not efficient.There is nocentralized database mHealth repository, to systematically evaluate the appsregarding their effectiveness and health outcome prices and user reviews. As aconcept Xu and his team were able to develop a database repository to list anddisplay health related applications. As a result Xu was able to providedetailed information for more than 60,000 health related applications fromApple App Store and Google Play Store (Xu, and Liu, 2015). So the concept of a centralized databaserepository is feasible and tested for its effectiveness. Gamification to increase user motivation:Gamificationis another source of motivation that increases users’ engagement towards healthrelated apps, especially physical activities or food intake (Helf, and Hlavacs,2016).

Applyinggraphics, animation, challenges in term of game levels, is a more engagingdigital solution than normal texts, reports and statistics. Gamification methodworks absolutely perfect for kids and children’s education and as well as inadults. A goodexample would be Pokémon Go mobilegame, which enabled users to keep moving and discovering landmarks. This gamealmost achieved 10,000,000 downloads from Google Play Store (Android Users) andsimilar figures for iOS (Apple Users).Anothergood example is Zombies Run withmore than 800, 000 users, the goal is to improve the user’s level of PA.Another good example is the Skip a BeatGame, which uses the heart rate sensor as a game controller to create awarenessof user’s heart rate levels and enable users to control their heart rate. Andfinally another game called mySugr whichis a diabetes management application and social engagements (Helf, and Hlavacs,2016). ConclusionsHealth, fitness and wellbeing are areas that interestsindividuals and organisations.

mHealth mobile applications represents anessential platform to facilitate the way of achieving this goal. mHealthapplications have indicated significant improvements in helping individualsbeing more fit and healthy, and participated in several medical areas likediabetes, weight management and quit smoking.Smart watches and activity trackers expanded activitytracking to cover maximum capturing of personal activities in areas of absenceof the smartphone, like swimming or sleeping.mHealth applications are facing some challenges that can becompromised into four areas, design, continuity, security and data quality.As mHealth applications indicated future potentialevolvement and usage in Health, Fitness, Nutrition and general wellbeing, theseareas should be addressed and these challenges should be considers.Some of the suggested solutions are a UserCentred Design approach to resolve Application Design usability issues.

Acentralised database repository to enable users evaluate the mHealthapplications before downloading them and individually test them. Gamificationmight be another tool to be used to increase user’s motivation and engagement.


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