Unlocking the Potential of mHealth: Integrating Behaviour Change Techniques in Hypertension App Design

Background: Smartphone apps offer a promising avenue for delivering scalable interventions for hypertension self-management. This study aimed to characterise the behaviour change technique ontology (BCTO) elements present in apps available on popular platforms, map the theoretical domains framework (TDF), and describe the apps' functionalities. Methods: A comprehensive search of app stores was conducted to identify relevant hypertension self-management apps. The identified apps were then analysed for BCTO elements, which were subsequently mapped to TDF. App functionalities and quality were assessed as well. Results: Functionalities such as self-monitoring were consistently observed across all app types, aligning with established hypertension self-management strategies. However, other key functionalities, including goal setting via reminders, communication with healthcare professionals, and data export capabilities, were less prevalent. AI-empowered apps incorporated a broader range of behaviour change techniques compared to non-AI and RCT-tested apps, suggesting a potentially more comprehensive approach to supporting behaviour change. The domains of "Knowledge", "Emotions", "Behavioural regulation", "Skills", and "Beliefs about Consequences" were most frequently targeted by app developers. AI-empowered apps incorporated a broader range of BCTs compared to non-AI and RCT-tested apps, potentially offering more comprehensive support for behaviour change. Conclusions: While existing hypertension self-management apps incorporate a variety of BCTs, there is room for improvement in terms of incorporating a wider range of functionalities and BCTOs, particularly those targeting more intrinsic and habitual aspects of behaviour.