Steps Toward Better Health

UNM Study Compares Effectiveness of an App with Personal Coaching to Promote More Active Lifestyle

Peripheral artery disease, a painful condition affecting older adults, is caused by a buildup of plaque in the blood vessels of the arms and legs that restricts circulation. Smoking, diabetes, obesity and high cholesterol are contributing factors.

Claudication, the cramping pain patients experience in their extremities, affects their quality of life. “It’s really poor leg circulation,” says Tracie Collins, MD, MPH, dean of The University of New Mexico College of Population Health. “It compromises your ability to walk.”

Medications can help alleviate the symptoms, but taking regular walks is the most effective way to regain mobility. The trick is getting patients to follow their doctor’s advice when walking is painful.

In a pilot study published online this week in the Journal of Medical Internet Research, Collins and colleagues at UNM and the University of Kansas (where she taught before joining UNM in 2019) compared the effectiveness of a one-on-one technique called motivational interviewing (MI) with a specially developed mobile phone app in getting people to walk and lose some weight.

The study was small – with just 25 participants completing the three-month intervention. Participants underwent testing at the outset to see how far they could walk in six minutes and were assessed for weight, quality of life, exercise behaviors and dietary habits.

Then they were randomized into two groups. One participated in motivational interviewing, with a single hour-long face-to-face meeting with a health counselor followed by four 20-minute phone check-ins.

The other group used the smartphone app, which allowed users to input dietary and walking plans, track walking intervals and record episodic pain, as well as achievement of dietary goals. There were also in-app notifications to encourage patient use, as well as diet and exercise management.

At the end of three months, participants underwent another health assessment. Those who had undergone motivational interviewing showed significantly greater improvements in their walking distance and lost more weight than patients who relied on the phone app alone.

“With MI you’ve got that human contact,” Collins says. “You’ve got the ability to work with someone on what s/he might do differently. It was just more personable.”

The researchers, who hope to continue developing the app, were undaunted by its lackluster performance.

“That just means we need to work more on the app and try to improve it,” Collins says. “We’re working on another app that will be more sophisticated and will be compatible with Android and Mac iOS.”