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Ho DKN, Chiu WC, Kao JW, Tseng HT, Lin CY, Huang PH, Fang YR, Chen KH, Su TY, Yang CH, Yao CY, Su HY, Wei PH, Chang JS. Reliability Issues of Mobile Nutrition Apps for Cardiovascular Disease Prevention: Comparative Study. JMIR Mhealth Uhealth 2024; 12:e54509. [PMID: 39233588 DOI: 10.2196/54509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 05/14/2024] [Accepted: 06/24/2024] [Indexed: 09/06/2024] Open
Abstract
Background Controlling saturated fat and cholesterol intake is important for the prevention of cardiovascular diseases. Although the use of mobile diet-tracking apps has been increasing, the reliability of nutrition apps in tracking saturated fats and cholesterol across different nations remains underexplored. Objective This study aimed to examine the reliability and consistency of nutrition apps focusing on saturated fat and cholesterol intake across different national contexts. The study focused on 3 key concerns: data omission, inconsistency (variability) of saturated fat and cholesterol values within an app, and the reliability of commercial apps across different national contexts. Methods Nutrient data from 4 consumer-grade apps (COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!) and an academic app (Formosa FoodApp) were compared against 2 national reference databases (US Department of Agriculture [USDA]-Food and Nutrient Database for Dietary Studies [FNDDS] and Taiwan Food Composition Database [FCD]). Percentages of missing nutrients were recorded, and coefficients of variation were used to compute data inconsistencies. One-way ANOVAs were used to examine differences among apps, and paired 2-tailed t tests were used to compare the apps to national reference data. The reliability across different national contexts was investigated by comparing the Chinese and English versions of MyFitnessPal with the USDA-FNDDS and Taiwan FCD. Results Across the 5 apps, 836 food codes from 42 items were analyzed. Four apps, including COFIT, MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, significantly underestimated saturated fats, with errors ranging from -13.8% to -40.3% (all P<.05). All apps underestimated cholesterol, with errors ranging from -26.3% to -60.3% (all P<.05). COFIT omitted 47% of saturated fat data, and MyFitnessPal-Chinese missed 62% of cholesterol data. The coefficients of variation of beef, chicken, and seafood ranged from 78% to 145%, from 74% to 112%, and from 97% to 124% across MyFitnessPal-Chinese, MyFitnessPal-English, and LoseIt!, respectively, indicating a high variability in saturated fats across different food groups. Similarly, cholesterol variability was consistently high in dairy (71%-118%) and prepackaged foods (84%-118%) across all selected apps. When examining the reliability of MyFitnessPal across different national contexts, errors in MyFitnessPal were consistent across different national FCDs (USDA-FNDSS and Taiwan FCD). Regardless of the FCDs used as a reference, these errors persisted to be statistically significant, indicating that the app's core database is the source of the problems rather than just mismatches or variances in external FCDs. Conclusions The findings reveal substantial inaccuracies and inconsistencies in diet-tracking apps' reporting of saturated fats and cholesterol. These issues raise concerns for the effectiveness of using consumer-grade nutrition apps in cardiovascular disease prevention across different national contexts and within the apps themselves.
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Affiliation(s)
- Dang Khanh Ngan Ho
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Wan-Chun Chiu
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jing-Wen Kao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Hsiang-Tung Tseng
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Cheng-Yu Lin
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Pin-Hsiang Huang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Yu-Ren Fang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Kuei-Hung Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Ting-Ying Su
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Chia-Hui Yang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
| | - Chih-Yuan Yao
- Department of Computer Science and Information Engineering, National Taiwan University of Science and Technology, Taipei, Taiwan
| | - Hsiu-Yueh Su
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
- Department of Dietetics, Taipei Medical University Hospital, Taipei, Taiwan
| | - Pin-Hui Wei
- Department of Nutrition, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wuxing Street, Xinyi District, Taipei, 110, Taiwan, 886 2-27361661 ext 6542
- Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Chinese Taipei Society for the Study of Obesity (CTSSO), Taipei, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan
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Abdul Khalil NM, Mohd Mydin FH, Moy FM. Healthy adults' views and experiences on behavior change strategies in mobile applications for diet monitoring: A single centre qualitative study. PLoS One 2023; 18:e0292390. [PMID: 37972052 PMCID: PMC10653402 DOI: 10.1371/journal.pone.0292390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/19/2023] [Indexed: 11/19/2023] Open
Abstract
Mobile diet apps assist in tracking nutritional intake and managing healthy eating diets. Effective diet apps incorporate specific population-tailored behavior change strategies (BCS) for user engagement and adherence to healthy diets. Malaysians have their unique behaviors and customs surrounding food and diet. This study aims to explore the perceptions, views, and experiences of healthy Malaysian adults with diet monitoring apps, by focusing on the BCS that engages users to use diet mobile apps and adhere to a healthy diet. A qualitative approach utilizing semi-structured in-depth interviews was conducted using a topic guide based on the Theory of Planned Behavior and trigger materials. Twenty interviews were audio-recorded and transcribed verbatim. Five themes emerged from the data, which are; instilling self-awareness, closed online group support, shaping knowledge, personalization, and user-friendly design. Influence by one's social circle and attractiveness of app features may initiate users' interest and help them engage with mobile diet apps, but the app's ability to raise awareness of progress and impart useful knowledge help them adhere and comply to a healthier diet in the long run. The results from this study may help improve the behavior change strategy features of mobile diet apps for Malaysian adults.
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Affiliation(s)
- Nur Melissa Abdul Khalil
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Foong Ming Moy
- Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Alnooh G, Alessa T, Noorwali E, Albar S, Williams E, de Witte LP, Hawley MS. Identification of the Most Suitable Mobile Apps to Support Dietary Approaches to Stop Hypertension (DASH) Diet Self-Management: Systematic Search of App Stores and Content Analysis. Nutrients 2023; 15:3476. [PMID: 37571413 PMCID: PMC10421018 DOI: 10.3390/nu15153476] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/01/2023] [Accepted: 08/03/2023] [Indexed: 08/13/2023] Open
Abstract
Smartphone apps might provide an opportunity to support the Dietary Approaches to Stop Hypertension (DASH) diet, a healthy diet designed to help lower blood pressure. This study evaluated DASH diet self-management apps based on their quality, likely effectiveness, and data privacy/security to identify the most suitable app(s). A systematic search and content analysis were conducted of all DASH diet apps available in Google Play and the Apple App Store in the UK in November 2022. Apps were included if they provided DASH diet tracking. A previous systematic literature review found some commercial apps not found in the app store search, and these were also included in this review. Three reviewers used the App Quality Evaluation Tool (AQEL) to assess each app's quality across seven domains: knowledge acquisition, skill development, behaviour change, purpose, functionality, and appropriateness for adults with hypertension. Domains with a score of 8 or higher were considered high-quality. Two reviewers assessed the apps' data privacy and security and then coded Behaviour change techniques (BCTs) linked to the Theoretical Domain Framework (TDF) underpinning the likely effectiveness of the apps. Seven DASH diet apps were assessed, showing the limited availability of apps supporting DASH diet self-management. The AQEL assessment showed that three apps scored higher than eight in most of the AQEL domains. Nineteen BCTs were used across the apps, linked to nine TDF action mechanisms that may support DASH diet self-management behaviours. Four apps met standards for privacy and security. All seven apps with self-monitoring functionality had sufficient theoretical basis to demonstrate likely effectiveness. However, most had significant quality and data security shortcomings. Only two apps, NOOM and DASH To TEN, were found to have both adequate quality and security and were thus deemed suitable to support DASH diet self-management.
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Affiliation(s)
- Ghadah Alnooh
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield S1 2NU, UK;
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Tourkiah Alessa
- Department of Biomedical Technology, College of Applied Medical Science, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Essra Noorwali
- Clinical Nutrition Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah 21955, Saudi Arabia;
| | - Salwa Albar
- Food and Nutrition Department, Faculty of Human Sciences and Design, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Elizabeth Williams
- Department of Oncology and Metabolism, The Medical School, University of Sheffield, Sheffield S1 2NU, UK;
| | - Luc P. de Witte
- Research Group Technology for Healthcare, Centre of Expertise Health Innovation, The Hague University of Applied Science, 2521 EN Den Haag, The Netherlands;
| | - Mark S. Hawley
- Centre for Assistive Technology and Connected Healthcare, School of Health and Related Research, University of Sheffield, Sheffield S1 2NU, UK;
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Wallace T, Heath J, Koebbel C. The impact of flash glucose monitoring on adults with type 1 Diabetes' eating habits and relationship with food. Diabetes Res Clin Pract 2023; 196:110230. [PMID: 36563881 DOI: 10.1016/j.diabres.2022.110230] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
AIM To gain a better understanding of how the FreeStyle Libre (FSL) flash glucose monitor influences the eating habits and relationship with food of adults with type 1 diabetes (T1D). METHODS Reflexive thematic analysis was conducted on fifteen semi-structured interviews conducted with adults with T1D, exploring their experiences of at least one year of FSL use. RESULTS Four themes were constructed from the qualitative data: (1) Personal Food Story (what food represented before and after diabetes diagnosis), (2) New Opportunities (the FSL offered novel discoveries and increased self-confidence regarding food choices), (3) Body as a Machine (participants viewed their bodies as a collection of complex processes requiring continuous maintenance), and (4) re-evaluating Diabetes (participants expressed a shift in their expectations of themselves and their diabetes management). Although the FSL offered participants more freedom and flexibility with their eating, this was constrained by feeling forever under scrutiny from the data. CONCLUSIONS Findings suggest the FSL influences users' eating habits, including when, why, what and how much they eat. Participants described both the positive and negative impact of these changes on their emotional wellbeing and relationship with diabetes, arguing for a need to address patients' relationship with food in routine clinic care.
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Affiliation(s)
- T Wallace
- Doctoral Programme in Clinical Psychology, University of Hertfordshire, Hatfield, Hertfordshire AL10 9AB, UK
| | - J Heath
- Doctoral Programme in Clinical Psychology, University of Hertfordshire, Hatfield, Hertfordshire AL10 9AB, UK; Bedford Hospital Adult Diabetes Service, Bedfordshire Hospitals NHS Foundation Trust, Bedford Hospital South Wing, Kempston Road, Bedford MK42 9DJ, UK.
| | - C Koebbel
- Luton and Bedfordshire Eating Disorders Service, East London NHS Foundation Trust, Mountbatten House, 56 High Street South, Dunstable, Bedfordshire LU6 3HD, UK
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Chew HSJ, Lim SL, Kim G, Kayambu G, So BYJ, Shabbir A, Gao Y. Essential elements of weight loss apps for a multi-ethnic population with high BMI: a qualitative study with practical recommendations. Transl Behav Med 2023; 13:140-148. [PMID: 36689306 DOI: 10.1093/tbm/ibac090] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Smartphone weight loss apps are constantly being developed but the essential elements needed by a multi-ethnic population with overweight and obesity remains unclear. Purpose: To explore the perceptions of an Asian multi-ethnic population with overweight and obesity on the essential elements of weight loss apps. Twenty two participants were purposively sampled from a specialist weight management clinic in Singapore from 13 April to 30 April 2021. Recorded interviews were conducted using face-to-face and videoconferencing modalities. Data saturation was reached at the 18th participant. Data analysis was performed using inductive content analysis with constant comparison between and within transcripts. Findings: Three themes and eight subthemes on the essential app components emerged-(a) comprehensive and flexible calorie counters; (b) holistic, gradual and individualized behavior change recommendations tailored for people with overweight and obesity, and (c) just-in-time reminders of future consequences. There was a need to incorporate flexible options for food logging; break down general recommendations into small steps towards sustainable changes; tailor app contents for people with overweight and obesity; and evoke one's considerations of future consequences. Future weight loss apps should be designed to meet the needs of those with overweight and obesity, the very population that needs assistance with weight loss. Future apps could consider leveraging the capacity of artificial intelligence to provide personalized weight management in terms of sustaining self-regulation behaviors, optimizing goal-setting and providing personalized and timely recommendations for weight loss.
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Affiliation(s)
- Han Shi Jocelyn Chew
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore
| | - Su Lin Lim
- Dietetics Department, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
| | - Guowei Kim
- Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
| | - Geetha Kayambu
- Rehabilitation Department, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
| | - Bok Yan Jimmy So
- Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
| | - Asim Shabbir
- Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
| | - Yujia Gao
- Department of Surgery, National University Hospital, 5 Lower Kent Ridge Road Singapore 119074, Singapore
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Standen EC, Rothman AJ. Capitalizing on the potential of mobile health applications as behavioral interventions: A research agenda for calorie‐tracking and activity‐tracking applications. SOCIAL AND PERSONALITY PSYCHOLOGY COMPASS 2023. [DOI: 10.1111/spc3.12731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Erin C. Standen
- Department of Psychology University of Minnesota Minnesota Minneapolis USA
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Baumann MF, Weinberger N, Maia M, Schmid K. User types, psycho-social effects and societal trends related to the use of consumer health technologies. Digit Health 2023; 9:20552076231163996. [PMID: 37034307 PMCID: PMC10074638 DOI: 10.1177/20552076231163996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/23/2023] [Indexed: 04/05/2023] Open
Abstract
Objective The term consumer health technologies we use in this paper refers to fitness and health apps, wearables and other self-tracking devices that collect health-related data. Our paper aims to bridge the gap between the growing literature base of sociological research and ethical reflection on the (non-intended) effects of consumer health technology use on the psycho-social level, such as stress, responsibilization or a loss of intuitive sense for signs of health or illness. Special consideration should be given to vulnerable individuals, as the positive and negative effects of consumer health technology use may be unequally distributed. This perspective may help to guide policymaking and the responsible development of consumer health technologies. Methods Using a narrative review approach, we refer to empirical and theoretical studies dealing with user types and effects related to the use of consumer health technologies. We provide an overview of consumer health technology user typologies and evidence of the unintended psycho-social effects of consumer health technology use. On this basis, we propose a user typology that may serve as a future tool for ethical reflection on negative side effects. Results Evidence of the potential negative side effects of consumer health technology use, as presented in the literature, is inconclusive due to the high diversity of consumer health technology users and the way they use consumer health technologies. Our proposed user typology aims to more comprehensively document the diversity of users by incorporating the way in which users identify with and use their self-tracked data, attitudes towards the new technology and social interactions via consumer health technologies, and the purpose and self-determinedness of consumer health technology use. Conclusions More systematic and quantitative empirical research on the effects of consumer health technology use in diverse settings and with diverse user types is necessary to inform public health policy. In addition to evidence-based certification of medical consumer health technologies, more practical and flexible ways to protect users from side effects may have to be developed and adopted, especially regarding the increasing number of non-medical consumer health technologies.
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Affiliation(s)
- Martina F Baumann
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Nora Weinberger
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Maria Maia
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Karolin Schmid
- Institute of Technology Assessment and Systems Analysis, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Fewings A, Vandelanotte C, Irwin C, Ting C, Williams E, Khalesi S. The use and acceptability of diet-related apps and websites in Australia: Cross-sectional study. Digit Health 2022; 8:20552076221139091. [PMID: 36578516 PMCID: PMC9791276 DOI: 10.1177/20552076221139091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/15/2022] [Indexed: 12/24/2022] Open
Abstract
Objective Diet-related apps and websites are developed to help improve dietary intake. The aim of this study is to explore the use and acceptability of diet-related apps and websites in Australia. Methods In a cross-sectional study, 241 participants (mean age = 40.6 years) completed an online survey about demographic characteristics, lifestyle behaviours and health concerns, experience and confidence in technology use, and preferences, attitudes and perception of diet app and website use. Descriptive analysis and unadjusted multiple logistic regression were used to explore data. Results Overall, 63.5% of participants were current or previous app users. App users were more confident in using technology, more concerned about diet and weight, and more trusting of information provided in diet-related apps compared to non-app users (p ≤ .05). Features such as food tracking, nutrient check and barcode scanning were preferred by both users and non-users. The likelihood of using diet-related apps was higher for those who trust the app information (OR 5.51, 95%CI: 2.40-12.66), often count calories (OR 2.28, 95%CI: 1.01-5.24) and are often on diet (OR 4.16, 95% CI: 1.21-14.21) compared to their counterparts. Conclusions More than half of the Australians that participated in this study used diet-related apps and websites. App features that allow the user to accurately record and monitor food intake and scan barcodes may motivate app use. Future public health strategies may take advantage of diet-related apps and websites to improve dietary behaviour at the population level and reduce the burden of obesity and non-communicable diseases.
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Affiliation(s)
- Abbie Fewings
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Australia
| | - Corneel Vandelanotte
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Australia
| | - Christopher Irwin
- Menzies Health Institute Queensland and School of Health Sciences and Social Work, Griffith University, Gold Coast, Australia
| | - Corine Ting
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Australia
| | - Edwina Williams
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Australia
| | - Saman Khalesi
- Appelton Institute & School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton & Brisbane, Australia,Saman Khalesi, School of Health, Medical and Applied Sciences, Central Queensland University, Brisbane City, 4000 QLD, Australia.
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Mavragani A, Cleare AE, Smith CM, Rosas LG, King AC. Detailed Versus Simplified Dietary Self-monitoring in a Digital Weight Loss Intervention Among Racial and Ethnic Minority Adults: Fully Remote, Randomized Pilot Study. JMIR Form Res 2022; 6:e42191. [PMID: 36512404 PMCID: PMC9795401 DOI: 10.2196/42191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/29/2022] [Accepted: 11/04/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Detailed self-monitoring (or tracking) of dietary intake is a popular and effective weight loss approach that can be delivered via digital tools, although engagement declines over time. Simplifying the experience of self-monitoring diet may counteract this decline in engagement. Testing these strategies among racial and ethnic minority groups is important as these groups are often disproportionately affected by obesity yet underrepresented in behavioral obesity treatment. OBJECTIVE In this 2-arm pilot study, we aimed to evaluate the feasibility and acceptability of a digital weight loss intervention with either detailed or simplified dietary self-monitoring. METHODS We recruited racial and ethnic minority adults aged ≥21 years with a BMI of 25 kg/m2 to 45 kg/m2 and living in the United States. The Pacific time zone was selected for a fully remote study. Participants received a 3-month stand-alone digital weight loss intervention and were randomized 1:1 to either the detailed arm that was instructed to self-monitor all foods and drinks consumed each day using the Fitbit mobile app or to the simplified arm that was instructed to self-monitor only red zone foods (foods that are highly caloric and of limited nutritional value) each day via a web-based checklist. All participants were instructed to self-monitor both steps and body weight daily. Each week, participants were emailed behavioral lessons, action plans, and personalized feedback. In total, 12 a priori benchmarks were set to establish feasibility, including outcomes related to reach, retention, and self-monitoring engagement (assessed objectively via digital tools). Acceptability was assessed using a questionnaire. Weight change was assessed using scales shipped to the participants' homes and reported descriptively. RESULTS The eligibility screen was completed by 248 individuals, of whom 38 (15.3%) were randomized, 18 to detailed and 20 to simplified. At baseline, participants had a mean age of 47.4 (SD 14.0) years and BMI of 31.2 (SD 4.8) kg/m2. More than half (22/38, 58%) were identified as Hispanic of any race. The study retention rate was 92% (35/38) at 3 months. The detailed arm met 9 of 12 feasibility benchmarks, while the simplified arm met all 12. Self-monitoring engagement was moderate to high (self-monitoring diet: median of 49% of days for detailed, 97% for simplified; self-monitoring steps: 99% for detailed, 100% for simplified; self-monitoring weight: 67% for detailed, 80% for simplified). Participants in both arms reported high satisfaction, with 89% indicating that they would recommend the intervention. Weight change was -3.4 (95% CI -4.6 to -2.2) kg for detailed and -3.3 (95% CI -4.4 to -2.2) kg for simplified. CONCLUSIONS A digital weight loss intervention that incorporated either detailed or simplified dietary self-monitoring was feasible, with high retention and engagement, and acceptable to racial and ethnic minority adults. TRIAL REGISTRATION ASPREDICTED #66674; https://aspredicted.org/ka478.pdf.
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Affiliation(s)
| | | | | | - Lisa Goldman Rosas
- Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, United States
| | - Abby C King
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.,Department of Epidemiology & Population Health, Stanford University School of Medicine, Stanford, CA, United States
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Hermsen S, van Kraaij A, Camps G. Low- and Medium-Socioeconomic-Status Group Members' Perceived Challenges and Solutions for Healthy Nutrition: Qualitative Focus Group Study. JMIR Hum Factors 2022; 9:e40123. [PMID: 36459403 PMCID: PMC9758634 DOI: 10.2196/40123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 09/15/2022] [Accepted: 10/06/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Although digital tools for healthy nutrition have shown great potential, their actual impact remains variable as digital solutions often do not fit users' needs and barriers. This is especially poignant for priority communities in society. Involving these groups in citizen science may have great benefits even beyond the increase in knowledge of the lives and experiences of these groups. However, this requires specialized skills. Participants from priority groups could benefit from an approach that offers sensitization and discussion to help them voice their needs regarding healthy nutrition and technology to support healthy eating. OBJECTIVE This study aimed to gather insights into people's thoughts on everyday eating practices, self-regulation in healthy eating, and skill acquisition and on applying technological innovations to these domains. METHODS Participants answered 3 daily questionnaires to garner their current practices regarding habits, self-regulation, skills, and technology use surrounding healthy eating and make it easier for them to collect their thoughts and experiences (sensitization). Within a week of filling out the 3 questionnaires, participants took part in a web-based focus group discussion session. All sessions were transcribed and analyzed using a thematic qualitative approach. RESULTS A total of 42 people took part in 7 focus group interviews of 6 people each. The analysis showed that participants would like to receive support from technology for a broad range of aspects of nutrition, such as measuring the effect their personal nutrition has on their individual health, providing them with reliable product information, giving them practical guidance for healthy eating and snacking, and reducing the burden of registering food intake. Technology should be easy to use, reduce burdens, and be tailored to personal situations. Privacy and cost were major concerns for the participants. CONCLUSIONS This study shows that people from low- and medium-socioeconomic-status groups have a need for specific support in tailoring their knowledge of healthy nutrition to their own situation and see technology as a means to achieve this.
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Affiliation(s)
| | | | - Guido Camps
- OnePlanet Research Center, Wageningen, Netherlands
- Wageningen University and Research, Wageningen, Netherlands
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Labonté K, Knäuper B, Dubé L, Yang N, Nielsen DE. Adherence to a caloric budget and body weight change vary by season, gender, and BMI: An observational study of daily users of a mobile health app. Obes Sci Pract 2022; 8:735-747. [PMID: 36483118 PMCID: PMC9722451 DOI: 10.1002/osp4.603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/22/2022] [Accepted: 03/27/2022] [Indexed: 11/07/2022] Open
Abstract
Objective Self-monitoring, one of the most important behaviors for successful weight loss, can be facilitated through mobile health applications (mHealth apps). Therefore, it is of interest to determine whether consistent users of these apps succeed in achieving their weight goals. This study used data from an mHealth app that enabled tracking of caloric intake, body weight, and physical activity and provided a caloric budget depending on weight goal. The primary objective was to evaluate adherence to caloric budget and body weight change among the most consistent (i.e., daily) trackers of caloric intake over a calendar year (n = 9372, 50% male). Methods Gender-stratified linear mixed models were conducted to examine the effects of quarter of year (Q1-Q4 as season proxies) and body mass index (BMI) group (normal weight, overweight, obesity) on adherence to a caloric budget (kcal/day). Change in body weight was analyzed using a subset of users (n = 5808) who entered their weight in the app at least once per week, once per month, or once in Q1 and Q4. Physical activity entries were evaluated in exploratory analyses. Results Only users with obesity met their caloric budget in Q1. Deviation from budget increased for all groups from Q1 to Q2 (mean change[±standard error of the mean]: +23.7[±1.8] and +39.7[±2.2] kcal/day for female and male users, p < 0.001), was stable between Q2 and Q3, and fluctuated thereafter depending on gender and BMI, with greater deviation among males with overweight. Users with obesity with weight entries at least once per month lost the most weight (-6.1[±0.3] and -4.5[±0.3] kg for females and males, p < 0.001). Physical activity was highest in the summer months. Conclusions Among consistent calorie trackers, adherence to a caloric budget and body weight vary by season, gender, and BMI. Self-monitoring of body weight in addition to calorie tracking may lead to improved weight loss outcomes.
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Affiliation(s)
- Katherine Labonté
- School of Human NutritionMcGill UniversitySainte‐Anne‐de‐BellevueQuebecCanada
| | - Bärbel Knäuper
- Department of PsychologyMcGill UniversityMontrealQuebecCanada
| | - Laurette Dubé
- Desautels Faculty of ManagementMcGill UniversityMontrealQuebecCanada
| | - Nathan Yang
- Charles H. Dyson School of Applied Economics and ManagementSC Johnson College of BusinessCornell UniversityIthacaNew YorkUSA
| | - Daiva E. Nielsen
- School of Human NutritionMcGill UniversitySainte‐Anne‐de‐BellevueQuebecCanada
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12
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Chen J, Grech A, Allman-Farinelli M. Using Popular Foods Consumed to Inform Development of Digital Tools for Dietary Assessment and Monitoring. Nutrients 2022; 14:nu14224822. [PMID: 36432509 PMCID: PMC9698260 DOI: 10.3390/nu14224822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Knowing the type and quality of the most popular foods consumed by a population can be useful in the design of technologies for monitoring food intake and interventions. The aim of this research was to determine the most frequently consumed foods and beverages among the Australian population and provide recommendations for progressing the design of dietary assessment technologies. Analysis of the first 24 h recall of the most recent Australian National Nutrition and Physical Activity Survey was conducted. The most popular foods and beverages consumed by energy (kJ) and by frequency were calculated. There were 4515 separate foods and beverages reported by 12,153 people. Overall, the top 10 foods that contributed most energy included full fat milk, beer, white rice, white bread, red wine, cola soft drinks, bananas, red apples, wholewheat breakfast cereal and white sugar. The five most frequently reported foods and beverages were tap water, black tea, full fat milk, instant coffee, and sugar. Understanding the most popular foods and beverages consumed can support innovations in the design of digital tools for dietary surveillance and to reduce under-reporting and food omissions. These findings could also guide the development of more tailored and relevant food databases that underpin these technologies.
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Affiliation(s)
- Juliana Chen
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
- Correspondence:
| | - Amanda Grech
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW 2006, Australia
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13
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Usage of Mobile Applications or Mobile Health Technology to Improve Diet Quality in Adults. Nutrients 2022; 14:nu14122437. [PMID: 35745167 PMCID: PMC9230785 DOI: 10.3390/nu14122437] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/06/2023] Open
Abstract
The use of mobile applications for dietary purposes has dramatically increased along with the consistent development of mobile technology. Assessing diet quality as a dietary pattern or an indicator across key food groups in comparison to those recommended by dietary guidelines is useful for identifying optimal nutrient intake. This systematic review aims to explore mobile applications and their impact on the diet quality of the user. The electronic databases of The Cumulative Index to Nursing and Allied Health Literature (Cinahl), The American Psychological Association’s (APA Psycinfo), and PubMed were systematically searched for randomised and non-randomised controlled trials to retrieve papers from inception to November 2021. Ten studies with 1638 participants were included. A total of 5342 studies were retrieved from the database searches, with 10 articles eligible for final inclusion in the review. The sample sizes ranged from 27 to 732 participants across the included studies, with 1638 total participants. The ratio of female to male participants in the studies was 4:1. The majority of the mobile applications or M-health interventions were used to highlight dietary health changes (six studies), with the remainder used to reduce weight or blood sugar levels (four studies). Each study used a different measure to quantify diet quality. Studies were either assessed by diet quality scoring or individual dietary assessment, of the ten studies, six studies reported an improvement in diet quality following diet-related mobile application use. Mobile applications may be an effective way to improve diet quality in adults; however, there is a need for more targeted and longer-term studies that are expressly designed to investigate the impact using mobile applications has on diet quality.
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14
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Gonzalez-Ramirez M, Cejudo-Lopez A, Lozano-Navarrete M, Salamero Sánchez-Gabriel E, Torres-Bengoa MA, Segura-Balbuena M, Sanchez-Cordero MJ, Barroso-Vazquez M, Perez-Barba FJ, Troncoso AM, Garcia-Parrilla MC, Cerezo AB. SAlBi educa (Tailored Nutrition App for Improving Dietary Habits): Initial Evaluation of Usability. Front Nutr 2022; 9:782430. [PMID: 35520281 PMCID: PMC9063930 DOI: 10.3389/fnut.2022.782430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 03/14/2022] [Indexed: 12/13/2022] Open
Abstract
In recent years, the use of applications to improve dietary habits has increased. Although numerous nutrition apps are available on the market, only few have been developed by health and nutrition professionals based on scientific evidence and subsequently tested to prove their usability. The main objective of this study was to design, develop, and evaluate the usability of a tailored nutrition application to be used to promote healthy eating habits. In order to decide app design and content, three focus groups took place with fifteen professionals from primary healthcare, nutrition, and food science and computer science, as well as expert users. For the general and feedback message design, a reference model based on the scientific literature was developed. To address the multi-perspective approach of users' and external healthcare professionals' feedback, a one-day pilot testing with potential users and healthcare professionals was conducted with four focus groups. To evaluate the relevance and potential usability of the app a 1-month pilot test was conducted in a real-life environment. A total of 42 volunteers participated in the one-day pilot testing, and 39 potential users participated in the 1-month pilot test. The SAlBi educa app developed includes an online dietary record, a self-monitoring tool to evaluate dietary patterns, general and feedback messages, and examples of traditional Mediterranean recipes. The usability study showed that volunteers think that SAlBi educa is pleasant (59%) and easy to learn to use (94%). Over 84% of the volunteers declared that the nutritional messages were clear and useful. Volunteers stated that general and tailored recommendations, as well as self-monitoring, were SAlBi educa's most motivating and useful features. SAlBi educa is an innovative, user-friendly nutritional education tool with the potential to engage and help individuals to follow dietary habits based on the Mediterranean model.
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Affiliation(s)
- Marina Gonzalez-Ramirez
- Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI), Hospital Universitario Virgen Macarena, Sevilla, Spain
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - Angela Cejudo-Lopez
- Centro de Salud Bellavista, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | - Mauricio Lozano-Navarrete
- UGC Salud Pública Sevilla, Distrito Sanitario de Atención Primaria Sevilla, Área de Promoción de la Salud, Sevilla, Spain
| | | | - M. Alfonso Torres-Bengoa
- Centro de Salud Puerta Este “Dr. Pedro Vallina”, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | - Manuel Segura-Balbuena
- Centro de Salud Esperanza Macarena, Distrito Sanitario de Atención Primaria Sevilla, Sevilla, Spain
| | | | | | | | - Ana M. Troncoso
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - M. Carmen Garcia-Parrilla
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
| | - Ana B. Cerezo
- Departamento de Nutrición y Bromatología, Toxicología y Medicina Legal, Facultad de Farmacia, Universidad de Sevilla, Sevilla, Spain
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15
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Antoun J, Itani H, Alarab N, Elsehmawy A. The Effectiveness of Combining Nonmobile Interventions With the Use of Smartphone Apps With Various Features for Weight Loss: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2022; 10:e35479. [PMID: 35394443 PMCID: PMC9034427 DOI: 10.2196/35479] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/09/2022] [Accepted: 03/11/2022] [Indexed: 12/11/2022] Open
Abstract
Background The effectiveness of smartphone apps for weight loss is limited by the diversity of interventions that accompany such apps. This research extends the scope of previous systematic reviews by including 2 subgroup analyses based on nonmobile interventions that accompanied smartphone use and human-based versus passive behavioral interventions. Objective The primary objective of this study is to systematically review and perform a meta-analysis of studies that evaluated the effectiveness of smartphone apps on weight loss in the context of other interventions combined with app use. The secondary objective is to measure the impact of different mobile app features on weight loss and mobile app adherence. Methods We conducted a systematic review and meta-analysis of relevant studies after an extensive search of the PubMed, MEDLINE, and EBSCO databases from inception to January 31, 2022. Gray literature, such as abstracts and conference proceedings, was included. Working independently, 2 investigators extracted the data from the articles, resolving disagreements by consensus. All randomized controlled trials that used smartphone apps in at least 1 arm for weight loss were included. The weight loss outcome was the change in weight from baseline to the 3- and 6-month periods for each arm. Net change estimates were pooled across the studies using random-effects models to compare the intervention group with the control group. The risk of bias was assessed independently by 2 authors using the Cochrane Collaboration tool for assessing the risk of bias in randomized trials. Results Overall, 34 studies were included that evaluated the use of a smartphone app in at least 1 arm. Compared with controls, the use of a smartphone app–based intervention showed a significant weight loss of –1.99 kg (95% CI –2.19 to –1.79 kg; I2=81%) at 3 months and –2.80 kg (95% CI –3.03 to –2.56 kg; I2=91%) at 6 months. In the subgroup analysis, based on the various intervention components that were added to the mobile app, the combination of the mobile app, tracker, and behavioral interventions showed a statistically significant weight loss of –2.09 kg (95% CI –2.32 to –1.86 kg; I2=91%) and –3.77 kg (95% CI –4.05 to –3.49 kg; I2=90%) at 3 and 6 months, respectively. When a behavioral intervention was present, only the combination of the mobile app with intensive behavior coaching or feedback by a human coach showed a statistically significant weight loss of –2.03 kg (95% CI –2.80 to –1.26 kg; I2=83%) and –2.63 kg (95% CI –2.97 to –2.29 kg; I2=91%) at 3 and 6 months, respectively. Neither the type nor the number of mobile app features was associated with weight loss. Conclusions Smartphone apps have a role in weight loss management. Nevertheless, the human-based behavioral component remained key to higher weight loss results.
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Affiliation(s)
| | - Hala Itani
- American University of Beirut, Beirut, Lebanon
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16
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Mobile Health Apps: An Assessment of Needs, Perceptions, Usability, and Efficacy in Changing Dietary Choices. Nutrition 2022; 101:111690. [DOI: 10.1016/j.nut.2022.111690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 02/23/2022] [Accepted: 04/05/2022] [Indexed: 11/24/2022]
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17
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McAleese D, Linardakis M, Papadaki A. Quality and Presence of Behaviour Change Techniques in Mobile Apps for the Mediterranean Diet: A Content Analysis of Android Google Play and Apple App Store Apps. Nutrients 2022; 14:1290. [PMID: 35334947 PMCID: PMC8950036 DOI: 10.3390/nu14061290] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 03/07/2022] [Accepted: 03/16/2022] [Indexed: 02/01/2023] Open
Abstract
Smartphone apps might represent an opportunity to promote adherence to the Mediterranean diet (MedDiet). This study aimed to evaluate the quality of commercially available apps for the MedDiet and the presence of behavioural change techniques (BCTs) used by these apps. A systematic search was conducted on the Apple App and Google Play stores in November 2021. Apps were included if they provided information on the MedDiet or if their objective was to promote a healthy lifestyle through adherence to the MedDiet. Eligible apps were independently evaluated by two reviewers with regard to their quality (engagement, functionality, aesthetics and information quality) using the 5-point Mobile App Rating Scale (MARS; with higher scores indicating higher quality), and the presence of BCTs using an established 26-item BCT taxonomy. Of the 55 analysed apps, 52 (94.5%) were free, 50 (90.9%) provided recipe ideas, 29 (52.7%) provided meal plans, and 22 (40%) provided information on the health benefits of the MedDiet. The overall quality mean MARS score was 2.84 (standard deviation (SD) = 0.42), with functionality being the highest scored MARS domain (mean = 3.58, SD = 0.44) and engagement the lowest (mean = 2.29, SD = 0.61). The average number of BCTs in the analysed apps was 2.3 (SD = 1.4; range: 0-6 per app). The number of BCTs was positively correlated with app information quality (rrho = 0.269, p = 0.047), overall MARS score (rrho = 0.267, p = 0.049), app subjective quality (rrho = 0.326, p = 0.015) and app-specific quality (rrho = 0.351, p = 0.009). These findings suggest that currently available apps might provide information on the MedDiet, but the incorporation of more BCTs is warranted to maximise the potential for behaviour change towards the MedDiet.
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Affiliation(s)
- Daniel McAleese
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
- Department of Oncology, Medical Sciences Division, University of Oxford, Oxford OX3 7DQ, UK
| | - Manolis Linardakis
- Department of Social Medicine, Faculty of Medicine, University of Crete, 71003 Heraklion, Crete, Greece;
| | - Angeliki Papadaki
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
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18
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Shabir H, D’Costa M, Mohiaddin Z, Moti Z, Rashid H, Sadowska D, Alam B, Cox B. The Barriers and Facilitators to the Use of Lifestyle Apps: A Systematic Review of Qualitative Studies. Eur J Investig Health Psychol Educ 2022; 12:144-165. [PMID: 35200235 PMCID: PMC8871456 DOI: 10.3390/ejihpe12020012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Mobile-health applications are revolutionising the way healthcare is being delivered. However, current research focusses on apps aimed at monitoring of conditions rather than the prevention of disease. Healthcare apps that prevent disease can be classified as lifestyle apps (LAs) and encompass mindfulness, exercise, and diet apps. In order for widespread implementation of these apps, perspectives of the user must be taken into consideration. Therefore, this systematic literature review identifies the barriers and facilitators to the use of LAs from a user's perspective. OBJECTIVE To both identify the facilitators to the use of LAs from a user perspective as well as identify the barriers to the use of LAs from a user perspective. METHODS A systematic literature review was conducted following PRISMA guidelines. Qualitative articles focussed on a healthy non-diseased population were obtained. Two independent researchers coded the articles, and themes were identified. RESULTS Our results found that there were five barriers and five facilitators to app use. The facilitators included (1) motivational aspects to the user, (2) effective marketing and communication, (3) user-centred design and content, (4) humanising technology, and (5) accessibility. The five barriers identified were (1) a non-conducive, (2) poor marketing and branding, (3) controlling and invasive, (4) disengaging content, and (5) inaccessibility. CONCLUSIONS By overcoming the barriers of LAs and encouraging the facilitators found, users are more likely to engage with this method of health promotion. Future research must be conducted on the barriers and facilitators to development and distribution of apps in order for LAs to be implemented in widespread healthcare practice.
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Affiliation(s)
- Habiba Shabir
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Matthew D’Costa
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Zain Mohiaddin
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Zaeem Moti
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Hamza Rashid
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Daria Sadowska
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
| | - Benyamin Alam
- The Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham B15 2GW, UK;
| | - Benita Cox
- Business School, Imperial College London, London SW7 2AZ, UK; (M.D.); (Z.M.); (Z.M.); (H.R.); (D.S.); (B.C.)
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19
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Lim SL, Ong KW, Johal J, Han CY, Yap QV, Chan YH, Zhang ZP, Chandra CC, Thiagarajah AG, Khoo CM. A Smartphone App-Based Lifestyle Change Program for Prediabetes (D'LITE Study) in a Multiethnic Asian Population: A Randomized Controlled Trial. Front Nutr 2022; 8:780567. [PMID: 35141265 PMCID: PMC8819073 DOI: 10.3389/fnut.2021.780567] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/29/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction Landmark studies have established that lifestyle interventions focused on weight loss, diet modification and physical activity can prevent diabetes progression. However, the effectiveness of mobile health application among Asians with prediabetes remains largely unexamined. We aimed to assess whether a smartphone app-based lifestyle intervention program would lead to weight loss, normoglycemia and improved metabolic indices in a multiethnic Asian population with prediabetes. Research Design and Methods This multicentre prediabetes RCT is part of the Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) trial. Adults (n = 148) with prediabetes and BMI ≥ 23 kg/m2 were randomly allocated either to the intervention group (n = 72) empowered by self-monitoring features of the Nutritionist Buddy Diabetes app with in-app dietitian coaching for 6 months, or the control group (n = 76) receiving standard diet counseling at baseline. Primary outcome was defined as change in body weight at 6 months, while secondary outcomes included glycemic control and other metabolic indices analyzed using Generalized Linear Mixed Model analysis with intention-to-treat approach. Results Intervention group achieved a significantly greater weight loss of 4.2 vs. 1.3 kg [mean difference of −3.1 kg (95% CI −4.5 to −1.7), p < 0.001], and a 4.3-fold increased likelihood of achieving ≥ 5% weight loss, as compared to the control group at 6 months. The likelihood of achieving normoglycemia (defined as HbA1c < 5.7%) was 2.1 times higher in intervention group than in the control group (p < 0.018). Changes to blood pressure, total and LDL cholesterol were not statistically significant. Conclusion An app-based lifestyle program led to clinically significant weight loss and improved glycemia, and can potentially augment current standard care in the prevention of diabetes among an Asian multiethnic population. Clinical Trial Registration anzctr.org.au, identifier: ACTRN12617001112358.
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Affiliation(s)
- Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore, Singapore
- *Correspondence: Su Lin Lim
| | - Kai Wen Ong
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Jolyn Johal
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Chad Yixian Han
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Qai Ven Yap
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Zhi Peng Zhang
- Department of Family Medicine, National University Polyclinics, Singapore, Singapore
| | | | | | - Chin Meng Khoo
- Division of Endocrinology, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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20
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Vasiloglou MF, Christodoulidis S, Reber E, Stathopoulou T, Lu Y, Stanga Z, Mougiakakou S. Perspectives and Preferences of Adult Smartphone Users Regarding Nutrition and Diet Apps: Web-Based Survey Study. JMIR Mhealth Uhealth 2021; 9:e27885. [PMID: 34328425 PMCID: PMC8367144 DOI: 10.2196/27885] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/18/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023] Open
Abstract
Background Digital technologies have evolved dramatically in recent years, finding applications in a variety of aspects of everyday life. Smartphones and mobile apps are being used for a steadily increasing number of tasks, including health monitoring. A large number of nutrition and diet apps are available, and some of them are very popular in terms of user downloads, highlighting a trend toward diet monitoring and assessment. Objective We sought to explore the perspectives of end users on the features, current use, and acceptance of nutrition and diet mHealth apps with a survey. We expect that this study can provide user insights to assist researchers and developers in achieving innovative dietary assessments. Methods A multidisciplinary team designed and compiled the survey. Before its release, it was pilot-tested by 18 end users. A 19-question survey was finally developed and was translated into six languages: English, German, French, Spanish, Italian, and Greek. The participants were mainly recruited via social media platforms and mailing lists of universities, university hospitals, and patient associations. Results A total of 2382 respondents (1891 female, 79.4%; 474 male, 19.9%; and 17 neither, 0.7%) with a mean age of 27.2 years (SD 8.5) completed the survey. Approximately half of the participants (1227/2382, 51.5%) had used a nutrition and diet app. The primary criteria for selecting such an app were ease of use (1570/2382, 65.9%), free cost (1413/2382, 59.3%), and ability to produce automatic readings of caloric content (1231/2382, 51.7%) and macronutrient content (1117/2382, 46.9%) (ie, food type and portion size are estimated by the system without any contribution from the user). An app was less likely to be selected if it incorrectly estimated portion size, calories, or nutrient content (798/2382, 33.5%). Other important limitations included the use of a database that does not include local foods (655/2382, 27.5%) or that may omit major foods (977/2382, 41%). Conclusions This comprehensive study in a mostly European population assessed the preferences and perspectives of potential nutrition and diet app users. Understanding user needs will benefit researchers who develop tools for innovative dietary assessment as well as those who assist research on behavioral changes related to nutrition.
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Affiliation(s)
- Maria F Vasiloglou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Stergios Christodoulidis
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,MICS Laboratory, Biomathematics Research Group, CentraleSupélec, Gif-sur-Yvette, Paris, France
| | - Emilie Reber
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thomai Stathopoulou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Ya Lu
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Zeno Stanga
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stavroula Mougiakakou
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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21
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Song T, Yu P, Bliokas V, Probst Y, Peoples GE, Qian S, Houston L, Perez P, Amirghasemi M, Cui T, Hitige NPR, Smith NA. A Clinician-Led, Experience-Based Co-Design Approach for Developing mHealth Services to Support the Patient Self-management of Chronic Conditions: Development Study and Design Case. JMIR Mhealth Uhealth 2021; 9:e20650. [PMID: 34283030 PMCID: PMC8335618 DOI: 10.2196/20650] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 11/09/2020] [Accepted: 05/17/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Despite the increasing use of mobile health (mHealth) services, such as mHealth apps or SMS text messaging services, that support the patient self-management of chronic conditions, many existing mHealth services lack theoretical guidance. In addition, although often the target audience for requirement acquisition at the initial mHealth app design stage, it is a common challenge for them to fully conceptualize their needs for mHealth services that help self-manage chronic conditions. OBJECTIVE This study proposes a novel co-design approach with the initial requirements for mHealth services proposed by clinicians based on their experiences in guiding patients to self-manage chronic conditions. A design case is presented to illustrate our innovative approach to designing an mHealth app that supports the self-management of patients with obesity in their preparation for elective surgery. METHODS We adopted a clinician-led co-design approach. The co-design approach consisted of the following four cyclic phases: understanding user needs, identifying an applicable underlying theory, integrating the theory into the prototype design, and evaluating and refining the prototype mHealth services with patients. Expert panel discussions, a literature review, intervention mapping, and patient focus group discussions were conducted in these four phases. RESULTS In stage 1, the expert panel proposed the following three common user needs: motivational, educational, and supportive needs. In stage 2, the team selected the Social Cognitive Theory to guide the app design. In stage 3, the team designed and developed the key functions of the mHealth app, including automatic push notifications; web-based resources; goal setting and monitoring; and interactive health-related exchanges that encourage physical activity, healthy eating, psychological preparation, and a positive outlook for elective surgery. Push notifications were designed in response to a patient's risk level, as informed by the person's response to a baseline health survey. In stage 4, the prototype mHealth app was used to capture further requirements from patients in the two focus group discussions. Focus group participants affirmed the potential benefits of the app and suggested more requirements for the function, presentation, and personalization needs. The app was improved based on these suggestions. CONCLUSIONS This study reports an innovative co-design approach that was used to leverage the clinical experiences of clinicians to produce the initial prototype app and the approach taken to allow patients to effectively voice their needs and expectations for the mHealth app in a focus group discussion. This approach can be generalized to the design of any mHealth service that aims to support the patient self-management of chronic conditions.
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Affiliation(s)
- Ting Song
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
| | - Ping Yu
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Vida Bliokas
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Psychology, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Yasmine Probst
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Gregory E Peoples
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Siyu Qian
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Illawarra Shoalhaven Local Health District, Wollongong, Australia
| | - Lauren Houston
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Pascal Perez
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Mehrdad Amirghasemi
- Smart Infrastructure Facility, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Tingru Cui
- School of Computing and Information Systems, Faculty of Engineering and Information Technology, University of Melbourne, Melbourne, Australia
| | - Nadeesha Pathiraja Rathnayaka Hitige
- Centre for Digital Transformation, School of Computing and Information Technology, Faculty of Engineering and Information Sciences, University of Wollongong, Wollongong, Australia
| | - Natalie Anne Smith
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, Australia
- Department of Anaesthesia, Wollongong Hospital, Wollongong, Australia
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Lieffers JRL, Quintanilha M, Trottier CF, Johnson ST, Mota JF, Prado CM. Experiences with and Perception of a Web-Based Mindfulness, Nutrition, and Fitness Platform Reported by First-Year University Students: A Qualitative Study. J Acad Nutr Diet 2021; 121:2409-2418.e3. [PMID: 34119458 DOI: 10.1016/j.jand.2021.04.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 04/14/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND My Viva Plan (MVP) (https://www.myvivainc.com/) is a web-based application developed by a dietitian that aims to support healthy living by providing resources and self-monitoring tools to help promote a healthy diet, healthy mind, and physical fitness. First-year university students have the potential to benefit because poor dietary choices, limited physical activity, and high stress are prevalent in this population. In addition, they are also active technology users. OBJECTIVE This study aims to understand experiences and perception of MVP by first-year university students using this tool as part of a 12-week randomized controlled trial. DESIGN One-on-one semistructured interviews were conducted following a 12-week intervention involving use of MVP. PARTICIPANTS/SETTING First-year university students from the University of Alberta, Edmonton, Canada (n = 32). INTERVENTION Participants were instructed to use MVP as much as possible for 12 weeks in either the fall/2018 or winter/2019 semesters. QUALITATIVE DATA ANALYSIS Interviews were audio-recorded, transcribed verbatim, and analyzed abductively using content analysis. RESULTS Participants reported varied use of MVP across the 12-week period. Data were categorized using the HealthChange Methodology (Behaviors, Emotions, 37 Situations, Thinking) framework. Participants provided various examples of emotions (eg, motivation, stress), situations (eg, time, living arrangements, finances), and thinking (eg, self-awareness, level of satisfaction with MVP, and how MVP was or could be better tailored for students) that acted as either facilitators or barriers to MVP use and explained their behaviors associated with this tool. CONCLUSIONS Overall, participant behaviors regarding MVP varied and were influenced by several factors, including their emotions, situations, and thinking. The Behaviors, Emotions, Situations, Thinking framework may be helpful for dietitians to identify barriers and facilitators affecting their client's use of ehealth tools for lifestyle behavior change. This information can be used to optimize client support when using these tools.
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König LM, Attig C, Franke T, Renner B. Barriers to and Facilitators for Using Nutrition Apps: Systematic Review and Conceptual Framework. JMIR Mhealth Uhealth 2021; 9:e20037. [PMID: 34254938 PMCID: PMC8409150 DOI: 10.2196/20037] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 01/11/2021] [Accepted: 04/01/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Nutrition apps are effective in changing eating behavior and diet-related health risk factors. However, while they may curb growing overweight and obesity rates, widespread adoption is yet to be achieved. Hence, profound knowledge regarding factors motivating and hindering (long-term) nutrition app use is crucial for developing design guidelines aimed at supporting uptake and prolonged use of nutrition apps. OBJECTIVE In this systematic review, we synthesized the literature on barriers to and facilitators for nutrition app use across disciplines including empirical qualitative and quantitative studies with current users, ex-users, and nonusers of nutrition apps. METHODS A systematic literature search including 6 databases (PubMed, Web of Science, PsychINFO, PSYNDEX, PsycArticles, and SPORTDiscus) as well as backward and forward citation search was conducted. Search strategy, inclusion and exclusion criteria, and the planned data extraction process were preregistered. All empirical qualitative and quantitative studies published in German or English were eligible for inclusion if they examined adolescents (aged 13-18) or adults who were either current users, ex-users, and nonusers of nutrition apps. Based on qualitative content analysis, extracted individual barriers and facilitators were grouped into categories. RESULTS A total of 28 publications were identified as eligible. A framework with a 3-level hierarchy was designed which grouped 328 individual barriers and facilitators into 23 subcategories, 12 categories, and 4 clusters that focus on either the individual user (goal setting and goal striving, motivation, routines, lack of awareness of knowledge), different aspects of the app and the smartphone (features, usability of the app or food database, technical issues, data security, accuracy/trustworthiness, costs), positive and negative outcomes of nutrition app use, or interactions between the user and their social environment. CONCLUSIONS The resulting conceptual framework underlines a pronounced diversity of reasons for (not) using nutrition apps, indicating that there is no "one-size-fits-all" approach for uptake and prolonged use of nutrition apps. Hence, tailoring nutrition apps to needs of specific user groups seems promising for increasing engagement.
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Affiliation(s)
- Laura Maria König
- Department of Psychology, University of Konstanz, Universitätsstraße 10, Konstanz, DE
- Faculty of Life Sciences, University of Bayreuth, Kulmbach, DE
| | - Christiane Attig
- Department of Psychology, Chemnitz University of Technology, Chemnitz, DE
| | - Thomas Franke
- Institute for Multimedia and Interactive Systems, University of Lübeck, Lübeck, DE
| | - Britta Renner
- Department of Psychology, University of Konstanz, Universitätsstraße 10, Konstanz, DE
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24
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Trottier CF, Lieffers JRL, Johnson ST, Mota JF, Gill RK, Prado CM. The Impact of a Web-Based Mindfulness, Nutrition, and Physical Activity Platform on the Health Status of First-Year University Students: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e24534. [PMID: 33688844 PMCID: PMC7991982 DOI: 10.2196/24534] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 12/11/2022] Open
Abstract
Background First-year university students are at an increased risk for developing mental health issues and a poor nutritional status. Self-care plays an essential role in optimizing mental health and can prevent or manage stress, anxiety, and depression. Web-based self-monitoring of diet and physical activity can lead to similar or improved health outcomes compared with conventional methods. Such tools are also popular among university students. Objective The primary aim of this 12-week randomized controlled trial is to assess the impact of a web-based wellness platform on perceived stress among first-year university students. The secondary aim is to assess the effects of the platform on diet quality. The exploratory objectives are to explore the effects of the platform on body composition, health-related quality of life, mindfulness, mental well-being, and physical activity. Methods A total of 97 first-year undergraduate students were randomized to either the intervention (n=48) or control (n=49) group. The intervention consisted of access to a web-based platform called My Viva Plan (MVP), which aims to support healthy living by focusing on the topics of mindfulness, nutrition, and physical activity. The platform is fully automated and guided by the principles of cognitive behavioral theory. Participants in the intervention group were instructed to use the MVP as frequently as possible over 12 weeks. The control group did not receive access to MVP. Perceived stress was assessed using the Stress Indicators Questionnaire at baseline, week 6, and week 12. Three-day food records were used to analyze the dietary intake at baseline and week 12. Health-related quality of life, mindfulness, mental well-being, and physical activity questionnaires were completed at baseline, week 6, and week 12. Body composition was assessed at baseline and week 12. Study assessments were completed in person at baseline and week 12 and electronically at week 6. Results Study recruitment started in August 2018, with batch enrollment for students registered in the fall (September 2018 to December 2018) and winter (January 2019 to April 2019) academic terms at the University of Alberta, Edmonton, Alberta. Conclusions This study is the first to explore the impact of a web-based platform designed to promote health and wellness on perceived stress and diet quality among first-year university students. Trial Registration ClinicalTrials.gov NCT03579264; https://clinicaltrials.gov/ct2/show/NCT03579264. International Registered Report Identifier (IRRID) DERR1-10.2196/24534
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Affiliation(s)
- Claire F Trottier
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Jessica R L Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - Steven T Johnson
- Faculty of Health Disciplines, Athabasca University, Athabasca, AB, Canada
| | - João F Mota
- Clinical and Sports Nutrition Research Laboratory (LABINCE), Faculty of Nutrition, Federal University of Goiás, Goiânia, Brazil
| | - Roshni K Gill
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
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Evaluation of the Ability of Diet-Tracking Mobile Applications to Estimate Energy and Nutrient Intake in Japan. Nutrients 2020; 12:nu12113327. [PMID: 33138088 PMCID: PMC7694045 DOI: 10.3390/nu12113327] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 12/15/2022] Open
Abstract
We evaluated the energy and nutrient intake estimates of popular Japanese diet-tracking mobile applications (apps). We identified five diet-tracking apps in the iTunes store during August 2020. A researcher entered the dietary data from a one-day paper-based dietary record (DR) previously obtained from apparently healthy free-living adults (15 males and 15 females; 22-65 years) into each app. The energy and nutrient intakes estimated by the apps were compared with those calculated using the Standard Tables of Food Composition in Japan based on the paper-based DR (reference method). The number of dietary variables available ranged from one (energy in Mogutan) to 17 (FiNC). Compared to the DR-based estimates, the median energy intake was significantly overestimated by MyFitnessPal, Asken, Calomiru, and Mogutan. Moreover, the intakes of many nutrients were overestimated by Asken and Calomiru and underestimated by MyFitnessPal. For energy intake, the Spearman correlation coefficient between the DR and the apps was lowest for Mogutan (0.76) and highest for FiNC (0.96). The median correlation coefficient for nutrient intakes was lower in MyFitnessPal (0.50) than in the other three apps (0.80 in Asken, 0.87 in FiNC, and 0.88 in Calomiru). These results suggest that intake calculations differ among apps. Further evaluation is needed in free-living settings, where users input their own food intake.
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Stehr P, Karnowski V, Rossmann C. The multi-faceted usage patterns of nutrition apps: a survey on the appropriation of nutrition apps among German-speaking users of MyFitnessPal. BMC Med Inform Decis Mak 2020; 20:279. [PMID: 33115444 PMCID: PMC7594461 DOI: 10.1186/s12911-020-01294-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 10/15/2020] [Indexed: 12/28/2022] Open
Abstract
Background Current systematic reviews of randomized controlled trials suggest positive influences of mobile app-based health promotion programs on dietary and physical activity behaviors. However, the actual adoption of and rates of nutrition app use remain low among the overall population. Therefore, we took a step back and investigated actual use patterns. In doing so, we took an appropriation perspective in order to reveal different styles of everyday life integration of these apps. Methods We conducted an online survey with 761 German-speaking users of the MyFitnessPal app. Respondents were asked about their detailed use of nutrition apps according to an adapted version of the mobile phone appropriation model. Based on a cluster analysis, different user types were identified. These user types were compared and further described based on analyses of variance. In addition, we conducted a multinomial logistic regression to determine significant predictors of the varying usage patterns.
Results Four different user types were identified: (1) Supported, (2) Indifferent, (3) Health-conscious, and (4) Socializer. These user types mainly differed regarding three aspects: (1) their willingness to adjust default settings to one’s own needs and abilities, (2) the role of social support and social norms, and (3) app use for socializing and competition. Conclusions Our study sheds light on the multi-faceted appropriation patterns of nutrition apps in Germany, thus paving the way for future studies on mHealth appropriation patterns and the design of more refined mHealth-interventions.
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Affiliation(s)
- Paula Stehr
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany.
| | | | - Constanze Rossmann
- Department of Media and Communication Science, University of Erfurt, Erfurt, Germany
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Gonzalez-Ramirez M, Cejudo-Lopez A, Lozano-Navarrete M, Salamero Sánchez-Gabriel E, Torres-Bengoa A, Segura-Balbuena M, Sanchez-Cordero MJ, Barroso-Vazquez M, Perez-Barba FJ, Troncoso AM, Garcia-Parrilla MC, Cerezo AB. SAlBi educa: A promising, tailored nutrition app for promoting healthy eating habits (Preprint). JMIR Form Res 2020. [DOI: 10.2196/23060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Szinay D, Jones A, Chadborn T, Brown J, Naughton F. Influences on the Uptake of and Engagement With Health and Well-Being Smartphone Apps: Systematic Review. J Med Internet Res 2020; 22:e17572. [PMID: 32348255 PMCID: PMC7293059 DOI: 10.2196/17572] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The public health impact of health and well-being digital interventions is dependent upon sufficient real-world uptake and engagement. Uptake is currently largely dependent on popularity indicators (eg, ranking and user ratings on app stores), which may not correspond with effectiveness, and rapid disengagement is common. Therefore, there is an urgent need to identify factors that influence uptake and engagement with health and well-being apps to inform new approaches that promote the effective use of such tools. OBJECTIVE This review aimed to understand what is known about influences on the uptake of and engagement with health and well-being smartphone apps among adults. METHODS We conducted a systematic review of quantitative, qualitative, and mixed methods studies. Studies conducted on adults were included if they focused on health and well-being smartphone apps reporting on uptake and engagement behavior. Studies identified through a systematic search in Medical Literature Analysis and Retrieval System Online, or MEDLARS Online (MEDLINE), EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsychINFO, Scopus, Cochrane library databases, DataBase systems and Logic Programming (DBLP), and Association for Computing Machinery (ACM) Digital library were screened, with a proportion screened independently by 2 authors. Data synthesis and interpretation were undertaken using a deductive iterative process. External validity checking was undertaken by an independent researcher. A narrative synthesis of the findings was structured around the components of the capability, opportunity, motivation, behavior change model and the theoretical domains framework (TDF). RESULTS Of the 7640 identified studies, 41 were included in the review. Factors related to uptake (U), engagement (E), or both (B) were identified. Under capability, the main factors identified were app literacy skills (B), app awareness (U), available user guidance (B), health information (E), statistical information on progress (E), well-designed reminders (E), features to reduce cognitive load (E), and self-monitoring features (E). Availability at low cost (U), positive tone, and personalization (E) were identified as physical opportunity factors, whereas recommendations for health and well-being apps (U), embedded health professional support (E), and social networking (E) possibilities were social opportunity factors. Finally, the motivation factors included positive feedback (E), available rewards (E), goal setting (E), and the perceived utility of the app (E). CONCLUSIONS Across a wide range of populations and behaviors, 26 factors relating to capability, opportunity, and motivation appear to influence the uptake of and engagement with health and well-being smartphone apps. Our recommendations may help app developers, health app portal developers, and policy makers in the optimization of health and well-being apps.
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Affiliation(s)
- Dorothy Szinay
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Andy Jones
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Tim Chadborn
- Behavioural Insights, Public Health England, London, United Kingdom
| | - Jamie Brown
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Felix Naughton
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
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Ghelani DP, Moran LJ, Johnson C, Mousa A, Naderpoor N. Mobile Apps for Weight Management: A Review of the Latest Evidence to Inform Practice. Front Endocrinol (Lausanne) 2020; 11:412. [PMID: 32670197 PMCID: PMC7326765 DOI: 10.3389/fendo.2020.00412] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 05/26/2020] [Indexed: 12/14/2022] Open
Abstract
Over the last decade, mobile technology has emerged as a potentially useful platform to facilitate weight management and tackle the current obesity epidemic. Clinicians are being more frequently asked to give advice about the usefulness of mobile apps and many individuals have already integrated apps into their attempts to manage weight. Hence, it is imperative for clinicians involved in weight management to be aware of the latest developments and knowledge about available mobile apps and their usefulness in this field. A number of newly published studies have demonstrated promising results of mobile-based interventions for weight management across different populations, but the extent of their effectiveness remains widely debated. This narrative literature review synthesizes the latest evidence, primarily from randomized controlled trials (RCTs), regarding the clinical use of mobile applications for weight management, as well as highlight key limitations associated with their use and directions for future research and practice. Overall, evidence suggests that mobile applications may be useful as low-intensity approaches or adjuncts to conventional weight management strategies. However, there is insufficient evidence to support their use as stand-alone intensive approaches to weight management. Further research is needed to clarify the extent of utility of these applications, as well as the measures required to maximize their potential both as stand-alone approaches and adjuncts to more intensive programs.
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Affiliation(s)
- Drishti P. Ghelani
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Cameron Johnson
- Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
| | - Aya Mousa
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Negar Naderpoor
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Diabetes and Vascular Medicine Unit, Monash Health, Melbourne, VIC, Australia
- *Correspondence: Negar Naderpoor
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Shin Y, Kim SK, Lee M. Mobile phone interventions to improve adolescents' physical health: A systematic review and meta-analysis. Public Health Nurs 2019; 36:787-799. [PMID: 31456259 DOI: 10.1111/phn.12655] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/23/2019] [Accepted: 07/25/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND We conducted a systematic review and meta-analysis to evaluate the effectiveness of mobile phone intervention in promoting a healthy lifestyle among adolescents. METHODS Six databases were used for literature searches: MEDLINE, Embase, Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, KoreaMed, and Research Information Sharing Service. The keywords used were "adolescents," "mobile phone," "smartphone," "mHealth," "application," and "text message." The search was restricted to intervention studies using randomized controlled studies and pre- and post-control group studies targeting adolescents, all written in English and Korean. RESULTS Eleven intervention studies, including 1,472 adolescents, were included. Included studies published between 2013 and 2018 used various mobile phone features: four studies utilized phone call and text messaging, whereas seven studies used health applications. Methodological quality was assessed and the overall quality of the studies was mid to low. The pooled data favored intervention in improving physical activity and reducing sugar-sweetened beverage intake and screen time. In a pooled data analysis, the effectiveness of mobile phone intervention on body mass index and weight loss was not statistically significant. CONCLUSION This study provided evidence that mobile phone intervention improved physical health and fitness among adolescents. More beneficial effects can be guaranteed when interventions involve informative and motivational messages. Strategies to ensure the durability of such interventions are needed to promote active and continuous engagement.
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Affiliation(s)
- YunHee Shin
- Department of Nursing, Wonju College of Medicine, Yonsei University, Wonju, Korea
| | - Sun Kyung Kim
- Department of Nursing, Mokpo National University, Muan, Korea
| | - Mihyun Lee
- College of Nursing, Chungnam National University, Daejeon, Korea
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31
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Li Y, Ding J, Wang Y, Tang C, Zhang P. Nutrition-Related Mobile Apps in the China App Store: Assessment of Functionality and Quality. JMIR Mhealth Uhealth 2019; 7:e13261. [PMID: 31364606 PMCID: PMC6691672 DOI: 10.2196/13261] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/02/2019] [Accepted: 06/18/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND There are an increasing number of mobile apps that provide dietary guidance to support a healthy lifestyle and disease management. However, the characteristics of these nutrition-related apps are not well analyzed. OBJECTIVE This study aimed to evaluate the functionality and quality of nutrition-related apps in China. METHODS Mobile apps providing dietary guidance were screened in the Chinese iOS and Android app stores in November 2017, using stepwise searching criteria. The first screening consisted of extracting information from the app descriptions. Apps that (1) were free, (2) contain information on diet and nutrition, and (3) were last updated after January 1, 2016, were downloaded for further analysis. Nutritional functionalities were determined according to the Chinese Dietary Guidelines framework. Market-related functionalities were developed from previous studies and tailored to downloaded apps. The quality of apps was assessed with the user version of the Mobile App Rating Scale (uMARS). RESULTS Out of 628 dietary guidance apps screened, 44 were nutrition-related. Of these, guidance was provided on diet exclusively (11/44, 25%), fitness (17/44, 39%), disease management (11/44, 25%), or maternal health (5/44, 11%). Nutritional functionalities included nutritional information inquiry (40/44, 91%), nutrition education (35/44, 80%), food record (34/44, 77%), diet analysis (34/44, 77%), and personalized recipes (21/44, 48%). Dietary analysis and suggestions mainly focused on energy intake (33/44, 75%) and less on other factors such as dietary structure (10/44, 23%). Social communication functionalities were available in 42 apps (96%), user incentives were supported in 26 apps (59%), and intelligent recognition technology was available in 8 apps (18%). The median score for the quality of the 44 apps, as determined on a 5-point uMARS scale, was 3.6 (interquartile range 0.7). CONCLUSIONS Most nutrition-related apps are developed for health management rather than for dietary guidance exclusively. Although basic principles of energy balance are used, their nutritional functionality was relatively limited and not individualized. More efforts should be made to develop nutrition-related apps with evidence-based nutritional knowledge, comprehensive and personalized dietary guidance, and innovative technology.
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Affiliation(s)
- Yuan Li
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - Jingmin Ding
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Yishan Wang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Chengyao Tang
- Public Health Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Puhong Zhang
- The George Institute for Global Health at Peking University Health Science Center, Beijing, China.,Faculty of Medicine, University of New South Wales, Sydney, Australia
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Jazayeri SMHM, Jamshidnezhad A. Top Mobile Applications in Pediatrics and Children's Health: Assessment and Intelligent Analysis Tools for a Systematic Investigation. Malays J Med Sci 2019; 26:5-14. [PMID: 30914890 PMCID: PMC6419874 DOI: 10.21315/mjms2019.26.1.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/10/2018] [Indexed: 11/15/2022] Open
Abstract
The development of intelligent software in recent years has grown rapidly. Mobile health has become a field of interest as a tool for childcare, especially as a means for parents of children with diverse diseases and a resource to promote their health conditions. Current systematic review was conducted to survey the functionalities of available applications on the mobile platform to support pediatrics intelligent diagnosis and children healthcare. Results which met the inclusion criteria (such as patient monitoring, decision support, diagnosis support) were obtained, assessed and organised into a checklist. In this study, 379 potential apps were identified using the search feature in Apple App Store and Google Play Store. After careful consideration of the selected apps, only three (Google Play Store) and one (iTunes Store), fulfilled all the general inclusion criteria and special criteria, such as intelligence tools. The results showed that Artificial Intelligence (AI) was used minimally in diagnostic apps due to a limited amount of mobile hardware and software, such as the reliable programming of intelligent algorithms.
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Affiliation(s)
| | - Amir Jamshidnezhad
- Department of Health Information Technology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Asklund I, Samuelsson E, Hamberg K, Umefjord G, Sjöström M. User Experience of an App-Based Treatment for Stress Urinary Incontinence: Qualitative Interview Study. J Med Internet Res 2019; 21:e11296. [PMID: 30869644 PMCID: PMC6437616 DOI: 10.2196/11296] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 11/23/2018] [Accepted: 12/12/2018] [Indexed: 01/08/2023] Open
Abstract
Background Stress urinary incontinence (SUI) affects 10%-39% of women. Its first-line treatment consists of lifestyle interventions and pelvic floor muscle training (PFMT), which can be performed supervised or unsupervised. Health apps are increasing in number and can be used to improve adherence to treatments. We developed the Tät app, which provides a 3-month treatment program with a focus on PFMT for women with SUI. The app treatment was evaluated in a randomized controlled trial, which demonstrated efficacy for improving incontinence symptoms and quality of life. In this qualitative interview study, we investigated participant experiences of the app-based treatment. Objective This study aimed to explore women’s experiences of using an app-based treatment program for SUI. Methods This qualitative study is based on telephone interviews with 15 selected women, with a mean age of 47 years, who had used the app in the previous randomized controlled trial. A semistructured interview guide with open-ended questions was used, and the interviews were transcribed verbatim. Data were analyzed according to the grounded theory. Results The results were grouped into three categories: “Something new!” “Keeping motivation up!” and “Good enough?” A core category, “Enabling my independence,” was identified. The participants appreciated having a new and modern way to access a treatment program for SUI. The use of new technology seemed to make incontinence treatment feel more prioritized and less embarrassing for the subjects. The closeness to their mobile phone and app features like reminders and visual graphs helped support and motivate the women to carry through the PFMT. The participants felt confident that they could perform the treatment program on their own, even though they expressed some uncertainty about whether they were doing the pelvic floor muscle contractions correctly. They felt that the app-based treatment increased their self-confidence and enabled them to take responsibility for their treatment. Conclusions Use of the app-based treatment program for SUI empowered the women in this study and helped them self-manage their incontinence treatment. They appreciated the app as a new tool for supporting their motivation to carry through a slightly challenging PFMT program. Trial Registration ClinicalTrials.gov NCT01848938; https://clinicaltrials.gov/ct2/show/NCT01848938 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT01848938)
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Affiliation(s)
- Ina Asklund
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Eva Samuelsson
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Katarina Hamberg
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Göran Umefjord
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
| | - Malin Sjöström
- Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden
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Phillips SA, Ali M, Modrich C, Oke S, Elokda A, Laddu D, Bond S. Advances in Health Technology Use and Implementation in the Era of Healthy Living: Implications for Precision Medicine. Prog Cardiovasc Dis 2018; 62:44-49. [PMID: 30597149 DOI: 10.1016/j.pcad.2018.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 12/27/2018] [Indexed: 12/24/2022]
Abstract
Much of the focus of precision medicine has been directed toward genomics, despite the fact that "lifestyle and behavioral factors" are included in the description of precision medicine. Numerous structured diet and PA interventions have demonstrated success in preventing and/or reducing chronic-disease risk. The use of personal health technologies has expanded exponentially in the health care arena; there are a number of consumer-based technologies yielding health information to individual users. The explosion in technology use provides an opportunity for broader dissemination of health care services and products. In addition, tracking cardiovascular disease risk and lifestyle and behavioral aspects of healthy living (HL) profiles in those products may be an important leveraging interface for precision medicine. This review will discuss and present an overview of current health technologies, their use in promotion of HL metrics and how this data may be integrated into venues that support HL and precision medicine.
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Affiliation(s)
- Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Mohamed Ali
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Charles Modrich
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Shariwa Oke
- Department of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, IL, USA
| | - Ahmed Elokda
- Department of Rehabilitation Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
| | - Deepika Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Samantha Bond
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA; Department of Biomedical and Health Information Sciences, College of Applied Science, University of Illinois, Chicago, IL, USA
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Wang ML, Little TV, Frisard C, Borg A, Lemon SC, Rosal MC. Development and validation of a Weight Literacy Scale in English and Spanish. PLoS One 2018; 13:e0204678. [PMID: 30356277 PMCID: PMC6200187 DOI: 10.1371/journal.pone.0204678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 09/12/2018] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To develop and validate a Weight Literacy Scale in English and Spanish for adults. METHODS The two-phase study utilized quantitative and qualitative methods. Phase 1 of the study consisted of developing an initial survey (English and Spanish versions) assessing weight literacy based on a review of the literature; conducting semi-structured interviews with content experts (N = 9) to refine survey items; and conducting in-person cognitive interviews with 20 study participants (N = 10 English-speaking and N = 10 Spanish-speaking adults) for survey pre-testing. Survey items were modified based on Phase 1 findings. Phase 2 consisted of a psychometric study of the Weight Literacy Scale developed in Phase 1. Procedures included administering the Weight Literacy Scale to 200 study participants (N = 100 English-speaking and N = 100 Spanish-speaking adults), a quantitative survey assessing dietary and physical activity behaviors and sociodemographics, measuring participants' height and weight, and assessing the scale's validity and internal reliability. A subset of Phase 2 participants (N = 71) completed the weight literacy scale at two-weeks follow-up to assess test-retest reliability. Participant recruitment and study procedures took place in community settings in central Massachusetts for both study phases. Weight literacy scale scores were calculated as the sum of total correct items. Three rounds of factor analysis were performed to identify items for elimination. The Kuder Richardson's Coefficient of reliability was calculated. Correlations between the Weight Literacy Scale scores and related measures (body mass index and weight status, dietary behaviors, physical activity behaviors, and confidence in filling out medical forms) were examined. RESULTS The final scale included 31 items and demonstrated strong internal consistency (Kuder Richardson Coefficient = 0.90), reasonable construct validity, and acceptable test-retest reliability (ρ = 0.72). CONCLUSION The Weight Literacy Scale is a reliable and valid research instrument to assess weight literacy among English- and Spanish-speaking adults.
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Affiliation(s)
- Monica L. Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Tariana V. Little
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Christine Frisard
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Amy Borg
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
| | - Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America
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A Qualitative Evaluation of the eaTracker ® Mobile App. Nutrients 2018; 10:nu10101462. [PMID: 30304766 PMCID: PMC6213652 DOI: 10.3390/nu10101462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 09/29/2018] [Accepted: 10/04/2018] [Indexed: 11/17/2022] Open
Abstract
Background: eaTracker® is Dietitians of Canada’s online nutrition/activity self-monitoring tool accessible via website and mobile app. The purpose of this research was to evaluate the eaTracker® mobile app based on user perspectives. Methods: One-on-one semi-structured interviews were conducted with adult eaTracker® mobile app users who had used the app for ≥ 1 week within the past 90 days. Participants (n = 26; 89% female, 73% 18–50 years) were recruited via email. Interview transcripts were coded using first level coding and pattern coding, where first level codes were grouped according to common themes. Results: Participants mentioned several positive aspects of the mobile app which included: (a) Dashboard displays; (b) backed by dietitians; (c) convenience and ease of use; (d) portion size entry; (e) inclusion of food and physical activity recording; and (f) ability to access more comprehensive information via the eaTracker® website. Challenges with the mobile app included: (a) Search feature; (b) limited food database; (c) differences in mobile app versus website; and (d) inability to customize dashboard displayed information. Suggestions were provided to enhance the app. Conclusion: This evaluation provides useful information to improve the eaTracker® mobile app and also for those looking to develop apps to facilitate positive nutrition/physical activity behavior change.
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