4. Discussion
Velicer, AMD
Few randomized and controlled clinical trials have analyzed the effectiveness of promoting the MD (in Spanish adults) of smartphone apps with certain similarities to e-12HR [The main findings of this work were (significant intergroup statistical modifications): First: in relation to the main objective, in the entire sample of Spanish university students, the increase in AMD from week two throughout the follow-up of the study (at week four the increase was favorable to IG versus CG by +25.7% for MDSS index and by +74.5% for the percentage of participants with moderate/high (≥9) MDSS index) (The increase in MDSS index (CG versus IG) with the use of e-12HR can be considered moderate (with higher values in the IG): in the entire sample of university students, +25.7%; in the subgroups, ranging from +17.8% (for ≥20 years) to +33.0% (for <20 years). However, this moderate increase among university students could be considered, at the same time, promising. University students are not characterized by being in high motivation stages to change a lifestyle factor (preparation or action, following the model of Prochaska and Velicer [As previously mentioned, some randomized and controlled clinical trials have used applications with certain similarities to e-12HR to improve AMD in Spanish adults [This study presents several limitations. First, all the data collected were self-administered: the participants completed the daily nutrition questionnaire using the app (e-12HR being a self-reporting method, it presents the inherent limitations of this type of tool, described in detail in the bibliography [