An app a day keeping the doctor away?

Lark

 

Natalie Wischer RN, BN, RM, CDE, Grad Dip Mgt

Executive Director, Australian Diabetes Online Services

Chief Executive Officer, National Association of Diabetes Centres

 

Trends are not just uniquely the domain of the fashion industry, and my dad’s wardrobe containing an orange skivvy, from possibly the 70’s, indicates that some trends are misguided and perhaps even harmful, as was the case when I found the skivvy and spent a good 10 minutes laughing at him.

The health care industry is another area that attracts an abundance of trends and fads that often come with much hype and die a quiet death when the outlandish statements of their health benefits are found to be unsubstantiated by the masses who purchase what they believe will be the answer to all their problems. Think back…., not that long ago when we were told that only seven minutes a day on the ‘ab circle pro’ would give us an up to 10 kg weight loss and a six pack set of abs in only a few weeks. Then remember those sneakers that have a uniquely shaped sole that would give us the pert buttocks we had always wanted? I could go on and on, but the industry is littered with examples, and many have little or no scientific rigor to prove their claims. So where does technology in health care and diabetes fit into this? Is it a fad that will die a quiet death, or is it genuinely evidence based?

Like most things, it depends. It depends on the type of technology, who it is designed for, how it works, and what type of person is using it. Nevertheless, if you have been following my articles, you would know that multifunctional technology aids designed for people with diabetes can decrease HbA1c of up to 1.9%[1]. The latest health trend utilising fitness trackers has been the source of emerging research, but note that most devices are worn on average for less than 12 months. Where they have improved or motivated people are in those that were generally active and fit already and had a propensity to measure, track and analyse everything anyway, and thus the benefits have been less than remarkable on the whole. However, this is by no means a reason to ditch fitness trackers or other similar technologies, because what they do offer is a window of education, an opportunity for people to become a little more self-aware of how many steps they are taking, how well they are sleeping or how much they are eating. The magic lies in translating this knowledge into opportunities for behaviour change that can be sustained long term. This is where an app like Lark is focusing its effects.

Lark is an app that is trying to be a personal fitness, sleep, and food coach in your pocket. Named by Apple as one of the top 10 Apps of 2015, it has made a big splash in the e-health market. The app, even its free version, tracks exercise time, sleep quality, and diet, and with a mix of artificial intelligence and the texting interface, will provide personalised responses and education support 24/7. The feedback it gives is in an encouraging and educational format that is optimised toward your goals and focus. In the apps settings, you can customise the coach to support you in your goals such as weight loss, asking about meal types and even allows you to set your diet preferences such as vegetarian, vegan, paleo, low to no carb diets, lactose/dairy free or gluten free. You can also set up notifications and frequency which will, if switched on, provide reminders on the need to increase your activity during the day.

One of the most beneficial and useful elements of Lark is that it provides feedback on your activity levels and compares your status to previous days and weeks and can even tell you, on average, which days you are most active and at what times of day. Push notifications can also give positive reinforcement to healthy habits by sending messages that say “nice job on that walk you just did”.

Lark did not just haphazardly stumble on a well-designed holistic app; it was specifically designed to be evidenced based in its behavioural coaching focus. The advisory committee for the app included world leading experts in health and behaviour change from Stanford, Harvard and beyond with expertise in sleep, diabetes, psychology, nutrition, exercise physiology and cognitive behaviour therapy to name just a few.

As with all apps and technology, the key is not only in how well it engages the person using it over the long term, but how well it can lead to sustained behaviour change. This app is one of the best I have personally used and even in its free version it has potential to be a fabulous resource for all those trying to eat well, sleep better and be more active, and let’s face it, there are not many of us, or our patients, that can’t do with a bit of personal coaching in all these areas.

Even if this app is a download fad, it should be one that inspires more apps to be personalised, synchronised, motivating and evidence based. Now all it needs is some scientific research to analyse its effect on the long term health changes made by its users. This is a research study begging to be done.

LARK OVERVIEW

COST

  • Free
  • Or $30.99 a month for the personalised 16-week weight loss program

Available on:

  • iOS 8.0 or later (compatible with iPhone, iWatch and iPod touch)
  • Android

Ratings

4.2 (2610 ratings for all versions)

Synchronises

  • Lark will synchronise data with many common fitness and activity trackers on the market but will also use the phones in built tracking devices available or most newer models.

 

[1] Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011 Sep;34(9):1934-42

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