1. THE EFFECT OF mHEALTH APPLICATIONS
ON OBESITY DUE TO POLYCYSTIC
OVARIAN SYNDROME
An Action Research Project in Fulfillment
of the Requirements for the Degree
Master of Arts in Strategic Communication Management
by
Kami-O Betzina
Concordia University, St. Paul, MN
August 10th, 2015

2. Context - mHealth Apps
• mHealth (short for mobile health) apps are growing rapidly ranging
from simply making an doctor’s appointment to monitoring a patient’s
pain level, management of conditions such as diabetes, asthma, obesity,
and diseases such as heart disease, and certain types of cancers.
• There are over 6,000 health and fitness apps available, with features
such as activity monitoring, food diaries, and calorie counting.
(Khalaf, S., 2014)
Top 10 doctor recommended mHealth apps.
1. MyFitnessPal
2. Weight Watchers Mobile
3. Lose It!
4. White Noise Lite
5. First Aid (American Red Cross)
6. Runkeeper (Map my Walk/Run)
7. Stroke Riskometer
8. Emergency First Aid & Treatment Guide
9. Instant Heart Rate
10. Fooducate

3. Context - Polycystic Ovarian Syndrome
• Polycystic ovary syndrome (PCOS) is a complex
endocrine (hormone) chronic disorder.
• Women with PCOS may suffer from a variety of
symptoms including hair loss, acne, facial hair,
aggressive behavior, infertility, and obesity.
• Approximately 50-60% of women with PCOS are overweight or obese compared
to 30% of women in the general population. (Khalaf, S., 2014)
• Treatment of PCOS must focus on normalizing the body’s need to produce too
much testosterone, lack of ovulation, and metabolic complications. This can be
achieved through strict diet and exercise.
• There is no cure, just reduction of symptoms.
• Due to the stress PCOS puts on the thyroid and metabolism, typical diets and diet
programs such as Jenny Craig, Weight Watchers, Medifast and “eating healthy” do
not work for most.
• Dietary modifications eliminating carbohydrates such as rice, bread, and pasta
as well high amounts of fat work hand in hand with regular exercise.
• Rapid weight gain and rapid weight loss occurs for
those who are obese.

4. Problem
• How can a female with PCOS lose weight when regular
methods do not work?

5. Limitations
• Due to the difficult nature of the study, participants may
drop out.
• Difficult to recruit participants without incentives.

6. Research Question
“Can the use of mHealth apps reduce obesity due to
PCOS?”

7. Hypotheses
• Using mHealth apps can assist in reducing obesity due
to PCOS because it easily tracks calories and activity.
• The mHealth app will help reduce weight increasing
accountability and self esteem as well as decreasing side
effects associated with this illness.

8. Variables
Using
mHealth
app
Manually
tracking
Reducing
obesity due
to PCOS
Cycle One Cycle Two
Dependent
Variable
Independent
Variable
Independent
Variable

9. Cycle One Methodology
• Participants were asked to pick 1 out of the 3
methods to manually keep track of diet and
exercise
Choosing one of the following:
 Diet/activity journal
 A paleo, vegetarian or vegan diet with exercise
 Mental calorie/activity counting
• 6 week cycle
• Measured in a survey at the beginning, mid cycle, and after
cycle was completed

10. Cycle Two Methodology
• The same participants were asked to pick 1 out
of 3 recommended mHealth apps to track diet
and exercise
Choosing one of the following:
 Lose It!
 MyFitnessPal
 Map My Walk/Run
• 6 week cycle
• Measured in a survey at the beginning, mid cycle, and after
cycle was completed

11. Survey Questions- Beginning of Cycles
Questions
Average Respondent Score (1-5 range on Likert questions)
Cycle One
Survey 1
Cycle Two
Survey 1
1. Did you involve a buddy? No-57% No-57%
2. Did you reach out for support? No-57% No-57%
3. Did you find it easier to track your lifestyle
modification based on the method you chose?
Yes-57% Yes-100%
4. Overall, where you satisfied with the method you
chose?
(1 not satisfied and 5 extremely satisfied)
3.14 4.29
5. How would you rate the level of difficulty with this
method?
(1 not difficult and 5 extremely difficult)
3.86 1.57

12. Survey Questions- End of the Cycles
Questions
Average Respondent Score (1-5 range on Likert questions)
Cycle One
Survey 3
Cycle Two
Survey 3
1. Did you involve a buddy? No-57% No-57%
2. Did you reach out for support? No-57% No-57%
3. Overall, where you satisfied with the method you
chose?
(1 not satisfied and 5 extremely satisfied)
3.14 4.57
4. How would you rate the level of difficulty with this
method?
(1 not difficult and 5 extremely difficult)
4.0 1.29
5. Overall are you satisfied with how much weight
was lost?
Satisfied-
83%
Satisfied-
100%

13. Cycle One Data
83% said that manual tracking assisted them in achieving their
weight loss goal.

14. Cycle Two Data
100% said that using the mHealth app assisted them in achieving their
weight loss goal.

15. Combined Data

16. • While the mHealth app assisted participants in losing weight they found
only certain aspects of it were applicable to their weight loss journey,
noting 75% preferred using the mHealth app over manually. Whereas
25% noted that they could have used both to accomplish the same goal.
• Overall 100% of the participants felt that using the mHealth app assisted
them in achieving their weight loss goal.
Analysis – Overall Findings
• 80% of the participants no longer used the calorie tracking portion of the
app and only tracked activity during the last several weeks of Cycle Two.

17. • So while Cycle One fulfilled the hypothesis of losing weight, Cycle Two
made it more convenient to do so.
• These findings indicate that using a mHealth app is an effective tool, and
holds promise as a tool for future study. There many aspects of this tool
that need to explored and additional consideration should be discussed to
explore next steps.
• The conclusion of the study is the finding that both manual tracking and
tracking with a mHealth app can both be tools for PCOS women to benefit
from. It depends on the individual on how either could be used for
maximum weight loss.
Analysis – Overall Findings

18. • “Research by Flurry Analytics (as stated by Khalaf, 2014) found that in
2013, the overall mobile app industry grew 112% in terms of average
daily use” (p. 33).
• Khalaf also states that in the first half of 2014, health and fitness apps
specifically saw a 62% increase in use, an 87% faster growth than the
rest of the mobile app industry, which is itself growing at an
exponential rate.
• There are over 6,000 health and fitness mobile apps available, with
features such as activity monitoring, food diaries, and calorie counting
(Khalaf, 2014, p.33).
Comparison to Literature-mHealth Apps

19. • PCOS is a common disorder affecting 4-12% of women of reproductive age
(Sheehan, 2004, p. 13-27; Azziz, 2004, p.49).
• PCOS was first described in the United States in 1935 (Stein & Leventhal,
1935, p. 181-191).
• Women with PCOS may suffer from symptoms such as hair loss, acne,
irregular menstrual cycles, facial hair, aggressive behavior, infertility, and
obesity (Ehrmann, 2005, 1223–36).
• Even modest weight loss of about 10-20% improves most symptoms of
PCOS in obese patients (Harlass et. al, 1984; Guzick et al., 1994; Holte et.
al., 1995; Kiddy et. al., 2008, p. 649).
Comparison to Literature-PCOS

20. • Research question: “can the use of a mHealth app change obesity due to
PCOS?”
• Improving weight loss manually or with an app has shown itself in the
study to require convenience and efficiency to those who use them.
• Both cycles showed weight loss and their hypotheses to be correct, but the
balance of their future use should be considered carefully to find the
correct combination to enable continued overall loss of weight.
Answer to Research Question

21. Azziz, R., Woods, K. S., Reyna, R., Key, T. J., Knochenhauer, E. S., &
Yildiz, B. O. (2004). The prevalence and features of the polycystic ovary
syndrome in an unselected population. J Endocrinal Invest, 89(6), 2745-9.
Retrieved, from http://www.ncbi.nlm.nih.gov/pubmed/3089520 doi:
PMC1341046
Ehrmann, D. A. (2005), Medical Progress: Polycystic Ovary Syndrome.
New England Journal of Medicine, 352(12), 1223–36. Retrieved from
http://www.ncbi.nlm.nih.gov/pubmed/12788499
Harlass, F. E. Plymate, S .R. Fariss, B. L., & Belts, R. P. (1984). Weight loss
is associated with correction of gonadotropin and sex steroid
abnormalities in the obese anovulatory female. Fertility and Sterility,
42(4): 649-52
References

22. Khalaf, S. (2014). Health and Fitness Apps Finally Take Off, Fueled by
Fitness Fanatics, Flurry Analytics, Retrieved from
http://flurrymobile.tumblr.com/post/112192181465/health-and-fitness-
apps-finally-take-off-fueled
Stein, I., Leventhal, M. (1935). Amenorrhea associated with bilateral
polycystic ovaries. Am. J. Obstet. Gynecol. 29, 181-191.
Sheehan, M. T. (2004). Polycystic ovarian syndrome: diagnosis and
management. Clin Med Res. 2(1) 13–27 doi: 12931331
References

23. Questions?