User preferences for health app promoting physical activity: a discrete choice experiment

Abstract Physical activity is essential for maintaining physical, mental, and social well-being, reducing chronic disease risk. Despite these benefits, physical inactivity remains a widespread global problem, particularly among older adults. A significant percentage of older adults remain inactive: 40-70% of women and 30-60% of men across age groups and WHO regions. Digital health interventions offer promising opportunities for promoting physical activity but often fail when designs do not align with user preferences. The aim of this study is to evaluate individual preferences regarding key attributes of health apps designed to promote physical activity. A Discrete Choice Experiment (DCE) was conducted to assess user preferences for physical activity apps. Key attributes included: app developer, ease of use, social engagement features, gamification elements, and personalization options. The design included 10 choice sets using a D-optimal algorithm. Data were collected via online survey. A mixed-effect logit model was used to estimate choice behavior and calculate attribute importance. The study included 162 participants (67% female, mean age 47 years). Statistical analysis showed app developers (β = 1.382, p < 0.001) and ease of use (β = 0.674, p < 0.001) significantly influenced app selection, with healthcare professionals strongly preferred as developers. Social engagement, gamification, and customization features showed no significant impact. Willingness-to-trade analysis confirmed developer importance as the crucial decision factor. The high heterogeneity in preferences suggests that a one-size-fits-all approach may not be effective for all users. These preliminary findings provide guidance for designing more targeted and acceptable digital health interventions for specific populations. Tailoring apps to user preferences could reduce inequalities in accessing physical activity resources for underserved populations, ultimately promoting more equitable health outcomes. Key messages • Health professional involvement and ease of use are key factors influencing physical activity app selection, while social engagement and gamification features have minimal impact on user preferences. • High preference heterogeneity suggests that tailored app design is key to promote physical activity effectively, potentially reducing health inequalities and improving access for underserved groups.