Review of Applied Management and Social Sciences (RAMSS) Vol.

5, (2) 2022, 219-230

Effects of Social Media Apps on University Students’ Health Behaviour in

Physical Activity, Weight Loss, and Nutrition Perspective
a Muhammad Ashraf, b Wang Rui Yuan, c Muhammad Raza, d Noureen Kanwal

a
Beijing Sport University Beijing China; Research Scholar, School of Exercise and Human Science, and
Department of Sport Science, China
Email: [email protected]
b
School of Exercise and Human Sciences Beijing Sports University, China
Email: [email protected]
c
Beijing Sport University Beijing China; Research Scholar, School of Management, Department of Sports
Humanities and Sociology, China
Email: [email protected]
d
School of sport & Physical education North university of China, China
Email: [email protected]

ARTICLE DETAILS ABSTRACT

History: The extensive body of literature focuses on examining the role of social media
Accepted 05 June 2022 apps in health-related matters. Conversely, developing county like Pakistan,
Available Online June 2022 there is lack of empirical evidence regarding social media app influence
specifically on health-related matters in developing countries like Pakistan. The
study aimed to examine the purpose of social media apps, commonly used apps,
Keywords:
impact, and demographic attributes on health-related matters. Three domains
Social Media Apps, Health- of health (physical activity, weight loss, and nutritional choices) were
Related Matters, Physical considered among university students in Southern Punjab, Multan, Pakistan.
Activity, Weight Loss, Nutritional This quantitative study was carried out on 200 university students aged 18-29
Choices years, through a survey design. Results showed the primary reason for using
social media apps is to gain health-related information, effectively and
JEL Classification: conveniently and YouTube is the most preferred application for this purpose.
L82, P36 The impact of apps on health-related matters (physical activity, weight loss,
and nutritional choices) was found to be significant and measured through
regression analysis. Demographic variables, gender, and age were examined
relative to study variables (app usage, physical activity, weight loss, and
DOI: 10.47067/ramss.v5i2.230 nutritional choices), gender differences are significant in health-related app
usage and physical activity, while it remains insignificant in weight loss and
nutritional choices. Age differences were significant in in-app usage, physical
activity, weight loss, and nutritional choices. The key findings of this particular
study could assist app developers and health practitioners to encourage the
masses in adopting health-related behaviors and by providing sufficient
introductory app-related information by creating realistic performance
expectancy thus minimizing the risk perception of the masses.

© 2022 The authors. Published by SPCRD Global Publishing. This is an

open-access article under the Creative Commons Attribution-
NonCommercial 4.0
Corresponding author’s email address: [email protected]
219
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

1. Introduction
The impact of social media on the healthcare industry cannot be denied. Many platforms
allow the general public to have easy access to medical professionals who are available online
(Hausmann et al., 2017), who can help them with their health-related concerns. Lerman et al., (2017)
investigated Facebook groups dedicated to assisting depressed people. Diabetics have similar groups
where they can share their problems and form a community. These groups were not limited to just
Facebook. Twitter also provides a platform for discussing health-related topics and although you
cannot make groups, discussions regarding health issues can be focused on using hashtags and lists.
The health sector recognizes the importance of these platforms and works to promote awareness
about health issues, health product advertisements, and launching campaigns. These platforms also
prove a cost-effective means of medical consultations, especially for those who cannot afford them in
person (Ittefaq et al., 2022).

China has some of the world's most popular social media platforms for discussing various
health and lifestyle-related topics. The medical support provided by these platforms reaches beyond
the developed nations to the developing ones. China has Sina Weibo and WeChat are two of the most
popular platforms in the country for discussing health-related topics. Zhang et al., (2017) studied
WeChat, although reporting a large amount of misinformation to be present on the platform,
showing it to provide a means of interactions between medical professionals and users seeking
guidance regarding various medical issues. Instagram, while becoming more and more popular
among the masses, is being increasingly used to advertise tobacco and alcohol campaigns. . Guo and
Goh (2014) looked into one such AIDS group on Weibo, finding most of its content to be either
informative or supportive in both medical and social domains

Social media apps were engaged by various medical institutions during the Ebola widespread
endemic, Guidry et al., (2017) discovered Doctors Without Borders/ Médecins Sans Frontières (MSF)
to have used social media platform “Instagram” more while WHO and the Centers for Disease
Control and Prevention (CDC) were more active on social media platform “Twitter”. People besides
organizations prefer diverse platforms for different purposes. Nevertheless, in the case of Pakistani
millennials, their means and motive for medical discussions on social media lack documentation.
Previous research has found that age, gender, and race all have an impact on a person's social media.
Social media is typically used as a platform for political debates or as a source of information for the
duration of a catastrophe. On the same phase, the application of social media among college students
frequently is to express their opinions on independence, their choices, autonomy politics, and human
rights, as well as for sharing information or communicating with their friends, groups or family. The
majority of this information was gathered from students at Pakistan's various universities and
colleges (Ahmad et al., 2019).

Lack of physical activity and poor eating habits are key threating features for the common
non- transmissible infections (cardiovascular disease, type 2 diabetes, and certain forms of cancer ),
and they both contribute significantly to the worldwide disability, illness and deaths (WHO, 2019).
Lack of physical activity and unhealthy eating habits are the main risk dynamics leading to
maximum shared non- transmissible illnesses (cardiovascular disease, type 2 diabetes, and certain
forms of cancer), and they both contribute significantly to the worldwide burden of disability,
morbidity rates, and mortality indices (WHO, 2019). The WHO European Region research
"Integrating Diet, Physical Activity, and Weight Management Services into Primary Care", also
revealed the extraordinary prevalence noninfectious illnesses in Europe, meant for premature deaths

220
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

at 86% while disease burden up to 77%. Moreover, a third of individuals in Europe are insufficiently
active, according to estimates, and more than a third are overweight or obese (WHO, 2020).

The mobile health applications industry is the fastest growing domain and has the potential
to offer health-related assistance to a wide spectrum of audiences. It is the easiest way to rapidly
transmit and track health information and intervene by allowing the audience in improving health
outcomes. Apps serve as an interactive display and modify health-related habits (Steinhbul et al.,
2015; Trifan et al., 2019). Regardless of the emergence and extensive usage of Health apps, their
determinants and effectiveness are largely unknown, and the area of health app research is still in
its beginning. A large spectrum of health applications has not been rigorously tested. As a result, it
lacks concrete information, and the majority of health applications users are not sure about
reliability and effectiveness, furthermore, evidence in favor of Health lack solid bases, are mostly
inconclusive and vague ( Kitsiou et al., 2017).

Health-related apps are the most effective means to communicate health problems, some
other powerful digital health technologies are SMS messages, voice agents, interactive chat boxes,
and emails. Smartphone health-related apps are gaining popularity and enormous applications are
available for free downloading (Ferrara et al., 2019). Many smartphones may now passively gather a
range of health-related data, such as physical activity, movement patterns, social contact, and sleep,
and conclude users’ psychological and physical well-being. By combining these features with active
user participation, these mobile applications provide a variety of behavioral interventions that can
help users live healthier lives by decreasing health-related threats. Mobile applications are intend to
target a wide range of activities to avoid health-related problems thus improving the patients’ health
(Han et al., 2019). However, the usefulness of mobile health apps has yet to be shown (Hagger,
2019).

Social media is used for a variety of purposes worldwide and the same is the case in Pakistan.
Pakistan has 61.34 million internet users (27.5 percent of the population) and 46 million active social
media users in January 2021, with 77.7% of Pakistanis utilizing mobile phones. Twitter, Facebook,
YouTube, and WhatsApp are few widly used sites, approximately 58% masses use the internet at
least once a day in Pakistan (Internet world, 2019). Males are in majority with the age range 18-35
years (Ittefaq et al., 2022). In Pakistan's health industry, mobile applications are becoming
increasingly important. For example, according to Ittefaq & Iqbal, (2018), a health-related app
“Marham” enhances public knowledge in health-related matters. Its Facebook page deals with female
issues, child ailments, and psychological problems in the general population.

Physical exercise is crucial for improving corporeal and mental health, but it must not be
mistaken for exercise. Physical activity is skeleton produce body movement involving energy
expenditure "physical activity involves workout, as well as other activities involving physical
movements and, are done as part of continuing to play, working, physical movement, house chores,
and leisure activities" (WHO, 2019). Physical activity improves mental health by lowering
depression, stress, and anxiety, as well as delaying the consequence of advanced dementia or
Alzheimer's disease (WHO, 2019 b). The recommended physical activity is 150 min per week or
participation in moderate-intensity aerobic or 75 min vigorous-intensity activity per week is
appraised as to be the cause of reducing the risk of diabetes (27%), breast cancer (21%), heart
ailment (30%), and colon cancer (25%). lack of physical activity is considered the fourth biggest
cause of obesity, non-communicable disease, and mortality according to WHO, (2019).

221
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

Technology development and societal changes, decrease physical activity to a minimum and a
new generation has been dubbed “phono-sapiens” (use cellphones for daily activities) needed to
make health management plans a priority base. Students who practice a sedentary lifestyle and less
physical activity intensify their health issues. Mobile phone apps are unique modes of
communication, utilized to offer health-related information and care information. This technology
has been proposed for use in physical activity promotion initiatives (Kim & Seo, 2020). Physical
exercise is an essential primary and secondary preventive approach for non-communicable diseases.
Many apps provide nutrient and physical-based assistance, and utilization of such applications has
increased at an astonishing rate over time, as an effective way of health management, intervention,
and weight loss treatments (Huang & Zhou, 2019). These apps frequently include information,
assistance, intervention, and even statistics on the nutritional value of various foods, calories burned
with each exercise, and help with weight management through diet and exercise (Robbins et al.,
2019). Health-related apps have proven to be the simplest, quickest, most cost-effective, and even
more practical means of gathering health-related information and as a self-health management tool
(Lee & Cho, 2017; Molina & Sundar, 2020). However, in the context of weight loss apps, the
contextual relevance of the classical theory of the acceptance and use of technology model to
measure both intention and actual usage behavior in such new technology has not been fully
explored (Magsamen- Conrad et al., 2019), and has remained a hot academic issue inviting a large
number of researchers to investigate the as-yet unexplored areas of this field. To avoid non-
communicable diseases (NCDs), the main behavioral risks that are lack of physical activity, being
overweight and an unhealthy diet must be minimized. A healthy diet appropriate to age and weight
and regular physical activity helps to control weight (WHO 2018). In this course nutritional and
health-related applications are an effective approach to providing information and guidance to the
general population, however, customized information is also available for a specific population like
cancer survivors, heart patients, and obese persons (Okumus et al., 2018).

The demand for health and fitness applications has increased dramatically (Schoeppe et al.,
2016, 2017; Lowe et al., 2015; Allman-Farinelli & Gemming, 2017). Among health-related
applications weight management and nutritional information base apps are highly recommended
and are in request, according to surveys (Krebs & Duncan, 2015; Franco et al., 2016; Samoggia &
Riedel, 2020). These apps guide the users to monitor their food intake, keep track of their physical
activities and help them to buy food with nutritional values (Lupton, 2018). Using a nutritionist and
medical viewpoint, the previous studies assessed that nutrition information applications help in
health-related behavior modification (e.g. diet, physical activity), disorders like diabetes and obesity
(Mummah et al., 2016; Flaherty et al., 2018), and weight management (Wharton, Johnston,
Cunningham, & Sterner, 2014; Schoeppe et al., 2016). Still, few pieces of research highlight food
purchasing behavior and application relationship (Doub et al., 2015; Gilliland et al., 2015; Flaherty et
al., 2018). Most of the studies focus on nutrition-information apps that might help people makes
better food purchasing decisions (Okumus et al., 2017). The widespread usage of mobile phones, as
well as the rapidly expanding health and fitness app sector, provides an opportunity to employ
applications to avoid hazardous lifestyle behaviors (Covolo et al., 2017). Even though mobile phones
are rapidly being utilized to deliver health care facilities, empirical evidence of their usefulness is
lacking. Most of the research has generally prioritized perspectives associated with the nutritionist
and medical viewpoint, while mostly ignoring an important perspective that is “consumer behavior”
(Elbert et al., 2016). The nutrition-information applications encourage good eating habits and
appropriate nutrition behaviors have to be investigated further (Schoeppe et al., 2017).

222
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

2. Literature Review
Researches on phone applications are evidence that mobile phone app recommendations are
significant for diet, medical care, and in some cases weight management (Covolo et al., 2017). The
effectiveness of mobile phone apps was positively assessed as operative interventions that track diet
and physical activity, such as web-based, paper-based, and website and print food diaries, education
programs with health tips, and podcasts and interaction on Twitter. Changes in eating habits like
calories intake, self-report food measurements, fiber, fats, and protein proportioning are related to
medical consequences in form of diabetes, blood pressure, living standard, fitness, cholesterol level,
and body weight all these and many more are monitored using the app treatments (Schoeppe et al,
2016; Covolo et al., 2017). Weight loss or a decrease in BMI or body fat were observed in certain
interventions (Allman-Farinelli & Gemming, 2017). People can interact by utilizing mobile phone
applications in a variety of ways, including direct or indirect mediums like voice, video, and text
(Elbert et al., 2016). Healthy habits, regardless of physical activity or healthy eating, do not develop
in a day or two. Teaching-based interventions are not a feasible approach. On the other hand,
information about food chains based on food consumption, as well as awareness of healthy eating
guidelines, must be used to convert into healthy habits. In reality, recipes and various food vendors
aid in the dissemination of beneficial nutritional knowledge (Gilliland et al., 2015). In addition, the
latest results reveal a correlation between the app's effectiveness and high food shopping
participation. If the app user is in charge of food purchasing, extra information about healthy foods
will be provided by using nutritional base applications. This could lead to improved food choices and
dietary patterns, as well as a decrease in the prevalence of unhealthy products (Flaherty et al., 2018).
Mobile applications have the potential to improve patient consequences and might be used to
construct cost-effective and accessible treatments in the future. Conversely, for interventions to be
effective in increasing physical activity, they must inspire people to change their behavior, set
realistic goals that may be paired with primary care advice, and provide regular feedback on activity
levels (Gill et al., 2017). The current research is important in the fields of digital well-being, , health
information technology, community health, intercultural studies and health communication

3. Hypotheses of the study

1. The primary motives intended for using social media health-related apps among university
students.
2. Social media apps are widely used regarding health-related matters among university
students.
3. There is a positive relationship between health-related apps, physical activity, weight loss,
and nutritional choices among university students.
4. Health-related apps have a significant impact on the overall health (physical activity, weight
loss, and nutritional choices) of university students.
5. There will be a significant gender difference in the level of app usage, physical activity,
weight loss, and nutritional choices of the students at the university level.
6. There will be significant age differences in app usage, physical activity, weight loss, and
nutritional choices of the students at the university level.

4. Materials and Methods

4.1 Study Design
The present study was carried out by correlational study design to investigate the reasons and
preferred use of social media apps regarding health-related activities and the impact of social media
apps on overall health (physical health, weight loss, and nutrition choices) among university

223
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

students. For data collection self-report survey- method is utilized in June 2022. A pilot test was
conducted to identify ambiguous questions or complicated statements. Based on the feedback, some
of the questions were rephrased to enhance clarity. The population of the study was B.Z.U university
students, approached through a convenient sampling technique as it is an effective and affordable
means to approach the sample. 200 students currently enrolled in university were selected as the
sample of the study. A survey was carried out through questionnaires comprising informed consent,
the purpose of the study, the estimated time to complete the survey, and participants' rights. The
Institutional Review Board (IRB) of the authors’ university approved the study instrument

4.2 Instruments
The demographic variables are gender (male and female) and age (18-20 years, 21-23 years,
and 24-26 years). To measure the reason for using social media apps following questions were
adopted 1) I think social media are useful to get health-related information; (2) I think social media
are useful to communicate and share health-related information; (3) I think social media are useful
to interact with the online community regarding specific health issues (on a five-point Likert scale)
(Lin & Ho, 2018).To the rate of frequency of social media usage among university students, some
questions were adopted from Pew Research Center 24 (p. 3) (about the frequency of using Twitter,
Facebook, YouTube, and WhatsApp) on a five-point Likert scale. Attitude toward physical activity
scale (Francis et al., 2004), four-item; perception of the body weight scale (Cai et al., 2017), four
items; and nutrition-related knowledge scale (Macías & Glasauer, 2019) 5 items were used to
examine physical activity attitude, perception of body weight and nutritional related knowledge
respectively, on a five-point Likert scale ranging from (1) strongly agree to (5) strongly disagree.
Statistical package for social science (SPSS-23) used for analyzing data.

3. Results
Table 1: Demographic Variables of Survey Participants
Variable Value Percent
Gender Male 45.0 %
Female 55.0 %
Total 100 %
Age 17-19 years 26.5 %
20-22 years 44.0 %
23- 25 years 29.5%
Total 100 %

The respondents’ characteristics table shows the percentage of males ( 45 %) and females (
55%). 26.5 % of respondents' age range between 17 -19 years, 44 % of respondents' age range 20-
22 years, and 29.5 % of respondents' age range is 23-25 years.
Table 2: Reasons for using Social Media apps for health-related matters
Variable Mean SD N
To interact with the online community regarding specific 2.5100 1.76507 200
health issues
To get health-related information 2.9500 1.26312 200
To communicate and share health-related information 2.6000 1.34127 200

224
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

Note: five-point Likert scale was used to gain responses for each reason. The table shows the reason
for using apps getting health-related information, followed by communicating and sharing health-
related information and then interacting with the online community.

Table 3: Preferences of Social Media Apps for health-related matters

Variable Mean SD N
1 You tube 2.2150 1.23954 200
2 Facebook 2.1150 1.17417 200
3 Twitter 2.0650 1.10311 200
4 What’s app 1.7650 .95095 200

Note: Respondents were asked to indicate on a five-point scale) for each of the social media use for
health-related information. Results show YouTube is preferred or widely used to gain health-related
information, followed by Facebook, Twitter, and what’s app.

Table 4: Correlation matrix among Use of Social Media Apps, Physical Activity, Body Weight, and
Nutritional Choices
Scale Apps usage Physical activity Body weight Nutritional
choices
Apps usage 1 .426 .311 .283
Physical activity 1 .707 .782
Weight loss 1 .728
Nutritional choices 1
Mean 8.0600 11.0550 12.2250 11.5400
SD 3.88224 4.18564 3.49075 3.73472

Table 4 shows app usage is positively correlated with physical activity, body weight, and nutritional
choices among university students. Similarly, physical activity is significantly correlated with body
weight and nutritional choice.

Table 5: Multiple Linear Regression Analysis of Social Media Apps on Overall Health (physical
activities, weight loss, and nutrition) among university students (N=200)
Predictor B Std. Error Beta t p-value
(Constant) 26.672 1.573 16.955 .000
Overall well-being 1.011 .176 .378 5.747 .000

R2= .143, Adjusted R2 =-.139

Impact pf overall health (physical activity, weight loss, and nutritional choices) was found to
have been significantly predicted by the usage of social media health-related social media apps.

225
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

Table 6: Mean, Standard Deviation, t-value, and scores of Physical Activity, Body Weight, and
Nutrition Choices concerning Gender of respondents (N=200)
Gender N M Std.Deviation df t-test Sig.
AU Male 90 9.4222 3.81887 198 -4.723 .000
Female 110 6.9455 3.58088
PA Male 90 12.1000 4.08629 198 -3.271 .001
Female 110 10.2000 4.08802
WL Male 90 12.5778 3.32501 198 -1.306 .193
Female 110 11.9364 3.61007
NC Male 90 12.0222 3.47375 198 -1.679 .095
Female 110 11.1455 3.90680

Table 5 shows insignificant gender differences in app usage and physical activity while weight loss
and nutritional choices were found to be insignificant concerning gender among university students.

Table 6: Analysis of variance in Physical Activity, Body Weight, and Nutrition Choices concerning the
Age of respondents (N=200)
Variable Source of Sum of DF Mean F Sig.
variation square square
Apps usage Between Groups 213.472 2 106.736 7.548 .001
Within Groups 2785.808 197 14.141
Total 2999.280 199
Physical activity Between Groups 157.687 2 78.844 4.666 .010
Within Groups 3328.708 197 16.897
Total 3486.395 199
Weight loss Between Groups 385.631 2 192.816 18.627 .000
Within Groups 2039.244 197 10.351
Total 2424.875 199
Nutrition Between Groups 188.530 2 94.265 7.178 .001
Within Groups 2587.150 197 13.133
Total 2775.680 199

Table 7 shows significant differences in app usage, physical activity, weight loss, and
nutritional value among university students concerning the age of respondents.

4. Discussion
This study describes the impact of social media apps on physical activity, weight loss, and
nutritional choices in a sample of Pakistani university students in Multan. Pakistani students know
the importance of physical activity, weight loss, and healthy nutritional choices but still, their
perceptual level is low in comparison to other countries (China, Japan, or Western countries). Based
on the analysis, university students, in general, display a favorable attitude to health-related
applications. They highlight the importance of physical activity as a factor of health enhancement
and try to gain, interconnecting, as well as sharing health - associated information through the usage
of social media apps. Pakistani Generation Z uses social media apps for health-associated difficulties
and problems, researcher attempts to find the motives and sources of health-related information

226
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

available and used by university students Based on the survey of 200 university students, aged 18-
29 provides scholarly and practical implications for the application of social media apps for health-
related matters. The respondents of this study were male (45%) and female (55%) university
students, the majority of them were 21-23 years (44%) age group followed by 23-29 years (29.5%)
and then 17-19 years (26.5%).

The primary reason to use health-related apps among university students is to gain health-
related information followed by communicating and sharing health-related information and
cooperating by means of the internet with online community concerning detailed and particular
healthiness concerns. The use of social media for health issues and guidance is increasing because of
their convincing and cost-effective way to gain information. What’s app is frequently used in
Pakistan (Digital Information World, 2020), while YouTube is widely used for health- associated
materials monitored by different sites like as Facebook, Twitter, and then what’s apps specifically for
health-related information. YouTube is a visually engaging application and the second most
frequently used app in Pakistan, it is the reason why YouTube is widely used in health-related
information (Nason et al., 2016) The use of apps in health-related matters was found to be
significantly correlated with physical activity, weight loss, and nutritional choices among students.
The correlation matrix shows that app usage is positively correlated with physical activity,
perception of body weight, and nutritional choices. Physical activity is significantly correlated with
perception of body weight and nutritional choice, and similarly, perception of body weight
significantly correlates with nutritional choices. The impact of app usage on overall health (physical
activity, perception of body weight, and nutritional choices are highly significant. Several studies
have been conducted to investigate the usefulness of health applications for weight loss (
Puigdomènech et al., 2019), physical activity ( Kim & Seo, 2020), and nutritional choices (Krebs &
Duncan,2015; Franco et al., 2016; Samoggia & Riedel, 2020 ) were found significant as aligned with
our results. The gender differences were significant in-app usage, and in physical activities, male
students reported that social media apps are more useful in obtaining information and have higher
means of physical activity. There is a gender digital divide in Pakistan concerning using social media.
Data highlight that 12% of females use Twitter and 18 % use Facebook while the percentage of using
these two platforms in males is 88% and 82% respectively (Itteraq et al., 2020). The results with the
age of respondents in using health-related apps show significant outcomes concerning app usage,
physical activity, weight loss, and nutritional choices. All the variables were found to be higher
within groups as compared to between groups.

5. Recommendations
Mobile applications helps in encouraging physical movements in conjunction with balanced
diet and weight loss helps to the effective and efficient way in health education programs.
Considering the risk that problems (physical activity, weight gain, and unhealthy nutritional choices)
might taper off as the involvement with health-related apps ends, therefore subsequent reviews of
apps that keeps a check on physical activity to regulate if it was continued over time with suitable
inspiration (Romeo et al.,2020). Physical activity is influenced by several factors like as students'
experience related to physical activity, availability of resources for physical activity, or even home
environment which were not considered in this study. A suggestion regarding this manner is
building awareness due to a sedentary lifestyle, providing resources, and promoting physical
activities at the university and school levels.

227
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

6. Limitation
The data consists of a self-report measure; it might be a bonafide response. Second is the age-
specific study as the respondents' age range was 18- 29 years, results might be hard for other age
groups. The sample size of the study is small; a larger sample size will help to infer the study
variable more clearly. Assessing students’ attitudes toward health-related apps show a new horizon
for future researchers. Factors contributing to the perception of health-related apps also needed to
be examined thoroughly. The impact of social and electronic media on attitudes to health-related
apps should be studied. Despite all these limitations, the practical and theoretical implications of the
study contribute to research. Findings can be valuable for policymakers, technology companies, and
even for the general population. As far as we know this is the first study in Southern Punjab
examining the influence of social media apps proceeding to the healthiness associated materials in
university students. This study also helps to identify specific social media apps used for health-
related matters (YouTube, Facebook, Twitter, and WhatsApp) to develop tailored communication
strategies.

References

Allman-Farinelli, M., Partridge, S. R., McGeechan, K., Balestracci, K., Hebden, L., Wong, A., ... &
Bauman, A. (2016). A mobile health lifestyle program for prevention of weight gain in young
adults (TXT2BFiT): Nine-month outcomes of a randomized controlled trial. JMIR mHealth
and uHealth, 4(2), e5768.
Covolo, L., Ceretti, E., Moneda, M., Castaldi, S., & Gelatti, U. (2017). Does evidence support the use of
mobile phone apps as a driver for promoting healthy lifestyles from a public health
perspective? A systematic review of Randomized Control Trials. Patient education and
counseling, 100(12), 2231-2243.
Digital Information World. WhatsApp Usage, Revenue, Market Share and other Statistics (2019),
https://www. digitalinformationworld.com/2019/02/whatsapp-facts-stats.html (2020,
accessed 5 July 2020)
Doub, A. E., Levin, A., Heath, C. E., & LeVangie, K. (2015). Mobile app-etite: Consumer attitudes
towards and use of mobile technology in the context of eating behaviour. Journal of direct,
data and digital marketing practice, 17(2), 114-129.
Elbert, S. P., Dijkstra, A., & Oenema, A. (2016). A mobile phone app intervention targeting fruit and
vegetable consumption: the efficacy of textual and auditory tailored health information tested
in a randomized controlled trial. Journal of medical Internet research, 18(6), e5056.
Ferrara, G., Kim, J., Lin, S., Hua, J., & Seto, E. (2019). A focused review of smartphone diet-tracking
apps: usability, functionality, coherence with behavior change theory, and comparative
validity of nutrient intake and energy estimates. JMIR mHealth and uHealth, 7(5), e9232.
Flaherty, S. J., McCarthy, M., Collins, A., & McAuliffe, F. (2018). Can existing mobile apps support
healthier food purchasing behaviour? Content analysis of nutrition content, behaviour change
theory and user quality integration. Public Health Nutrition, 21(2), 288-298.
Franco, R. Z., Fallaize, R., Lovegrove, J. A., & Hwang, F. (2016). Popular nutrition-related mobile
apps: a feature assessment. JMIR mHealth and uHealth, 4(3), e5846.
Gill, D. P., Blunt, W., Bartol, C., Pulford, R. W., De Cruz, A., Simmavong, P. K., ... & Petrella, R. J.
(2017).
Gilliland, J., Sadler, R., Clark, A., O’Connor, C., Milczarek, M., & Doherty, S. (2015). Using a
smartphone application to promote healthy dietary behaviours and local food
consumption. BioMed research international, 2015.
Guidry, J. P., Jin, Y., Orr, C. A., Messner, M., & Meganck, S. (2017). Ebola on Instagram and Twitter:

228
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

How health organizations address the health crisis in their social media engagement. Public
relations review, 43(3), 477-486.
Guo, Y., & Goh, D. H. L. (2014). “I Have AIDS”: Content analysis of postings in HIV/AIDS support
group on a Chinese microblog. Computers in Human Behavior, 34, 219-226.
Guthold, R., Stevens, G. A., Riley, L. M., & Bull, F. C. (2018). Worldwide trends in insufficient physical
activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1· 9
million participants. The lancet global health, 6(10), e1077-e1086.
Hagger, M. S., & Weed, M. (2019). DEBATE: Do interventions based on behavioral theory work in the
real world?. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-10.
Han, M., & Lee, E. (2018). Effectiveness of mobile health application use to improve health behavior
changes: a systematic review of randomized controlled trials. Healthcare informatics
research, 24(3), 207-226.
Hausmann, J. S., Touloumtzis, C., White, M. T., Colbert, J. A., & Gooding, H. C. (2017). Adolescent and
young adult use of social media for health and its implications. Journal of Adolescent
Health, 60(6), 714-719.
Huang, G., & Zhou, E. (2018). Time to work out! Examining the behavior change techniques and
relevant theoretical mechanisms that predict the popularity of fitness mobile apps with
Chinese-language user interfaces. Health communication.
Internet World Stats. Pakistan, https://www.internetworldstats. com/asia.htm#pk (2019, accessed 5
December 2019).
Ittefaq, M., & Iqbal, A. (2018). Digitization of the health sector in Pakistan: challenges and
opportunities to online health communication: A case study of MARHAM social and mobile
media. Digital health, 4, 2055207618789281.
Ittefaq, M., Seo, H., Abwao, M., & Baines, A. (2022). Social media use for health, cultural
characteristics, and demographics: A survey of Pakistani millennials. Digital Health, 8,
20552076221089454.
Kim, H. N., & Seo, K. (2020). Smartphone-based health program for improving physical activity and
tackling obesity for young adults: a systematic review and meta-analysis. International
journal of environmental research and public health, 17(1), 15.
Kitsiou, S., Paré, G., Jaana, M., & Gerber, B. (2017). Effectiveness of mHealth interventions for
patients with diabetes: an overview of systematic reviews. PloS one, 12(3), e0173160.
Krebs, P., & Duncan, D. T. Health app use among US mobile phone owners: a national survey. JMIR
mHealth uHealth 3 (4), e101 (2015).
Lee, H. E., & Cho, J. (2017). What motivates users to continue using diet and fitness apps?
Application of the uses and gratifications approach. Health communication, 32(12), 1445-
1453.
Lerman, B. I., Lewis, S. P., Lumley, M., Grogan, G. J., Hudson, C. C., & Johnson, E. (2017). Teen
depression groups on Facebook: a content analysis. Journal of Adolescent Research, 32(6),
719-741
Lin, H. C., & Ho, W. H. (2018). Cultural effects on use of online social media for health-related
information acquisition and sharing in Taiwan. International Journal of Human–Computer
Interaction, 34(11), 1063-1076.
Magsamen-Conrad, K., Dowd, J., Abuljadail, M., Alsulaiman, S., & Shareefi, A. (2015). Life-span
differences in the uses and gratifications of tablets: Implications for older adults. Computers
in human behavior, 52, 96-106.
Molina, M. D., & Sundar, S. S. (2018). Can mobile apps motivate fitness tracking? A study of
technological affordances and workout behaviors. Health communication.

229
Review of Applied Management and Social Sciences (RAMSS) Vol. 5, (2) 2022, 219-230

Mummah, S. A., Mathur, M., King, A. C., Gardner, C. D., & Sutton, S. (2016). Mobile technology for
vegetable consumption: a randomized controlled pilot study in overweight adults. JMIR
mHealth and uHealth, 4(2), e5146.
Nason, K., Donnelly, A., & Duncan, H. F. (2016). YouTube as a patient‐information source for root
canal treatment. International endodontic journal, 49(12), 1194-1200.
Okumus, B., Ali, F., Bilgihan, A., & Ozturk, A. B. (2018). Psychological factors influencing customers’
acceptance of smartphone diet apps when ordering food at restaurants. International Journal
of Hospitality Management, 72, 67-77.
Park, H., Rodgers, S., & Stemmle, J. (2011). Health organizations’ use of Facebook for health
advertising and promotion. Journal of interactive advertising, 12(1), 62-77.
Pew Research Center. Social Media Use in 2018, https://
www.pewresearch.org/internet/2018/03/01/social-media-usein- 2018/ (2018, accessed 10
December 2019).
Puig, E. P., Robles, N., Saigí-Rubió, F., Zamora, A., Moharra, M., Paluzie, G., ... & Carrion, C. (2019).
Assessment of the efficacy, safety, and effectiveness of weight control and obesity
management mobile health interventions: systematic review. JMIR mHealth and
uHealth, 7(10), e12612.
Robbins, R., Krebs, P., Rapoport, D. M., Jean-Louis, G., & Duncan, D. T. (2019). Examining use of
mobile phones for sleep tracking among a national sample in the USA. Health
communication, 34(5), 545-551.
Romeo, A., Edney, S., Plotnikoff, R., Curtis, R., Ryan, J., Sanders, I., ... & Maher, C. (2019). Can
smartphone apps increase physical activity? Systematic review and meta-analysis. Journal of
medical Internet research, 21(3), e12053.
Samoggia, A., & Riedel, B. (2020). Assessment of nutrition-focused mobile apps' influence on
consumers' healthy food behaviour and nutrition knowledge. Food Research
International, 128, 108766.
Trifan, A., Oliveira, M., & Oliveira, J. L. (2019). Passive sensing of health outcomes through
smartphones: systematic review of current solutions and possible limitations. JMIR mHealth
and uHealth, 7(8), e12649.
Wharton, C. M., Johnston, C. S., Cunningham, B. K., & Sterner, D. (2014). Dietary self-monitoring,
but not dietary quality, improves with use of smartphone app technology in an 8-week weight
loss trial. Journal of nutrition education and behavior, 46(5), 440-444.
WHO (2018). Non-communicable diseases – Key Facts. https://www.who.int/en/news- 859 room/fact
sheets/detail/noncommunicable-diseases Accessed 08 July 2019
World Health Organization (Regional O_ce for Europe). Integrating Diet, Physical Activity and
Weight Management Services into Primary Care. 2016. Available online:
https://www.euro.who.int/__data/assets/ pdf_file/0016/324304/Integrating-diet-physical-
activity-weight-management-services-primary-care.pdf (accessed on 31 August 2020).
World Health Organization. Fact Sheets. Physical Activity. Available online:
https://www.who.int/newsroom /fact-sheets/detail/physical-activity (accessed on 4 December
2019).
World Health Organization. Obesity. Data and Statistics. 2018. Available online:
http://www.euro.who.int/ en/health-topics/disease-prevention/physical-activity/data-and-
statistics (accessed on 4 December 2019).
Zhang, X., Wen, D., Liang, J., & Lei, J. (2017). How the public uses social media wechat to obtain
health information in china: a survey study. BMC medical informatics and decision
making, 17(2), 71-79.

230