Introduction

The use of mobile apps to promote the practice of physical activity in the adolescent population has gained relevance in recent years [1,2]. This is because these tools have been shown to be effective in increasing the level of physical activity in this population [3,4], as well as in obtaining physical and body composition benefits [5–7].

Despite the effectiveness shown by mobile physical activity apps [8](Lee et al., 2019), previous research has shown that the adherence of adolescents to this type of intervention is low [9,10], with the use of these devices decreasing considerably after the first few weeks, when the initial novelty wears off [11]. In addition, another of the main problems encountered with the use of mobile apps is that those currently on the market, although used and shown to be effective in adult populations [12], are not designed for the adolescent population [13].

These handicaps hinder the independent use of apps by this population in their free time [6]. Previous studies have shown that a complex interface, not knowing how to use the application, a lack of interest, and the fact that the application does not work on the mobile devices of adolescents, given the high technical specifications required by most of them, are some of the reasons why almost 50% of adolescents abandon their use within a few weeks of starting [10]. On their use in the school context, previous research has shown that these apps have a complex interface that limits the possibilities of use in the educational classroom [14]. Thus, the mobile apps available have failed to capture the attention of adolescents [10], and do not make it easier for teachers to make an appropriate use of them in the classroom [14].

Previous research has analyzed what aspects must be included in a mobile physical activity app to increase its use by adolescents [15], but it has only considered its use outside school hours, leaving aside the possibility of turning it into an educational resource with a place in the school environment. Moreover, previous studies have neither considered the opinion of professionals working with adolescents (teachers, coaches, sports managers), nor experts in the development of mobile apps, who could offer an important perspective in terms of interface and functionality from that provided by adolescents. For this reason, the aims of the present research were a) to discover the opinion of adolescents on the mobile physical activity apps currently available on the market for physical activity practice; b) to discover the opinion of teachers, coaches, managers and experts in the field, on the mobile apps currently available on the market for use with adolescents; c) to determine the elements and characteristics that adolescents consider necessary to include in a physical activity mobile app so that its use is constant over time; and d) to establish the elements and characteristics that teachers, coaches, managers, and experts, consider necessary in a physical activity mobile app for adolescents to facilitate its implementation.

This study aims to answer the following questions: What do adolescents, teachers, coaches, managers, and experts think about the physical activity mobile apps currently available on the market? And what aspects do adolescents, teachers, coaches, managers, and experts consider necessary to include in a physical activity mobile app so that it is designed for adolescents and its use is constant over time?

Materials and methods

Focus groups and discussion topics

The research design was consistent with a critical realist epistemology, which allowed for adequate knowledge and understanding of what is happening in the field of mobile applications for physical activity through the experiences of adolescents, teachers, coaches, managers and experts [26,27].

The focus groups were conducted in Spanish and were composed of between 6 and 10 participants, which is an appropriate sample size to ensure adequate information collection from the group dynamics and interaction between participants. This number of participants and the heterogeneity present in each focus group increases the representativeness and validity of the results [16]. A soundproof room was used for the focus groups, with the participants seated in a circle, favoring interaction between participants and an adequate hearing of all contributions. All sessions were conducted by a single researcher, who was impartial and neutral with respect to the opinions given, avoiding taking a position that would influence opinions [28–30]. Two researchers collaborated in recording the sessions with a password-encrypted digital recording device to facilitate subsequent analysis. The duration of each focus group was standardized between 60 and 90 minutes, thus avoiding that the time factor could interfere with the results obtained [30].

Prior to the start of the focus groups and following the methodology of previous research [17], a group of 10 experts with previous experience in the design and use of this methodology designed the questions that would guide the discussions of the adolescents and the teachers, coaches, managers, and experts. For this purpose, a three-hour face-to-face meeting was held to discuss the questions to be included in both focus groups. This meeting resulted in a draft of questions that were discussed again in a second meeting two weeks later with the same group of experts. The meeting resulted in the final questions for the focus groups (Table 1).

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Table 1. Questions asked by focus group moderators.

https://doi.org/10.1371/journal.pone.0322074.t001

The questions followed a semi-structured approach, as they included leading questions, flexible probing questions, and clarification questions, as had been done in previous research [31]. The structure of the focus groups allowed the researchers to discuss different areas of perceived importance [32].

The focus groups encouraged collective discussions. The goal was to build upon and challenge ideas, ultimately reaching a consensus on a series of questions specifically developed by a group of experts, following established methodologies [16]. According to previous research, the participants’ subjective viewpoints and experiences were recorded during the focus groups, as well as their intentions, hopes, concerns, feelings, and beliefs. In addition, the participants’ opinion was about the external topic, not including demographic queries about income or other personal information [16].

At the beginning of the focus group sessions, the researchers made a presentation about the research and the associated project, according to the methodology of previous research [16]. After this, the participants made a short introduction in order to get to know each other and facilitate interaction during the focus group. Once the presentation was finished, the questions designed for each focus group were asked in the established order. Once the question was posed, the participants were free to participate and interact, sharing their experiences and personal anecdotes, questioning each other, supporting, or disagreeing with the opinions given, but without making value judgements on any participant, in accordance with the focus group’s operating procedures. No participant was obliged to take part in the questions, nor was there a pre-established order of intervention, so participation was free and voluntary. However, the moderator ensured that participation was as balanced as possible among the participants, according to previous research [16,17].

To ensure the truthfulness and authenticity of the data collected during the focus groups, an environment of trust was fostered in which participants felt comfortable sharing their perspectives in an honest manner. In addition, data triangulation was applied, comparing and contrasting the information obtained between the different focus groups to identify consistent patterns and possible discrepancies [33]. Researcher triangulation was also implemented, involving multiple analysts in the data interpretation process [34], which allowed us to reduce potential individual biases and enrich the understanding of the findings from diverse professional perspectives.

The implementation of eight focus groups also made it possible to obtain a more complete perspective of the phenomenon due to the heterogeneity of the sample, as well as to discover the opinion of the participants, avoiding the influence of aspects such as gender or the practice of physical activity. The observance of the study’s fundamental ethical principles of benefit, fairness, and conscience, and the anonymity of study participants with encrypted information was ensured. All of the above aspects contributed to the attainment of valid and reliable data on the subject in question, in line with previous research [28,29].

Results

Thematic analysis

Participants’ ideas and reactions were assigned codes. Where necessary, subcategories of a theme were created to indicate that it was nested within a broader idea or concept. The results on the constructs of the focus group of students and the focus group of teachers, coaches, managers and experts were presented separately. All quotes were contextualized through the use of codes. Figs 1 and 2 show the coding process, showing the areas with overlap and the most cited areas (bold). These themes, groups and codes were established after the following process: 1) initial reading of text; 2) identify specific text segments related to objectives; 3) label the segments of text to create categories; 4) reduce overlap and redundancy among the categories; and 5) incorporating the most important categories. All this was always carried out by two investigators who always sought concordance.

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Fig 1. Graphic representation of NVivo coding in the student focus groups.

https://doi.org/10.1371/journal.pone.0322074.g001

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Fig 2. Graphic representation of NVivo coding in the teachers, coaches, managers, and experts focus groups.

https://doi.org/10.1371/journal.pone.0322074.g002

Student’s analysis

The codes of the student focus groups were established. From these codes, two themes were obtained. The first referred to the opinions and experiences of the students when using physical activity apps that were already available on the market (“use of physical activity existing apps”) (n=181 citations), with five groups into it: use of physical activity apps in different settings (n=97 citations); type of use (n=32 citations); limitations of use (n=18 citations); positive aspects of use (n=16 citations); and gender designed (n=18 citations) (Fig 1 and Table 2).

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Table 2. Themes, groups, and codes identified in the students focus groups.

https://doi.org/10.1371/journal.pone.0322074.t002

Within the group “type of use”, the codes “individual” (n=19 citations) and “shared” (n=13 citations) were established. In the group “limitations of use”, the code “interface and functionality” (n=11 citations) was the most important. In the group “positive aspects of use”, the codes “interface and functionality” (n=9 citations) was highlighted. Within the group “use of PA apps in different settings”, the codes “useful in out of school settings” (n=24 citations) and “useful in the establishment of healthy habits” (n=24 citations) were the most cited (Fig 1 and Table 2).

The second theme included the opinions and suggestions that this population would like to find in a physical activity app that was designed specifically for them (“needs for a future app for adolescents”) (n=261 citations), with three groups: interface needs for adolescents (n=182 citations); contents to be included (n=64 citations); and type of app (n=15 citations) (Fig 1 and Table 2).

In the group “contents to be included”, the codes “physical activity” (n=16 citations), “diet/calories” (n=14 citations) and “sleep time” (n=13 citations) were the most cited. In the group “interface needs for adolescents”, the codes “challenge/competition/progress” (n=25 citations), “multimedia (social network, photos, videos)” (n=24 citations), “privacy” (n=24 citations), “information/notifications” (n=20 citations) and “rewards” (n=18 citations) were highlighted (Fig 1 and Table 2). Finally, in the group “type of app”, the code “gamified” (n=15 citations) was found.

Teachers, coaches, managers, and experts’ analysis

In the case of teachers, coaches, managers, and experts, the codes gave rise to three main themes. The first theme was “use of physical activity apps” (n=168 citations), with four groups: setting of use (n=40 citations); limitations and positive aspects on the use (n=47 citations); design (n=55 citations); and establishment of healthy habits (n=26 citations) (Fig 2 and Table 3).

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Table 3. Themes, groups, and codes identified in the teachers, coaches, managers, and experts focus groups.

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The “design” group was composed for “not for adolescents” (n=19 citations) and “gender designed” (n=15 citations) as highlights. Within the group “setting of use”, the codes “outside school” (n=19 citations) and “at school” (n=13 citations) were highlighted. In the group “limitations and positive aspects on the use”, the codes “limitations at school” (n=19 citations) and “positive aspects in and/or out of school” (n=16 citations) were the most cited. In the group “establishment of healthy habits”, the codes “non-effective” (n=17 citations) were highlighted.

The second theme was “needs for a future app for adolescents” (n=87 citations) with two groups: “interface needs for adolescents” (n=64 citations) and “design” (n=23 citations) (Fig 2 and Table 3).

The group “interface needs for adolescents” is composed of the codes “information/recommendations/notifications” (n=15 citations), “feedback” (n=13 citations) and “challenge/competition/progress” (n=12 citations), among others. Within the “design” group, the codes “offline” (n=11 citations) and “gamified” (n=7 citations) were highlighted (Fig 2 and Table 3).

The third theme was “teachers, coaches, managers and experts’ requirements for using the app” (n=50 citations), with a unique group: “interface and design needs” (n=50 citations). Into this group can be found the codes “facilitating the work” (n=14 citations), and “fast and simple interface” (n=11 citations) as key groups (Fig 2 and Table 3).

Discussion

The first and second objectives of the present study were to discover the opinion of adolescents and teachers, coaches, managers, and experts on the mobile physical activity applications that are currently available for the practice of physical activity. About the use of physical activity apps in different settings, it is worth noting that both students and teachers, coaches, managers, and experts referred to the usefulness of these devices in out-of-school hours. Previous research has shown that mobile apps become more useful and relevant when used in the out-of-school setting due to their greater applicability [13]. This is probably due to the fact that these devices are not prepared to be used at school [14], with some of the problems identified in previous research being difficulties in synchronizing the devices [41]; and teachers are unable to integrate them into physical education teaching units [42]. This finding is similar to previous research in which the extracurricular use of these physical activity apps is beginning to be promoted from physical education subject [4]. In addition, the positive aspects of using these apps in out-of-school hours to record physical activity could be the improvement in students’ physical capacity, which is consistent with previous research [4]; the apps allow them to establish a physical activity routine [43]; the objectivity and immediacy of the data [44,45]; it allows students to include their family or friends in the achievement of their goals with the app [46,47]; and it serves as a complement to the teaching and learning process of students [48].

One point of disagreement between students and teachers, coaches, managers and experts was whether these apps could be effective in improving adolescent health. In this respect, students considered that existing apps on the market could be useful to establish healthy habits. Previous research has shown that when these applications include general advice on physical activity [49,50], motivate people to be physically active [45], or include information about other healthy habits [51,52], showing to be beneficial for increased physical activity [53]. The results found in the present research agree with previous research, as the inclusion of healthy habits in the app was considered an effective strategy by the vast majority of participants. However, it should be noted that professionals consider that existing app are not effective for establishing healthy habits in adolescents. This could be due to the fact that the apps have major limitations in terms of the credibility of the health recommendations included, as they lack professional supervision and credible sources, which diminishes their credibility [54–56]. Another limitation in this field is that previous research has shown that the use of lifestyle apps may be related to increased problematic use of these devices [57]. In addition, one of the main problems of these apps is that they do not allow to control the intensity [58], which is a fundamental variable to obtain improvements in health [59], so their usefulness seems limited. This view of professionals about the lack of benefits that adolescents could obtain from the use of this type of apps may be another reason why their use and promotion is reduced [60].

It should also be noted that there was no consensus among both the students, and teachers, coaches, managers, and experts on the issue of apps designed for a specific gender. They indicate that that fitness apps are more targeted to men, while those that include social networks are designed for women. Previous research showed that the usage patterns of males and females may be different within the app [61]. In this line, males tend to use apps for improving muscle mass to a greater extent than females [62] and this could lead to focus group participants having this view that apps are gender biased. In addition, it is interesting that in the step-counting apps, no differences were found, indicating that they are designed for everyone. Aerobic exercise is more universal and has similar aims in terms of improving cardiorespiratory fitness, so there are fewer gender differences. Given the interesting results of this research, this is an area that still needs to be explored in future research.

Regarding the target group, there were no doubts among teachers, coaches, managers, and experts as the vast majority considered that they were not designed for adolescents, mainly highlighting interface issues, the lack of gamification, and the inclusion of motivational aspects for adults, but not for adolescents. These results are in line with previous research, which indicated that these apps are not designed specifically for adolescents [14], and that their future design should consider the target group, as meeting personal expectations would increase usage [63].

Not in vain, students indicated that there were limitations in terms of interface and functionality in the current app available on the market. These results are in line with previous research that show that one of the main reasons for not using the mobile apps was their complex interface [10]. This previous research also showed that functionality was one of the categories to which adolescents gave the lowest scores [10], and the fact that the app did not work on the mobile device [64,65], or that it uses a lot of battery were negative conditioning factors [45,66].

Regarding the type of use, it should be noted that there were disparate opinions among adolescents, since a considerable number of adolescents used it alone, while others used it with their family or friends. Previous research has also shown that adolescents use these apps alone and accompanied [5,67]. The fact of using them alone is due to the fact that they acquire a greater perception of autonomy to select and monitor their physical activity [5]; while when using them accompanied, it has been observed that the increase in physical activity is greater by involving close members and increasing the motivation to practice [68]. So future research needs to focus on this issue.

In response to the first research question regarding what adolescents, teachers, coaches, managers, and experts think about the mobile physical activity apps currently available, in terms of design, apps in general are not specifically designed for adolescents and it can be stated that adolescents observed limitations in the functionality and design of the apps. With regard to the setting of use, both adolescents and teachers, coaches, managers, and experts clearly indicated their potential for use outside school. Finally, there are discrepancies in the potential of the apps to generate healthy habits, where teachers, coaches, managers, and experts indicate that and not effective in establishing healthy habits; while adolescents think that it could be a resource to achieve this.

With regard to the third and fourth aim, to determine the elements and characteristics that adolescents and teachers, coaches, managers, and experts, consider necessary to include in a physical activity mobile app for adolescents so that its use is constant over time and to facilitate its implementation in different fields, the results show that both students and teachers, coaches, managers, and experts indicated that it is not only relevant to include the recording of physical activity, but that they would also like to find other healthy habits such as eating and sleeping. Previous research has shown that the acquisition of one healthy habit could favor the acquisition of others [69], and it could be the case that including physical activity in the app could lead to the acquisition of other healthy habits, or vice versa. This is of great relevance, as it would allow adolescents to achieve a state of comprehensive health, complementing the practice of physical activity with other healthy habits [70]. In addition, this could lead adolescents to use the app to a greater extent, as it would not be reduced only to recording the physical activity practiced, granting a greater versatility to the app, which is consistent with previous research in which function combinations, rather than standalone functions, contributed to app success [71].

In addition to the above, it should be noted that teachers, coaches, managers, and experts indicated that it is essential to include the ability to monitor progress and feedback on the activities carried out, through which users receive immediate information about the physical activity they have just practices. This is in line with the opinion of adolescents reported in previous studies, in that personalized feedback on performance was an important aspect of continued use of physical activity apps and other apps related to healthy habits [2,72,73]. One possible explanation for this is that feedback provided by teachers, coaches and peers has a positive effect on engagement [74,75], so the same could occur with the feedback provided by the app. This finding further highlights the importance of including feedback in such mobile apps, as it seems to have a very positive impact on motivation and engagement. So much so that apps that include feedback mechanisms increase the level of physical activity to a greater extent [76]; increase well-being [77]; and maintain engagement for longer [78]. Some of the mechanisms that can be introduced in these apps and that have been shown to be effective in previous research are personalized feedback, understood as personal suggestions based on the recorded data [79]; social feedback, in which comparisons of steps with peers are made, which can motivate the user [80]; or goal setting with feedback on progress, which shows the user his or her progress in the set challenges [81]. Therefore, the inclusion of elements that provide feedback in the app is a very good option because it does not imply a high increase in the app’s requirements and the benefits obtained are high in the psychological field, mainly in terms of motivation and engagement.

Regarding to the type of app, both adolescents and professionals referred to gamification as a key aspect for the app. The importance of gamification lies in several aspects: the relationship between gamification and the motivation, competence, or autonomy of adolescents [82,83], as well as on adherence and engagement [84,85], facilitating the acquisition of a routine [86,87]; the autonomy granted through the ability to customize and create one’s own character [15]; or the existence of a virtual world that encourages the practice of physical activity [88,89]. In fact, previous research using gamified mobile apps has shown benefits on body composition, physical fitness and psychological state of adolescents [89–91], which reinforces the importance of gamified mobile apps. Some elements that could be included would be points and rewards; competition; the possibility to customize and personalize; or the visual appearance [92,93]. All these aspects can have a considerable impact on adolescents’ playability and engagement, however, one of the main limitations of these apps is that they do not work on all devices due to the requirements they need [64,65]. Therefore, including these elements could be interesting, but it should be really assessed whether this possibility would increase usage or make it even more difficult.

Also in this interface needs topic, both adolescents and professionals showed great interest in finding challenges, competitions and rewards. These results are similar to those of previous studies showing the important role that competition and rewards plays for this adolescent population. In this regard, competition can drive engagement, allowing comparison with peers, which can motivate them to perform above the rest [94]. In addition, rewards are a powerful motivator, as they provide immediate gratification and recognition for the achievement of the goals set, which makes adolescents respond positively to them [5]. And, with respect to challenges, these provide a sense of accomplishment and progression, which is key to maintaining interest and motivation, especially in apps that offer various levels of difficulty and new challenges [95]. The combination of these three elements generates a dynamic and interactive environment that can keep teens interested in this type of apps [15].

It is interesting that adolescents see the need for a multimedia section where they can find photos, videos and ways to interact with others, as well as create communities within the app. This is similar to previous research, where was observed that one of the main preferences of adolescents in mHealth apps is that they offer peer support through social media [93]. A possible explanation for this could be that social media allow adolescents to develop emotionally, reducing the perception of loneliness and increasing the ability to relate to others [96], as well as to shape their social identity and improve their overall well-being [97,98]. It is also worth noting that in education, social media brings benefits related to early learning, exposure to new ideas and increased opportunities for social support and contact [99], which makes this issue even more relevant. However, there is another crucial aspect to consider that is closely related to multimedia: the privacy of these applications. Although adolescents claim to be able to show their achievements, share images or videos, and determine whether this content is public or private, this is an issue that generates controversy, also in previous literature [100,101], so the inclusion of this type of content in physical activity apps should be evaluated in depth.

Furthermore, a relevant aspect indicated by professionals is the possibility of using the app offline, and that the data can be loaded later when there is an internet connection. The importance of this lies in the fact that, for teachers, the app would truly become an educational tool that would serve as a complement to physical education classes, as sometimes the full potential of these apps is lost in the absence of a stable internet connection [102]; while for adolescents, the offline app would allow them to maintain a level of physical activity without the need to access the internet, making it easier to integrate exercise into their daily routine, regardless of connectivity [5]. For this reason, future app design needs to prioritize this over the creation of a community building or multimedia space, as apps are already available.

In terms of the needs that should be considered in the app for teachers, coaches, managers and experts to use it with adolescents, a fast and easy interface, and facilitation and automation of the teacher’s work stood out. What teachers seek when they include these tools in the classroom is a facilitator of their work, not an impediment that reduces students’ active time. In this sense, it seems more efficient to use a simple app, with a fast interface and the minimum necessary functionalities, than an app with an excess of functionalities that is slower [15]. Furthermore, it is important to highlight the fact that teachers see the need to inform students of the possibilities offered by these mobile apps, and to train them to learn how to use these devices correctly. This is because a large number of teachers and coaches see a high value in the use of mobile apps and digital resources to complement their work but perceive themselves as having a very low competence in the implementation of these tools [103,104]. Therefore, the training of teachers, coaches or managers may be an issue to consider if the aim is for these tools to be used as a complement to the teaching and learning process of adolescents.

In response to the second question regarding the characteristics and aspects that should be present in a mobile app aimed at adolescents, it is necessary to design a gamified app that, in addition to recording physical activity, include information on other healthy habits such as eating and sleeping. Moreover, both adolescents and professionals highlighted the importance of including challenges, competitions, and being able to observe the progress made, a multimedia section, as well as information and healthy recommendations. Specifically, the adolescents requested aspects related to privacy and obtaining rewards, while teachers, managers and experts asked for the inclusion of feedback in the app, the facilitation of work through a simple and quick interface, and that they be trained on the possibilities of using these apps with adolescents.

The present research is not without limitations. The use of the focus group, although a valid method for collecting information based on semi-structured interviews and spontaneous participation, may lead to a less in-depth approach to the problems raised than other methodologies such as interviews. The selection of the secondary school for accessibility may also mean that the findings obtained in the adolescent focus groups have limitations when extrapolated to students from other schools who may have different casuistries; therefore, it would be interesting to analyze this topic in students from other contexts. And, the sample used, although large as compared to previous research, was still small and could not be generalized to all adolescents and professionals in the field, so future research is needed to answer the questions raised in this study.

The practical implications derived from the present research that can be considered by app developers, educators, and policymakers are a) gamification seems to be a fundamental element to increase motivation and engagement for physical activity apps for adolescents. However, its inclusion usually entails an increase in the requirements of the devices on which the app is used, so it is an aspect to consider; b) the inclusion of challenges, competitions and rewards is an element that does not entail such a drastic increase in the requirements of the app and that maintains motivation and interest in the app, so its inclusion in an app for adolescents is fundamental and necessary; c) the professionals who work with adolescents are a fundamental element to promote the use of the app, so they must be included in an app designed specifically for adolescents. However, this makes it necessary to consider that these professionals will only use the app if they consider it to be simple, in terms of interface, and if it facilitates their day-to-day work. Therefore, the inclusion of a specific section for teachers within the app should be considered; and d) gender issues, although they do not appear to be decisive, may influence whether the app is ultimately used by a greater or lesser number of users. Therefore, all those issues (logos, characters) that may lead to associate the app with a certain gender should be avoided.

With the data obtained, future research should try to propose longitudinal designs to analyze the adherence generated by this type of app over time according to the different elements included (challenges, competition, gamification). In addition, it would be possible to analyze in depth whether there really are gender differences in the use of certain physical activity apps and, specifically, in step-counting apps, since there is no scientific evidence to date to corroborate this. And, of course, an app should be designed that includes the contents mentioned in this manuscript and that is adapted as much as possible to adolescents. This prototype should be used to analyze whether the changes achieved in body composition, physical condition or psychological state are similar to those obtained with the apps already available or whether there are significant improvements in comparison.

Conclusion

Based on the results obtained, it can be concluded that adolescents, teachers, coaches, managers, and experts consider that the apps currently available are more useful for use outside school but have limitations both in this setting and at school. These apps are not designed for adolescents, which considerably limits their use, as well as the possibilities of establishing healthy habits with them. There are discrepancies as to whether they are designed for males or females, but the fact that they are gamified seems to be one of the main aspects to take into consideration. In addition, the inclusion of information and healthy recommendations; challenges, competitions, and being able to observe the progress made; a multimedia section in which to find photos and videos; and the possibility of individualizing within the app is relevant for adolescents, teachers, coaches, managers, and experts. Furthermore, professionals asked for a quick and simple interface that facilitates and automates their work and that can be used offline so that it can be included during classes.

Acknowledgments

The authors would like to thank the school, management team, teachers, students, and research assistants who made it possible to carry out the measurements for this project.