@Article{info:doi/10.2196/63471, author="Leslie-Miller, Calissa J and Goltz, Shellen R and Barrios, Pamela L and Cushing, Christopher C and Badshah, Teena and Ungaro, Corey T and Qu, Shankang and Berezhnaya, Yulia and Brisbois, Tristin D", title="Evaluating the Acceptability and Utility of a Personalized Wellness App (Aspire2B) Using AI-Enabled Digital Biomarkers: Engagement Enhancement Pilot Study", journal="JMIR Form Res", year="2025", month="May", day="14", volume="9", pages="e63471", keywords="wellness application; development protocol; AI-enabled digital biomarkers; acceptability; nutrition; sleep; fitness; mobile phone", abstract="Background: There is significant global interest in promoting wellness, with digital solutions like mobile health apps being broadly downloaded; yet, there is a challenge in maintaining engagement for long-term behavior change. Developing a widely accepted mobile wellness app is imperative for advancing personalized wellness interventions. Objective: The primary objective of this study was to evaluate the Aspire2B wellness app (powered by Salus Optima), designed to exceed industry standards for participant engagement by incorporating evidence-based behavior change strategies and to assess its acceptability (eg, liking the face scan) and utility (eg, willing to use the face scan technology for other health insights) as a digital health solution. Methods: Participants aged 18-65 years, who were smartphone and fitness tracker users, were recruited in the United States during March-May 2022. Participants received US {\$}5 compensation for downloading the app, with no further incentive for usage. Following completion of onboarding (ie, survey questions about lifestyle behaviors), participants were placed in either a nutrition, sleep, or fitness 4-week challenge. During the challenge, participants used various app features at their own will, such as a facial scan for wellness insights (eg, heart rate and biological age), recipes, and workout videos. These interactions with the app were cumulatively evaluated as engagement metrics. Participants were also asked to answer offboarding questions to evaluate any changes to lifestyle behaviors and experience using the app features (eg, acceptability of face scan experience). Results: Out of the 398 people who created an account, 85.9{\%} (342/398) completed onboarding and a face scan. Following this, 74.9{\%} (298/398) of users completed additional survey questions about current wellness behaviors. Notably, interaction with the app was relatively stable from week 2 to 4 (173/398, 43.5{\%}), outperforming industry standards by roughly 3{\texttimes}. In addition, on average, participants completed 2.1‐2.7 face scans per week, with approximately 7{\%} (24/342) of participants maintaining regular use of face scan technology for 4 weeks. In users who completed offboarding questions, 88.8{\%} (111/125) found Aspire2B credible, 64.8{\%} (81/125) liked the face scan experience, 7.2{\%} (9/125) disliked the face scan experience, and 83.2{\%} (104/125) said they would use face scan technology for other insights into their health. Conclusions: These findings highlight strong initial engagement with Aspire2B, followed by significant sustained user engagement over a 4-week period. Furthermore, users indicated high levels of credibility and willingness to use face scan technology for wellness insights. These findings collectively demonstrate the capability of a personalized wellness app using AI-enabled digital biomarkers and evidence-supported behavior change techniques to yield positive user perception and provide long-term engagement. Trial Registration: ClinicalTrials.gov NCT06191822; https://clinicaltrials.gov/study/NCT06191822 ", issn="2561-326X", doi="10.2196/63471", url="https://formative.jmir.org/2025/1/e63471", url="https://doi.org/10.2196/63471" }