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Pala D, Petrini G, Bosoni P, Larizza C, Quaglini S, Lanzola G. Smartphone applications for nutrition Support: A systematic review of the target outcomes and main functionalities. Int J Med Inform 2024; 184:105351. [PMID: 38295584 DOI: 10.1016/j.ijmedinf.2024.105351] [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: 10/17/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/02/2024]
Abstract
INTRODUCTION A proper nutrition is essential for human life. Recently, special attention on this topic has been given in relation to three health statuses: obesity, malnutrition and specific diseases that can be related to food or treated with specific diets. Mobile technology is often used to assist users that wish to regulate their eating habits, and identifying which fields of application have been explored the most by the app developers and which main functionalities have been adopted can be useful in view of future app developments. METHODS We selected 322 articles mentioning nutrition support apps through a literature database search, all of which have undergone an initial screening. After the exclusion of papers that were already reviews, not presenting apps or not focused on nutrition, not relevant or not developed for human subjects, 100 papers were selected for subsequent analyses that aimed at identifying the main treated conditions, outcome measures and functionalities implemented in the Apps. RESULTS Of the selected studies, 33 focus on specific diseases, 24 on obesity, 2 on malnutrition and 41 on other targets (e.g., weight/diet control). Type 2 diabetes is the most targeted disease, followed by gestational diabetes, hypertension, colorectal cancer and CVDs which all were targeted by more than one app. Most Apps include self-monitoring and coaching functionalities, educational content and artificial intelligence (AI) tools are slightly less common, whereas counseling, gamification and questionnaires are the least implemented. Body weight and calories/nutrients were the most common general outcome measures, while glycated hemoglobin (HbA1c) was the most common clinical outcome. No statistically significant differences in the effectiveness of the different functionalities were found. CONCLUSION The use of mobile technology to improve nutrition has been widely explored in the last years, especially for weight control and specific diseases like diabetes; however, other food-related conditions such as Irritable Bowel Diseases appear to be less targeted by newly developed smartphone apps and their related studies. All different kinds of functionalities appear to be equally effective, but further specific studies are needed to confirm the results.
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Affiliation(s)
- Daniele Pala
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy; Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
| | - Giorgia Petrini
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Pietro Bosoni
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Cristiana Larizza
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Silvana Quaglini
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Giordano Lanzola
- Department of Computer, Electrical and Biomedical Engineering, University of Pavia, Pavia, Italy
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Crespo-Bellido M, Fernandez Ong J, Yaroch A, Byker Shanks C. E-health Dietary Interventions for Participants of SNAP and WIC: A Systematic Review. Curr Dev Nutr 2024; 8:102099. [PMID: 38706511 PMCID: PMC11069071 DOI: 10.1016/j.cdnut.2024.102099] [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: 11/01/2023] [Revised: 02/01/2024] [Accepted: 02/02/2024] [Indexed: 05/07/2024] Open
Abstract
The migration of federal assistance services to online platforms during the COVID-19 pandemic sparked interest in digital nutrition education for individuals participating in the Supplemental Nutrition Assistance Program (SNAP) and Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programs. With federal government investing in the modernization of the nutrition education components of both programs, there is a need to identify science-backed electronic health (e-health) dietary interventions to improve health outcomes in this population. Therefore, the objective of this systematic literature review was to summarize the effectiveness, acceptability, and feasibility of e-health dietary interventions among individuals participating in WIC or SNAP. Keyword searches were performed in Google Scholar, PubMed, and Science Direct. The search included peer-reviewed literature from 2014 to 2023 and a few articles offering context about interventions used long-term by the nutrition assistance programs. PRISMA guidelines were followed to conduct this systematic literature review, which resulted in 36 articles eligible for extraction. The studies evaluated e-health (52.8%), short message service/text messaging (27.8%), and smartphone application interventions (19.4%) delivered to WIC or SNAP participants. The interventions identified aimed to modify food choice, eating behavior, and dietary intake among SNAP participants, SNAP-eligible adults, and WIC participants. Most interventions were developed using content delivery and health behavior theoretical frameworks (77.8%) and evidence-based nutritional recommendations (59.3%). Review findings show a high level of acceptability and feasibility for e-health and mobile health dietary interventions among WIC and SNAP participants but varying levels of effectiveness. Level of engagement, dosage, retention, and adherence were strong predictors of positive dietary behavior change regardless of the mode of intervention delivery. Future studies need to prioritize health equity by recruiting samples representative of food nutrition assistance participants and addressing digital health literacy as a potential barrier to intervention effectiveness, as none of the present studies measured literacy among participants.
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Affiliation(s)
| | | | - Amy Yaroch
- Gretchen Swanson Center for Nutrition, Omaha, NE, United States
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Faber JS, Al-Dhahir I, Kraal JJ, Breeman LD, van den Berg-Emons RJG, Reijnders T, van Dijk S, Janssen VR, Kraaijenhagen RA, Visch VT, Chavannes NH, Evers AWM. Guide Development for eHealth Interventions Targeting People With a Low Socioeconomic Position: Participatory Design Approach. J Med Internet Res 2023; 25:e48461. [PMID: 38048148 PMCID: PMC10728791 DOI: 10.2196/48461] [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: 04/26/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND People with a low socioeconomic position (SEP) are less likely to benefit from eHealth interventions, exacerbating social health inequalities. Professionals developing eHealth interventions for this group face numerous challenges. A comprehensive guide to support these professionals in their work could mitigate these inequalities. OBJECTIVE We aimed to develop a web-based guide to support professionals in the development, adaptation, evaluation, and implementation of eHealth interventions for people with a low SEP. METHODS This study consisted of 2 phases. The first phase involved a secondary analysis of 2 previous qualitative and quantitative studies. In this phase, we synthesized insights from the previous studies to develop the guide's content and information structure. In the second phase, we used a participatory design process. This process included iterative development and evaluation of the guide's design with 11 professionals who had experience with both eHealth and the target group. We used test versions (prototypes) and think-aloud testing combined with semistructured interviews and a questionnaire to identify design requirements and develop and adapt the guide accordingly. RESULTS The secondary analysis resulted in a framework of recommendations for developing the guide, which was categorized under 5 themes: development, reach, adherence, evaluation, and implementation. The participatory design process resulted in 16 requirements on system, content, and service aspects for the design of the guide. For the system category, the guide was required to have an open navigation strategy leading to more specific information and short pages with visual elements. Content requirements included providing comprehensible information, scientific evidence, a user perspective, information on practical applications, and a personal and informal tone of voice. Service requirements involved improving suitability for different professionals, ensuring long-term viability, and a focus on implementation. Based on these requirements, we developed the final version of "the inclusive eHealth guide." CONCLUSIONS The inclusive eHealth guide provides a practical, user-centric tool for professionals aiming to develop, adapt, evaluate, and implement eHealth interventions for people with a low SEP, with the aim of reducing health disparities in this population. Future research should investigate its suitability for different end-user goals, its external validity, its applicability in specific contexts, and its real-world impact on social health inequality.
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Affiliation(s)
- Jasper S Faber
- Department of Human-Centered Design, Delft University of Technology, Delft, Netherlands
| | - Isra Al-Dhahir
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Jos J Kraal
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Linda D Breeman
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Rita J G van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, Netherlands
- Capri Cardiac Rehabilitation, Rotterdam, Netherlands
| | - Thomas Reijnders
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Sandra van Dijk
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
| | - Veronica R Janssen
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
- Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Roderik A Kraaijenhagen
- Vital10, Amsterdam, Netherlands
- NDDO Institute for Prevention and Early Diagnostics, Amsterdam, Netherlands
| | - Valentijn T Visch
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, Netherlands
| | - Andrea W M Evers
- Faculty of Social and Behavioral Sciences, Leiden University, Leiden, Netherlands
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
- Medical Delta, Leiden University, Delft University of Technology, Erasmus University, Delft, Netherlands
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Raber M, Villarreal I, Vazquez M, Thompson D. Designing a Digital Culinary Education Intervention for Parents With Low Income. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:667-676. [PMID: 37516954 DOI: 10.1016/j.jneb.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/31/2023]
Abstract
OBJECTIVE To examine cooking practices, online information-seeking habits, and intervention preferences among parents with low income to inform the development of a digital cooking intervention on the basis of the Healthy Cooking Index. METHODS This formative research study included a brief survey followed by in-depth interviews (from February to April, 2021) with parents of a child aged 6-11 years with low income (n = 20; 100% female, 70% African American or Hispanic White). Interview transcripts were analyzed using a semistructured hybrid coding approach. RESULTS Three main themes were identified to inform the development of the intervention: (1) current Healthy Cooking Index behaviors, (2) preferences for digital cooking intervention content, and (3) design and delivery preferences. A 7-step process was used to develop the intervention and integrate qualitative findings. CONCLUSIONS AND IMPLICATIONS Online culinary programs targeting parents with low income may consider short, mobile-friendly video formats and focus on easy-to-prepare recipes adaptable to family preferences.
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Affiliation(s)
- Margaret Raber
- MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX; US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX.
| | - Isabella Villarreal
- US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX; Rice University, Houston, TX
| | - Maria Vazquez
- MD Anderson Cancer Center, Department of Health Disparities Research, Houston, TX; US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
| | - Debbe Thompson
- US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX
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Eysenbach G, Augustyn M, Gross SM, Vernon P, Caulfield LE, Paige DM. Engagement With and Acceptability of Digital Media Platforms for Use in Improving Health Behaviors Among Vulnerable Families: Systematic Review. J Med Internet Res 2023; 25:e40934. [PMID: 36735286 PMCID: PMC9938444 DOI: 10.2196/40934] [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: 07/10/2022] [Revised: 10/27/2022] [Accepted: 12/19/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The use of digital communication platforms to improve health behaviors has increased dramatically over the last decade. Public health practitioners have adopted digital communication technologies such as text messages, mobile apps, and social media to reach diverse populations. However, the effectiveness of digital communication platforms used by community-serving agencies remains unclear, and patterns of engagement and acceptability of different platforms have not been studied. OBJECTIVE This review aimed to identify the types of digital communication strategies used by community-serving organizations to promote healthy behaviors, assess the strength of evidence for health behavioral change, and describe the degree of consumer engagement with and acceptability of these strategies. The study population included low-income pregnant women, parents of young children, and adolescents. METHODS A systematic review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using PubMed, Scopus, Web of Science, CINAHL, and APA PsycInfo, covering research conducted from 2009 to 2022. Studies were included if they examined the use of digital communication (ie, texting, mobile apps, or social media) to promote healthy behaviors in the target population. Risk of bias and strength of evidence were assessed using the Effective Public Health Practice Project Risk of Bias tool and criteria from Agency for Healthcare Research and Quality, respectively. RESULTS Twenty-three peer-reviewed research studies published between 2012 and 2022, conducted in the United States, the United Kingdom, and Australia, were included in the review. The sample comprised studies exploring the use of texting (n=12), apps (n=6), social media (n=3), and multiple platforms (n=2; eg, texting and mobile apps). Targeted health behaviors included healthy diet, physical activity, obesity prevention, healthy pregnancy, breastfeeding, vaccine use, smoking cessation, and nutrition benefit redemption. The sample included 8 randomized controlled trials, 6 pretest-posttest design, 3 mixed methods studies, 2 pilot studies, 1 feasibility study, 1 prospective cohort study, 1 descriptive study, and 1 cross-sectional study. The median sample size was 77.5. There was no strong evidence to suggest the effectiveness of digital media campaigns in improving health behaviors; however, there were moderate to high levels of engagement and high levels of acceptability across digital platforms. CONCLUSIONS Low-income pregnant women, parents of young children, and adolescents demonstrated moderate levels of engagement with and high levels of acceptability of digital media health campaigns conducted by community-serving agencies. The effectiveness of these strategies in improving health behaviors was inconclusive. Additional rigorous studies with larger sample sizes are required. In addition, more research is required to consistently measure and report participants' engagement with each platform. Digital communication platforms are critical tools for public health practitioners, and future investigations of the effectiveness of these platforms in engaging clients and improving health behaviors will maximize client services.
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Affiliation(s)
| | - Marycatherine Augustyn
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Susan M Gross
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Paris Vernon
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Laura E Caulfield
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - David M Paige
- Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
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Bonvicini L, Pingani I, Venturelli F, Patrignani N, Bassi MC, Broccoli S, Ferrari F, Gallelli T, Panza C, Vicentini M, Giorgi Rossi P. Effectiveness of mobile health interventions targeting parents to prevent and treat childhood Obesity: Systematic review. Prev Med Rep 2022; 29:101940. [PMID: 36161123 PMCID: PMC9501985 DOI: 10.1016/j.pmedr.2022.101940] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
Mobile apps are increasingly used in childhood obesity prevention to monitor food intake and PA, and send health messages. The studies' small sample size and the heterogeneous interventions prevent this review to conclude on effectiveness. The overall picture shows a trend toward improvement in some interventions, while others were essentially ineffective. The high acceptability and the widespread use of mobile apps, support new research to develop effective, trustworthy apps.
Childhood obesity is a high prevalence condition that causes a high burden of disease in adulthood. Mobile phone app are increasingly used to prevent it. We summarized the evidence on the effectiveness of mobile apps for devices used by parents to prevent and treat childhood and adolescent obesity. An update of a systematic review of the literature (De Lepeleere et al., 2017) was carried out. PubMed, Embase, Cochrane, CINAHL, PsycINFO, Scopus, and ERIC were searched up to 2020. The included studies should target children 1–18 years, compare an app aimed at preventing or treating overweight and obesity, as stand-alone intervention or as part of a complex program, installed on parents’ mobile devices, to no intervention or an intervention without the app. Outcomes related to weight status, diet, and physical activity (PA) behaviors were considered. Nineteen studies (14 RCTs and 5 non-randomized trials) were included. The app was mainly used to record food consumption and PA, to set goals, to view progress, and send health promotion messages. One study reported a significant decrease and one a suggestive decrease in anthropometric measures in obese and overweight children, while other studies observed no effect. One study reported a significant increase in PA. Six interventions proved to be effective in changing dietary behaviors. Interventions targeting overweight and/or obese children had the most positive results. All studies reported high acceptability and feasibility of interventions. The differences between interventions and the small sample size of the studies did not allow this review to reach conclusion on effectiveness.
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Affiliation(s)
- Laura Bonvicini
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilaria Pingani
- Graduated in Human Nutrition Sciences at the San Raffaele University of Rome, Rome, Italy
| | - Francesco Venturelli
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Corresponding author at: Via Amendola, 2 42122 Reggio Emilia.
| | | | - Maria Chiara Bassi
- Medical Library, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | - Francesca Ferrari
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Massimo Vicentini
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Carroll KA, Guthrie JF, Samek A. Impact of Recipe Cards and Nutrition Tips on Produce Selection in a Food Pre-Ordering Program. JOURNAL OF HUNGER & ENVIRONMENTAL NUTRITION 2022. [DOI: 10.1080/19320248.2022.2117004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Kathryn A. Carroll
- Department of Nutrition and Family Sciences, University of Central Arkansas, Conway, AR, USA
| | | | - Anya Samek
- Rady School of Management, University of California, San Diego, CA, USA
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Al-Dhahir I, Reijnders T, Faber JS, van den Berg-Emons RJ, Janssen VR, Kraaijenhagen RA, Visch VT, Chavannes NH, Evers AWM. The Barriers and Facilitators of eHealth-Based Lifestyle Intervention Programs for People With a Low Socioeconomic Status: Scoping Review. J Med Internet Res 2022; 24:e34229. [PMID: 36001380 PMCID: PMC9453585 DOI: 10.2196/34229] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/24/2022] [Accepted: 03/31/2022] [Indexed: 11/26/2022] Open
Abstract
Background Promoting health behaviors and preventing chronic diseases through a healthy lifestyle among those with a low socioeconomic status (SES) remain major challenges. eHealth interventions are a promising approach to change unhealthy behaviors in this target group. Objective This review aims to identify key components, barriers, and facilitators in the development, reach, use, evaluation, and implementation of eHealth lifestyle interventions for people with a low SES. This review provides an overview for researchers and eHealth developers, and can assist in the development of eHealth interventions for people with a low SES. Methods We performed a scoping review based on Arksey and O’Malley’s framework. A systematic search was conducted on PubMed, MEDLINE (Ovid), Embase, Web of Science, and the Cochrane Library, using terms related to a combination of the following key constructs: eHealth, lifestyle, low SES, development, reach, use, evaluation, and implementation. There were no restrictions on the date of publication for articles retrieved upon searching the databases. Results The search identified 1323 studies, of which 42 met our inclusion criteria. An update of the search led to the inclusion of 17 additional studies. eHealth lifestyle interventions for people with a low SES were often delivered via internet-based methods (eg, websites, email, Facebook, and smartphone apps) and offline methods, such as texting. A minority of the interventions combined eHealth lifestyle interventions with face-to-face or telephone coaching, or wearables (blended care). We identified the use of different behavioral components (eg, social support) and technological components (eg, multimedia) in eHealth lifestyle interventions. Facilitators in the development included iterative design, working with different disciplines, and resonating intervention content with users. Facilitators for intervention reach were use of a personal approach and social network, reminders, and self-monitoring. Nevertheless, barriers, such as technological challenges for developers and limited financial resources, may hinder intervention development. Furthermore, passive recruitment was a barrier to intervention reach. Technical difficulties and the use of self-monitoring devices were common barriers for users of eHealth interventions. Only limited data on barriers and facilitators for intervention implementation and evaluation were available. Conclusions While we found large variations among studies regarding key intervention components, and barriers and facilitators, certain factors may be beneficial in building and using eHealth interventions and reaching people with a low SES. Barriers and facilitators offer promising elements that eHealth developers can use as a toolbox to connect eHealth with low SES individuals. Our findings suggest that one-size-fits-all eHealth interventions may be less suitable for people with a low SES. Future research should investigate how to customize eHealth lifestyle interventions to meet the needs of different low SES groups, and should identify the components that enhance their reach, use, and effectiveness.
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Affiliation(s)
- Isra Al-Dhahir
- Faculty of Social and Behavioral Sciences, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Thomas Reijnders
- Faculty of Social and Behavioral Sciences, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Jasper S Faber
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Rita J van den Berg-Emons
- Department of Rehabilitation Medicine, Erasmus University Medical Centre, Rotterdam, Netherlands.,Capri Cardiac Rehabilitation, Rotterdam, Netherlands
| | - Veronica R Janssen
- Faculty of Social and Behavioral Sciences, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands.,Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands
| | - Roderik A Kraaijenhagen
- Vital10, Amsterdam, Netherlands.,NDDO Institute for Prevention and Early Diagnostics (NIPED), Amsterdam, Netherlands
| | - Valentijn T Visch
- Faculty of Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Niels H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.,National eHealth Living Lab, Leiden University Medical Centre, Leiden, Netherlands
| | - Andrea W M Evers
- Faculty of Social and Behavioral Sciences, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, Netherlands.,Medical Delta, Leiden University, Delft University of Technology, Erasmus University, Delft, Netherlands
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Martin NM, Barnett DJ, Poirier L, Sundermeir SM, Reznar MM, Gittelsohn J. Moving Food Assistance into the Digital Age: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1328. [PMID: 35162351 PMCID: PMC8835246 DOI: 10.3390/ijerph19031328] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/15/2022] [Accepted: 01/21/2022] [Indexed: 02/01/2023]
Abstract
One of the most basic needs globally, food assistance refers to the multitude of programs, both governmental and non-governmental, to improve food access and consumption by food-insecure individuals and families. Despite the importance of digital and mobile Health (mHealth) strategies in food insecurity contexts, little is known about their specific use in food assistance programs. Therefore, the purpose of this study was to address that gap by conducting a scoping review of the literature. Keywords were defined within the concepts of food assistance and digital technology. The search included relevant peer-reviewed and grey literature from 2011 to 2021. Excluded articles related to agriculture and non-digital strategies. PRISMA guidelines were followed to perform a partnered, two-round scoping literature review. The final synthesis included 39 studies of which most (84.6%) were from the last five years and United States-based (93.2%). The top three types of articles or studies included text and opinion, qualitative research, and website, application, or model development (17.9%). The top three types of digital tools were websites (56.4%), smartphone applications (20.5%), and chatbots (5.1%). Nineteen digital features were identified as desirable. Most tools included just one or two features. The most popular feature to include was online shopping (n = 14), followed by inventory management, and client tracking. Digital tools for individual food assistance represent an opportunity for equitable and stable access to programs that can enhance or replace in-person services. While this review identified 39 tools, all are in early development and/or implementation stages. Review findings highlight an overall lack of these tools, an absence of user-centered design in their development, and a critical need for research on their effectiveness globally. Further analysis and testing of current digital tool usage and interventions examining the health and food security impacts of such tools should be explored in future studies, including in the context of pandemics, where digital tools allow for help from a distance.
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Affiliation(s)
- Nina M. Martin
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Daniel J. Barnett
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA;
| | - Lisa Poirier
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Samantha M. Sundermeir
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
| | - Melissa M. Reznar
- Department of Interdisciplinary Health Sciences, Oakland University School of Health Sciences, Rochester, MI 48309, USA;
| | - Joel Gittelsohn
- Human Nutrition Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; (L.P.); (S.M.S.); (J.G.)
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Golper S, Nagao-Sato S, Overcash F, Reicks M. Frequency of Meals Prepared Away from Home and Nutrient Intakes among US Adolescents (NHANES 2011-2018). Nutrients 2021; 13:nu13114019. [PMID: 34836274 PMCID: PMC8625290 DOI: 10.3390/nu13114019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/29/2022] Open
Abstract
Frequency of consuming foods prepared away from home has been associated with lower diet quality among adults and adolescents in several earlier studies. Nutrient and food group intake and Healthy Eating Index (HEI)-2015 scores were compared among a U.S. nationally representative sample of adolescents (12–19 years, n = 3975) by frequency of consuming food prepared away from home ≤2 times/week (n = 2311) versus >2 times/week (n = 1664) using National Health and Nutrition Examination Survey (NHANES) data from 2011–2018. Regression analyses were used to compare intakes among adolescents by frequency of eating meals prepared away from home adjusting for covariates. Older (16–19 years) vs. younger (12–15 years) adolescents and those from homes with higher vs. lower family income to poverty ratios had greater frequency of eating meals prepared away from home. Intakes of nutrients of concern for adolescents including choline, vitamin D, potassium, magnesium, fiber, phosphorus, folate, iron, and total HEI-2015 scores and component scores for total vegetables, and greens and beans were lower among adolescents who consumed meals prepared away from home more vs. less often. However, no differences were noted among food group intakes considered good sources of nutrients of concern such as total fruit, total vegetables, whole grains, and total dairy, except for beans and peas by frequency of eating foods prepared away from home. Greater frequency of eating foods prepared away from home was associated with lower diet quality among adolescents in a nationally representative sample of U.S. adolescents.
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Neffa-Creech D, Clarke P, Evans SH, Glovinsky J. "Food is something everyone should participate in": A positive deviance approach to understanding the use of a food and nutrition app in low-income, Latino homes. SAGE Open Med 2020; 8:2050312120934842. [PMID: 32637105 PMCID: PMC7323275 DOI: 10.1177/2050312120934842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 05/21/2020] [Indexed: 12/20/2022] Open
Abstract
Objectives: Latino families are among the most likely to be overweight or obese, which are conditions associated with numerous health risks and diseases. These families might lack know-how for preparing vegetables that fall outside cooks’ culinary comfort zones and cultural traditions. Mobile apps are increasingly being developed for healthier cooking and eating, but research has not much explored how such apps are used among these families to help facilitate changes in eating patterns. This research seeks to identify behaviors and motivations that lead household cooks (i.e. mothers) in low-income Latino homes to use a food and nutrition app and create healthier eating environments for their families. Methods: This study uses a positive deviance approach and individual interviews with mothers who were frequent app users and experienced beneficial food outcomes during their participation in a randomized controlled trial that tested the effects of an app on their cooking and family eating behaviors. Interviews were analyzed for themes using a framework analysis approach. Results: Three themes emerged across interviews that were suggestive of approaches that led mothers to become frequent app users and prepare healthier meals: (1) mothers invited their children to use the app; (2) they involved both sons and daughters in the kitchen; and (3) they (cautiously) stepped outside their culinary comfort zones. Conclusion: Mobile apps and app-focused interventions should include features that invite: app co-use between mothers and children; opportunities for mothers to socialize boys, as well as girls into kitchen routines; and the use of culturally-familiar ingredients or recipes that are easily adaptable.
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Affiliation(s)
- Deborah Neffa-Creech
- Sentient Research, Los Angeles, CA, USA.,Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Peter Clarke
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
| | - Susan H Evans
- Annenberg School for Communication and Journalism, University of Southern California, Los Angeles, CA, USA
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Milne-Ives M, Lam C, De Cock C, Van Velthoven MH, Meinert E. Mobile Apps for Health Behavior Change in Physical Activity, Diet, Drug and Alcohol Use, and Mental Health: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e17046. [PMID: 32186518 PMCID: PMC7113799 DOI: 10.2196/17046] [Citation(s) in RCA: 132] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 12/03/2019] [Accepted: 01/26/2020] [Indexed: 01/16/2023] Open
Abstract
Background With a growing focus on patient interaction with health management, mobile apps are increasingly used to deliver behavioral health interventions. The large variation in these mobile health apps—their target patient group, health behavior, and behavioral change strategies—has resulted in a large but incohesive body of literature. Objective This systematic review aimed to assess the effectiveness of mobile apps in improving health behaviors and outcomes and to examine the inclusion and effectiveness of behavior change techniques (BCTs) in mobile health apps. Methods PubMed, EMBASE, CINAHL, and Web of Science were systematically searched for articles published between 2014 and 2019 that evaluated mobile apps for health behavior change. Two authors independently screened and selected studies according to the eligibility criteria. Data were extracted and the risk of bias was assessed by one reviewer and validated by a second reviewer. Results A total of 52 randomized controlled trials met the inclusion criteria and were included in the analysis—37 studies focused on physical activity, diet, or a combination of both, 11 on drug and alcohol use, and 4 on mental health. Participant perceptions were generally positive—only one app was rated as less helpful and satisfactory than the control—and the studies that measured engagement and usability found relatively high study completion rates (mean 83%; n=18, N=39) and ease-of-use ratings (3 significantly better than control, 9/15 rated >70%). However, there was little evidence of changed behavior or health outcomes. Conclusions There was no strong evidence in support of the effectiveness of mobile apps in improving health behaviors or outcomes because few studies found significant differences between the app and control groups. Further research is needed to identify the BCTs that are most effective at promoting behavior change. Improved reporting is necessary to accurately evaluate the mobile health app effectiveness and risk of bias.
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Affiliation(s)
- Madison Milne-Ives
- Digitally Enabled Preventative Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Ching Lam
- Digitally Enabled Preventative Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Caroline De Cock
- Digitally Enabled Preventative Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Michelle Helena Van Velthoven
- Digitally Enabled Preventative Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Edward Meinert
- Digitally Enabled Preventative Health Research Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom.,Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Cooking Matters Mobile Application: a meal planning and preparation tool for low-income parents. Public Health Nutr 2019; 22:2220-2227. [PMID: 31084663 DOI: 10.1017/s1368980019001101] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To describe low-income parents' and caregivers' perceptions of the Cooking Matters Mobile Application (CM App) meal planning and preparation features. DESIGN Explanatory mixed-methods design where data were gathered via online surveys based on the Theory of Planned Behaviour and the Theory of Reasoned Action, followed by telephone interviews. SETTING CM App, a mobile phone-based resource geared towards low-income parents and caregivers of young children (pregnancy/infant to age 5 years) for meal planning and preparation, with features based on skills taught in the Cooking Matters course: recipes, shopping list and meal planning. PARTICIPANTS Low-income parents and caregivers (survey participants, n 461; interview participants, n 20) who had downloaded the CM App to their smartphone and agreed to participate in the current evaluation. RESULTS Attitudes and self-efficacy related to CM App's subject matter and functions (meal planning; recipe use; creating and using a shopping list) were measured via surveys and interviews. Mean (sd) responses were positive towards 'meal planning' and 'shopping and cooking' (4·17 (0·63) and 3·49 (0·86) on a 5-point Likert scale, respectively). Interviewees described meal planning and preparation behaviours as intrinsic, based on habit, and influenced by family preference and food costs. Early adopters of the CM App may already be engaged in and/or are motivated to engage in the targeted health behaviours. CONCLUSIONS Users may benefit most from incorporating into their routines new ways to prepare easy, cost-efficient, healthy meals at home that their families will enjoy.
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Evans SH, Clarke P. Resolving design issues in developing a nutrition app: A case study using formative research. EVALUATION AND PROGRAM PLANNING 2019; 72:97-105. [PMID: 30321688 DOI: 10.1016/j.evalprogplan.2018.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 09/26/2018] [Accepted: 10/03/2018] [Indexed: 06/08/2023]
Abstract
Mobile phone apps have become ubiquitous in health, but they often fail to demonstrate effectiveness in achieving behavior outcomes among intended users. A failure to conduct formative research on app content or functions may contribute to some of this shortfall. We describe simple research procedures we followed when building a nutrition app for low-income household cooks. Our studies improved the placement and design of key screen controls, helped select and guide an illustrator who created graphic support for textual content, and tested whether adding secondary users to the primary audience would attract additional app use. Whether because of these preliminary tests, or for other reasons, our app has generated heavy use by its intended market and has demonstrated desired effects on client behavior. We offer our experiences in formative evaluation as potential tools for other app developers to adapt to their circumstances.
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Affiliation(s)
- Susan H Evans
- Annenberg School for Communication and Journalism, University of Southern California, University Park, Los Angeles, CA, 90089-0281, USA.
| | - Peter Clarke
- Annenberg School for Communication and Journalism, University of Southern California, University Park, Los Angeles, CA, 90089-0281, USA.
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