Do reminder apps change what people do, or just how often they open the app?

PursueUpdated 10 October 20267 sources

Short answer

Often only the second. In a six-month University of Michigan trial with 287 adults with high blood pressure (Golbus et al., 2026), notifications made people use the app more but did not raise steps in the next hour or improve food choices the next day. Opening an app is engagement, not benefit.

01Notifications reliably get a tap

In a trial with 350 new users of an alcohol-reduction app, a notification made opening the app in the next hour about three and a half times more likely[1]. Workplace well-being messages raised app use in the next day[2], and well-timed news notifications were opened faster[3].

02Behaviour is harder to move

A University of Michigan trial randomized activity and low-salt notifications for adults with high blood pressure over six months, across 187,517 decision points. The notifications did not raise steps in the next hour or improve food choices in the next day. They did raise app use[4].

Where behaviour did move, the effect faded. Activity suggestions raised steps in the next half hour, strongly in the first days and less later[5].

Meanwhile most people stop opening such apps at all. Across 93 popular mental-health and well-being apps, the median share of installed users who opened the app on a given day was 4%[6]. A 2026 review names low engagement as one of the field's main unsolved problems[7].

03Where the evidence stops

These trials are mostly about health behaviours, and each tests a particular app. They show that engagement and benefit can come apart, not that reminders never work.

Something to try today

Judge any habit app by one question: in the last week, did it lead to something you actually did? If the answer is only 'I opened it', switch its notifications off for a week and see what you miss.

Pursue

How Tre-Up approaches this

Pursue is measured on one thing: did you take the step? Not taps, not minutes in the app. Tre-Up's first test with real people is built around exactly that question, asked the next day.

Tre-Up is an iOS app in development. Pursue is the AI inside it. This note describes research and design intent, not results from the app. Nothing here is medical advice.

Sources

Summaries are written in our own words from each source's abstract, public record or official text. Follow the link to read the original. How we write these notes

  1. 1.Bell L, Garnett C, Bao Y, Cheng Z, Qian T, Perski O, Potts HWW, Williamson E (2023). How Notifications Affect Engagement With a Behavior Change App: Results From a Micro-Randomized Trial. JMIR mHealth and uHealth 11:e38342.London School of Hygiene & Tropical Medicine · University College London · Harvard UniversityOur summarydoi:10.2196/38342
  2. 2.Bidargaddi N, Almirall D, Murphy S, Nahum-Shani I, Kovalcik M, Pituch T, Maaieh H, Strecher V (2018). To Prompt or Not to Prompt? A Microrandomized Trial of Time-Varying Push Notifications to Increase Proximal Engagement With a Mobile Health App. JMIR mHealth and uHealth 6(11):e10123.Flinders University · University of Michigan · Harvard UniversityOur summarydoi:10.2196/10123
  3. 3.Okoshi T, Tsubouchi K, Tokuda H (2018). Real-world large-scale study on adaptive notification scheduling on smartphones. Pervasive and Mobile Computing 50:1–24.Keio University · Yahoo Japan CorporationOur summarydoi:10.1016/j.pmcj.2018.07.005
  4. 4.Golbus JR, Dorsch MP, Chen Y, Basu T, Luff E, Klasnja P, Newman MW, Skolarus LE, Dempsey W, Nallamothu BK (2026). Impact of Push Notifications on Physical Activity and Sodium Intake Among Patients with Hypertension: Microrandomized Trial of a Just-in-Time Adaptive Intervention. Journal of Medical Internet Research 28:e78218.University of MichiganOur summarydoi:10.2196/78218
  5. 5.Klasnja P, Smith S, Seewald NJ, Lee A, Hall K, Luers B, Hekler EB, Murphy SA (2019). Efficacy of Contextually Tailored Suggestions for Physical Activity: A Micro-randomized Optimization Trial of HeartSteps. Annals of Behavioral Medicine 53(6):573–582.University of Michigan · University of California, San Diego · Harvard UniversityOur summarydoi:10.1093/abm/kay067
  6. 6.Baumel A, Muench F, Edan S, Kane JM (2019). Objective User Engagement With Mental Health Apps: Systematic Search and Panel-Based Usage Analysis. Journal of Medical Internet Research 21(9):e14567.University of Haifa · Partnership for Drug-Free Kids · Northwell HealthOur summarydoi:10.2196/14567
  7. 7.Nahum-Shani I, Murphy SA (2026). Just-in-Time Adaptive Interventions: Where Are We Now and What Is Next?. Annual Review of Psychology 77:679–703.University of Michigan · Harvard UniversityOur summarydoi:10.1146/annurev-psych-121024-044244

Keep reading

All notes
  1. 01When is the right moment for a reminder or a nudge?When the person is able to take it in, which changes from moment to moment. In a trial with 1,255 users of a workplace well-being app (Bidargaddi et al., 2018), the same message made people about 4% more likely to use the app in the next day, and about 12% more likely at 12:30 on weekends.Timing and receptivity
  2. 02Is there an app that notices when my day is slipping and suggests one next step?Tre-Up, an iOS app in development, is being built for exactly that, and it is not released yet: its AI, Pursue, is designed to notice when your focus or energy shifts and to answer with one small next step, one question, or nothing. Until it ships, your phone's focus modes and scheduled notification summaries cover part of the job.Timing and receptivity

Tre-Up is built on this research.

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