BitHabit® – Application for Lifestyle Guidance and Mental Wellbeing

Intended Benefits of the Product 

The aim of the BitHabit application is to support healthy lifestyle habits, promote mental wellbeing, and prevent lifestyle-related diseases. The application is based on several behavioural theories. Its objective is to strengthen the formation of health-promoting habits and support the maintenance of behavioural change through repetition and gradually automated actions. BitHabit can be used either as a standalone solution or as part of other health and wellbeing services. 

Evidence Base for the Product Under Assessment 

This assessment included three randomised controlled trials (RCTs) conducted within the StopDia research project, in which the key intervention was the BitHabit application developed as part of the project and its use in lifestyle counselling. The studies utilised the same dataset, comprising approximately 3,000 individuals at elevated risk of developing diabetes. Participants were adults aged 18 to 74 years, of whom 80% were women and 20% were men. All participants had a Finnish Diabetes Risk Score (FINDRISC) of at least 12. At this level of risk, approximately one in six individuals is estimated to develop type 2 diabetes (T2D) within the next ten years. 

Participants were randomised into three groups of approximately equal size: a digital intervention group (DIGI), a combined digital and group-based intervention group (DIGI+GROUP), and a usual care group (CONTROL). The interventions provided to the DIGI and DIGI+GROUP groups were based on theories of habit formation, self-determination, and self-regulation. Participants in the DIGI+GROUP group used the BitHabit application and additionally received group counselling delivered by healthcare professionals. Participants in the CONTROL group received a one-off provision of information at baseline on lifestyle-related risk factors for T2D, together with recommendations on healthy diet and physical activity. [2,3,4] 

The objective of the first study was to describe the digital intervention designed for individuals at risk of T2D, namely the BitHabit application, which supports the adoption of healthy lifestyle habits [2]. The second study aimed to identify behavioural profiles associated with long-term use of the BitHabit application, examine factors predicting these profiles, and explore their associations with changes in T2D risk factors during the study period [3]. The third study evaluated the effects of a digital lifestyle intervention and a combined digital and group-based intervention on diet quality, physical activity, sedentary behaviour, total and central body fat, insulin resistance, and glucose metabolism, compared with usual care in adults at high risk of T2D. In addition, the study examined whether adherence to the interventions influenced outcomes associated with the digital and group-based interventions. [4] 

The results indicated that uptake of the application was successful and that weekly use remained relatively high over a six-month period, although daily use was less frequent [2]. Among participants, 38.0% used the application weekly, 10.8% approximately twice a week, and 4.3% almost daily throughout the follow-up period, whereas 46.9% discontinued use of the application after six months [3]. The proportion of participants who withdrew from the study was similar across all groups (DIGI 16%, DIGI+GROUP 16%, CONTROL 14%, p = 0.251). [2,3,4] Usage during the first month predicted later levels of engagement. More intensive use was associated with older age, higher diet quality, and positive user experiences, whereas extensive internet use and participation in face-to-face group coaching were associated with lower application usage. Individuals who rated the application less favourably were less likely to belong to the most active user group than those who would recommend it to others [3]. Active engagement with the interventions was associated with better outcomes [4]. 

The findings showed that the combined intervention (DIGI+GROUP) produced the greatest improvement in diet quality, as measured by the Healthy Diet Index (HDI). Over one year, the HDI improved more in the DIGI+GROUP group than in the CONTROL group (+3.2 vs. +1.4 points, p < 0.001). Furthermore, changes in HDI over time differed significantly between the groups (p < 0.001), supporting the effectiveness of the intervention in improving diet quality. Positive effects were also observed for waist circumference and insulin resistance; however, these effects did not reach statistical significance. No significant differences were observed in other key outcomes, including physical activity, body weight, and glucose measures. Adherence to the digital intervention was associated with increased physical activity and reduced sedentary behaviour [4]. Among participants who used the application almost daily, diet quality improved (p < 0.02), while body mass index (BMI; p < 0.01) and waist circumference (p < 0.02) decreased to a greater extent than among other participants [3]. 

In 2023, an observational cross-sectional study was conducted as part of the Feeling Good North Savo programme. Participants were recruited through an open call and completed the MySeula questionnaire, after which they had the option to use the BitHabit application for 1–2 months. The data were analysed using cross-tabulation as well as regression and clustering methods. A total of 1,646 adults participated in the study, of whom 77% were women, with a mean age of 46.7 years. More than half of the participants reported at least one life challenge, most commonly a psychological (31%) or physical (29%) functional limitation. Use of the BitHabit application was initiated by 52% of participants. 

Application uptake was more common among women, employed individuals, and those reporting a greater number of challenges and lower life satisfaction. Three user profiles were identified: non-active users with high wellbeing, non-active users experiencing a high burden of challenges, and active users. The findings suggest that the application is particularly attractive to individuals experiencing wellbeing-related difficulties, whereas active use was more common among users with better wellbeing and, in many cases, older age. These results highlight the need to target and tailor digital interventions to different user groups. [5] 

As part of the HYPE project (Improving the Effectiveness of Wellbeing Promotion and the Integration of Primary Health and Social Care Services in North Savo), an intervention study was conducted between 2024 and 2025 to evaluate the association of the BitHabit application with mental wellbeing, healthy lifestyle behaviours, and adoption of the digital service among the working-age population. The study employed a stepped-wedge design, allowing individuals awaiting intervention to serve as a comparison group. Application usage data were collected from 845 users. The objective was to identify the target groups that derive the greatest benefit from the application and the factors influencing user engagement. 

The mobile intervention showed indications of positive effects on mental wellbeing and lifestyle behaviours; however, uptake and participation rates varied between groups. Uptake was more likely among younger individuals, women, and those with higher educational attainment, whereas active use was more common among older participants. The findings suggest that the application may support the promotion of wellbeing, but its effectiveness and usability may not be consistent across all target groups. [6] 

During the first phase of the Mieliteko programme, the BitHabit application was used as a tool to support wellbeing through small everyday actions. The application was utilised both as part of lifestyle coaching and in a broader population pilot following completion of the MySeula questionnaire. Activities focused particularly on mental wellbeing and physical activity through small, achievable behavioural changes. 

While many participants initiated use of the application, sustained engagement remained limited. Short-term use was associated with a small but statistically significant improvement in life satisfaction. A key challenge was enhancing user engagement and encouraging continued use of the application over time. [7]  

Literature Reviews 

Sustained health behaviour change requires the development of new, automated habits; information and motivation alone are insufficient. Key facilitators of habit formation include planning, repetition, self-monitoring, feedback, realistic expectations, motivation, and positive experiences. At the same time, unhealthy habits need to be disrupted through modifications to the surrounding environment. Factors that hinder behavioural change include inconsistent repetition, unclear cues, and negative experiences. [8,9,10] Digital tools can support behaviour change through reminders, monitoring, and feedback. A habit-based approach requires long-term commitment to change, as behaviours become automated gradually, on average over approximately 66 days, although the process may take up to 252 days. [10,11] 

Systematic reviews have evaluated the effects of mobile applications on weight management, waist circumference, blood lipid and glucose levels, energy expenditure, and physical activity among overweight adults and adults with cardiovascular disease. The applications typically included self-monitoring, feedback, and personalised messaging, although the implementation of the interventions varied considerably. 

The evidence suggests that the use of mobile applications can contribute to modest weight reduction, particularly when a healthcare professional is involved in the intervention. In some studies, these effects have been statistically significant. However, mobile applications have not been shown to be more effective than other intervention methods. No consistent or significant effects have been observed for other outcomes, such as waist circumference, energy expenditure, lipid levels, or HbA1c (glycated haemoglobin). Nevertheless, the use of applications was associated with improved adherence to lifestyle interventions and lower dropout rates compared with traditional approaches. Behaviour change techniques, particularly action planning and graded tasks, may increase physical activity, while habit-focused approaches may also be effective. [12,13,14] 

Other Recommendations and Assessments 

According to an evidence-based policy recommendation developed within the HYPE project, digital wellbeing applications should be utilised to support population-level wellbeing and to identify at-risk groups. However, improving their effectiveness requires targeted implementation for specific user groups and personalised tailoring to individual needs. [6] 

According to the documentation provided, development follows the risk management principles set out in ISO 31000. The company has a risk management plan in place that defines processes and control measures related to product safety. A risk analysis has been conducted for the product, identifying certain potential adverse effects and specifying associated risk control measures. [1] 

According to the documentation provided, the risk management plan is subject to version control and is regularly maintained and reviewed. [1] 

Efforts to prevent incorrect use of the product include the provision of support materials, a user feedback channel, and regular ethical reviews of the content. [1] 

The company has appointed a designated individual responsible for product safety. [1] 

Costs are determined by the number of users and the contract period. Typical pricing for a Finnish client organisation is based on a per-user monthly licence fee (VAT 0%) under a 12-month contract. [1] 

The company invoices the organisation providing the service for use of the application. The client organisation determines any fees charged to end users for access to the product. [1] 

The licence fee includes maintenance and updates. No separate start-up or set-up fee is charged. However, implementation costs may be incorporated into the monthly fee if a minimum number of licences is purchased. Otherwise, implementation is invoiced separately, and the cost is influenced by factors such as the preparation of a communications plan and arrangements for data collection and delivery. 

Implementation of the product does not require modifications to premises, equipment, or information systems, nor does its use require integration with other information systems. If desired, the client organisation may arrange training for implementation of the application. The company can also prepare organisation-specific guidance for professionals using the application when required. [1] 

All billable work, including further product development and data collection, is agreed in writing in advance as part of the project delivery. [1] 

A cost analysis has been prepared for the product, comparing its costs with those of lifestyle interventions delivered through traditional methods. [1] 

Based on the information provided by the manufacturer, the costs of using the service appear reasonable when compared with alternative methods of delivering a similar service.  

This assessment was based on the information security and data protection requirements framework for health and social care procurements, together with the response materials provided by BitHabit. [1]

Risk Management and Security Testing 

The company follows a documented risk management process. Based on the materials provided, the process includes risk identification, assessment of impacts and probabilities, and the definition of risk control measures. The company does not hold ISO 27001 certification. The product undergoes automated security testing to identify known vulnerabilities in software components and dependencies, as well as manual penetration testing one to two times per year. [1] 

The risk management plan is maintained and reviewed every six months with respect to information security and data protection. The company has appointed a designated individual responsible for information security. [1] 

Log Management 

The system maintains logs of user and administrative activities. Log integrity is ensured, and logs are retained for 12 months. Application logs and technical metrics from the backend system are monitored using Azure monitoring solutions. [1] 

User Management 

User management is based on one-time password (OTP) authentication. Users are identified using pre-registered user information, and sign-in is performed using a single-use authentication code delivered via text message. The application does not include differentiated user levels or user roles; therefore, role-based access control is not applicable. [1] 

Infrastructure 

The product is a Software as a Service (SaaS) solution hosted within the Microsoft Azure environment. The solution also utilises Google Firebase services. The client application is available for iOS and Android mobile devices. [1] 

Data Protection 

According to the documentation provided, data protection measures include widely accepted and current encryption technologies, such as AES-256 encryption and TLS-protected data transmission connections. [1] 

Data covered by the General Data Protection Regulation (GDPR) is stored within the European Union (EU) and/or the European Economic Area (EEA). [15] 

A Data Protection Impact Assessment (DPIA) has been conducted for the product. [1] The company acts as the data processor, while the client organisation acts as the data controller. [1] The company has appointed a Data Protection Officer (DPO). [1] 

General instructions for procurement  

During the procurement phase, you should always contact the organisation’s IT management, data security expert and data protection expert. Discuss with them whether the product in question meets your requirements. In addition, we recommend that the wellbeing services counties use the Security Guide for ICT Procurement of the European Union Agency for Cybersecurity (ENISA) to support their procurement [15,16].

The service includes user interfaces for both healthcare professionals and end users. The product comprises native iOS and Android applications for end users, as well as a web-based application for healthcare professionals. 

According to the manufacturer, usability and accessibility development is an ongoing process that incorporates customer feedback. The development of the user interfaces has considered standards-based principles, including human-centred design, user-centred process design, and continuous user research. A free demonstration version of the product is available to end users as part of the implementation process; however, no equivalent demonstration version is available for the professional user interface. [1] 

End-User Usability 

The iOS and Android applications for end users were launched in February 2026. Previously, end users were offered a Progressive Web Application (PWA). As the iOS and Android applications are new, user experience and usability data are intended to be collected through feedback from users participating in the Digihoitokokeilu programme. Results are expected to become available during spring 2027; therefore, such information was not available at the time of this assessment. [1] 

End users can provide feedback and suggestions for usability improvements via email. The company takes this feedback into account in its product development activities. [1] 

End-User Accessibility 

According to the company, the usability and accessibility design of the product has not specifically considered particular user groups, such as people with visual impairments, low vision, hearing impairments, or sign language users. Instead, it is assumed that the accessibility features provided by Android and iOS platforms will facilitate use by individuals with functional limitations. [1] 

An accessibility assessment has been conducted for the product by the company itself. An independent external assessment of the new version of the application is scheduled to be carried out in August 2026. 

The product partially complies with the technical accessibility requirements defined in the European standard EN 301 549. [1] The current accessibility status is described in the product’s accessibility statement, which is available on the product website. [17] 

No version of the user instructions that fully complies with accessibility requirements is currently available. Feedback regarding accessibility can be submitted by email, and according to the company, responses are provided within 14 days. 

The end-user iOS and Android applications support all accessibility features provided by the respective platforms and follow the platforms’ design guidelines. [1]

Professional User Usability 

According to the company, individuals involved in the development of the professional user interface represented the actual end users of the product. Usability testing included users with varying levels of digital competence, as efforts were made to recruit professionals who experience the greatest challenges when using digital services. [1] 

Professional users can provide feedback and suggestions regarding usability via email. The company considers such feedback in its ongoing product development activities. [1] 

Professional User Accessibility 

The textual content of the product has been developed using clear language principles. According to the company, specific user groups have not been considered in the usability and accessibility design of the professional user interface, based on the assumption that it will be used by professionals without particular functional limitations. [1] 

No accessibility assessment has been conducted for the professional user interface. Responsibility for user guidance lies with the contact person designated by the client organisation. An accessible version of the user instructions is provided to the representative of the client organisation. [1] 

General instructions for procurement  

The purchasing organisation shall take into account the accessibility requirements set out in the legislation in force at the time. [18–20] 

Interoperability 

The product does not currently integrate with websites, other software applications, or external services. However, integration with electronic patient record systems is possible through REST API interfaces, and integration with the Finnish Personal Health Record (OmaKanta) is planned. [1] 

Data generated by the product can be exported in the widely used JSON file format. [1] 

Technical Stability 

Source code and configuration files are subject to version control and audit processes. The company uses a Git-based version control system, enabling software changes to be tracked and managed systematically. [1] 

Testing processes have been defined for the product and are carried out as part of ongoing software development and maintenance activities. [1] 

The company receives and processes product-related incident reports during office hours via email. [1] 

The operation of the product is proactively monitored to identify potential disruptions and faults. Monitoring is based on regular reviews of error logs and the software components and libraries used within the solution. [1] 

The company does not have a dedicated decommissioning plan for the product. According to the manufacturer, the product has not experienced service interruptions or downtime resulting from technical failures during the previous six months. [1] 

Product updates are implemented in a controlled manner using monitoring and logging mechanisms. Users are informed of updates both before deployment and after implementation.

Where necessary, the system can be reverted to a previous version. Updates are mandatory for users and are deployed centrally to all users. According to the manufacturer, updates do not result in user-visible service interruptions. [1] 

Use of the product requires an active internet connection, either through a wireless local area network (Wi-Fi) or a mobile network. [1] 

Training and Product Support 

The company provides product support on weekdays between 08:00 and 16:00 by email and telephone. [1] 

Organisation-specific guidance is provided to support implementation. Healthcare professionals assist patients with onboarding and initial use of the product. [1] 

Instructions for activation and use of the product are available in Finnish, Swedish, and English. [1]

Consumer Protection 

The company states that it responds to customer enquiries by no later than the following working day. [1] 

The intended purpose of the product is explained to end users within the application interface and in the user instructions. Customers have the opportunity to familiarise themselves with the product before full implementation. [1] 

Information, training materials, and support resources related to the product are available in several formats, including written instructions, video tutorials, and in-application guidance. [1] 

Information regarding the product’s content and pricing is provided on the company’s website, in application stores, or as part of organisational implementation processes. The product does not contain advertising. [1] 

The company has established procedures for situations in which a user wishes to discontinue use of the product. [1] 

There are no specific age restrictions associated with use of the product. However, downloading the application is subject to the country-specific age rating classifications applied by the application stores (App Store and Google Play). The content and guidance have been designed to be clear and easy to understand, and support can be adapted to the user’s level of knowledge and individual needs where necessary. [1] 

Product Distribution  

The product is available throughout Finland as a downloadable application. Since 2023, it has been adopted by three wellbeing services counties and has also been utilised in two research projects. [1]

1. The Digi-HTA questionnaire filled out by the company, not public information.­ 
2. Harjumaa, M., Absetz, P., Ermes, M., Mattila, E., Männikkö, R., Tilles-Tirkkonen, T., Lintu, N., Schwab, U., Umer, A., Leppänen, J., & Pihlajamäki, J. (2020). Internet-Based Lifestyle Intervention to Prevent Type 2 Diabetes Through Healthy Habits: Design and 6-Month Usage Results of Randomized Controlled Trial. JMIR diabetes, 5(3), e15219. https://doi.org/10.2196/15219 
3. Lavikainen, P., Mattila, E., Absetz, P., Harjumaa, M., Lindström, J., Järvelä-Reijonen, E., Aittola, K., Männikkö, R., Tilles-Tirkkonen, T., Lintu, N., Lakka, T., van Gils, M., Pihlajamäki, J., & Martikainen, J. (2022). Digitally Supported Lifestyle Intervention to Prevent Type 2 Diabetes Through Healthy Habits: Secondary Analysis of Long-Term User Engagement Trajectories in a Randomized Controlled Trial. Journal of medical Internet research, 24(2), e31530. https://doi.org/10.2196/31530 
4. Lakka, T. A., Aittola, K., Järvelä-Reijonen, E., Tilles-Tirkkonen, T., Männikkö, R., Lintu, N., Karhunen, L., Kolehmainen, M., Harjumaa, M., Mattila, E., Järvenpää, R., Ermes, M., Mikkonen, S., Martikainen, J., Poutanen, K., Schwab, U., Absetz, P., Lindström, J., & Pihlajamäki, J. (2023). Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk – A stop diabetes pragmatic randomised trial. The Lancet regional health. Europe, 24, 100527. https://doi.org/10.1016/j.lanepe.2022.100527 
5. Rekola, H., Tolmunen, T., Mattila, E., Strömmer, J., Lakka, T. A., Länsimies, H., & Mäki-Opas, T. (2025). User Archetypes of a Well-Being-Promoting Mobile App Among Adults: Cross-Sectional Study and Cluster Analysis of Usage Patterns. JMIR mHealth and uHealth, 13, e68982. https://doi.org/10.2196/68982 
6. Rekola H., Ahonen T., Holappa A-S., Sankilampi U., Mäki-Opas T. Politiikka-suositus. BitHabit-hyvinvointisovelluksen vaikuttavuus ja käyttöön vaikuttavat tekijät työikäisessä väestössä. Itä-Suomen yliopisto. https://sites.uef.fi/vaikuttavuuden-talo/wp-content/uploads/sites/28/2025/10/Rekola_etal_Policy_Brief_HYPE_BitHabit_vaikuttavuus.pdf. Accessed on  23.6.2026. 
7. Paronen E., Saijonkari M., Rekola H., Surakka A., Kurkinen K., Tolmunen T., Mäki-Opas T., Lammintakanen J. Mieliteko-ohjelman toimenpiteiden arviointi. https://www.mielitekomedia.fi/files/2023/October/Mieliteontoimenpiteidenarviointiraportti.pdf. Accessed on 23.6.2026. 
8. Wood, W., & Neal, D. T. (2016). Healthy through Habit: Interventions for Initiating & Maintaining Health Behavior Change. Behavioral Science & Policy, 2(1), 71-83. https://doi.org/10.1177/237946151600200109 
9. Lally, P., & Gardner, B. (2013). Promoting habit formation. Health Psychology Review, 7(sup1), S137–S158. https://doi.org/10.1080/17437199.2011.603640  
10. Gardner, B., Lally, P., & Wardle, J. (2012). Making health habitual: the psychology of ‘habit-formation’ and general practice. The British journal of general practice: the journal of the Royal College of General Practitioners, 62(605), 664–666. https://doi.org/10.3399/bjgp12X65946 
11. Harvey A. G. (2025). Maximizing benefits from evidence-based psychological treatments: Memory support and habit formation as key strategies. Behaviour research and therapy, 191, 104767. https://doi.org/10.1016/j.brat.2025.104767 
12. Semper, H. M., Povey, R., & Clark-Carter, D. (2016). A systematic review of the effectiveness of smartphone applications that encourage dietary self-regulatory strategies for weight loss in overweight and obese adults. Obesity reviews: an official journal of the International Association for the Study of Obesity, 17(9), 895–906. https://doi.org/10.1111/obr.12428 
13. Chew, H. S. J., Koh, W. L., Ng, J. S. H. Y., & Tan, K. K. (2022). Sustainability of Weight Loss Through Smartphone Apps: Systematic Review and Meta-analysis on Anthropometric, Metabolic, and Dietary Outcomes. Journal of medical Internet research, 24(9), e40141. https://doi.org/10.2196/40141 
14. Patterson, K., Davey, R., Keegan, R., Kunstler, B., Woodward, A., & Freene, N. (2022). Behaviour change techniques in cardiovascular disease smartphone apps to improve physical activity and sedentary behaviour: Systematic review and meta-regression. The international journal of behavioral nutrition and physical activity, 19(1), 81. https://doi.org/10.1186/s12966-022-01319-8 
15. National Cyber Security Centre: Information security and data protection requirements for social welfare and healthcare procurements. Available at: https://www.kyberturvallisuuskeskus.fi/en/instructions-and-guides/instructions-and-guides-organisations-and-companies/information-security-and-data-protection-requirements-social-welfare-and-healthcare-procurements Accessed on 24.6.2026 
16. The European Union Agency for Cybersecurity Procurement Guidelines for Cybersecurity in Hospitals. Saatavilla: https://www.enisa.europa.eu/publications/good-practices-for-the-security-of-healthcare-services Accessed on 24.6.2026 
17. BitHabit accessibility statement. Available at: https://bithabit.me/en/accessibility/ Accessed on 24.6.2026 
18. Act on the Provision of Digital Services 306/2019 (Available only in Finnish). Available at: https://www.finlex.fi/fi/laki/alkup/2019/20190306 Accessed on 24.6.2026 
19. Finnish Transport and Communications Agency Traficom, Digital Accessibility Supervision. The requirements of the Act on Provision of Digital Services. Available at: https://saavutettavuusvaatimukset.fi/en/requirements-act-provision-digital-services/requirements-act-provision-digital-services Accessed on 24.6.2026 
20. ct on public Procurement and concession contracts 1397/2016 (Available only in Finnish). Available at: https://www.finlex.fi/fi/laki/alkup/2016/20161397 Accessed on 24.6.2026 

Jari Haverinen, senior planning officer, FinCCHTA

Raija Järvinen, senior planning officer, FinCCHTA

Teemu Mustola, senior planning officer, FinCCHTA