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Braga BC, Nguyen PH, Tran LM, Hoang NT, Bannerman B, Doyle F, Folson G, Gangupantulu R, Karachiwalla N, Kolt B, McCloskey P, Palloni G, Thi Tran TH, Thuy Thi Trơưng D, Hughes D, Gelli A. Feasibility of Using an Artificial Intelligence-based Telephone Application for Dietary Assessment and Nudging to Improve the Quality of Food Choices of Female Adolescents in Vietnam: Evidence from a Randomized Pilot Study. Curr Dev Nutr 2024; 8:102063. [PMID: 38817706 PMCID: PMC11137395 DOI: 10.1016/j.cdnut.2023.102063] [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: 11/15/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 06/01/2024] Open
Abstract
Background Adolescent nutrition has faced a policy neglect, partly owing to the gaps in dietary intake data for this age group. The Food Recognition Assistance and Nudging Insights (FRANI) is a smartphone application validated for dietary assessment and to influence users toward healthy food choices. Objectives This study aimed to assess the feasibility (adherence, acceptability, and usability) of FRANI and its effects on food choices and diet quality in female adolescents in Vietnam. Methods Adolescents (N = 36) were randomly selected from a public school and allocated into 2 groups. The control group received smartphones with a version of FRANI limited to dietary assessment, whereas the intervention received smartphones with gamified FRANI. After the first 4 wk, both groups used gamified FRANI for further 2 wk. The primary outcome was the feasibility of using FRANI as measured by adherence (the proportion of completed food records), acceptability and usability (the proportion of participants who considered FRANI acceptable and usable according to answers of a Likert questionnaire). Secondary outcomes included the percentage of meals recorded, the Minimum Dietary Diversity for Women (MDDW) and the Eat-Lancet Diet Score (ELDS). Dietary diversity is important for dietary quality, and sustainable healthy diets are important to reduce carbon emissions. Poisson regression models were used to estimate the effect of gamified FRANI on the MDDW and ELDS. Results Adherence to the application was 82% and the percentage of meals recorded was 97%. Acceptability and usability were 97%. MDDW in the intervention group was 1.07 points (95% CI: 0.98, 1.18; P = 0.13) greater than that in the control (constant = 4.68); however, the difference was not statistically significant. Moreover, ELDS in the intervention was 1.09 (95% CI: 1.01, 1.18; P = 0.03) points greater than in the control (constant = 3.67). Conclusions FRANI was feasible and may be effective to influence users toward healthy food choices. Research is needed for FRANI in different contexts and at scale.The trial was registered at the International Standard Randomized Controlled Trial Number as ISRCTN 10681553.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Policy and Science, Tufts University, Boston, MA, United States
| | - Phuong H Nguyen
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
- Thai Nguyen University of Pharmacy and Medicine, Thai Nguyen, Vietnam
| | - Lan Mai Tran
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | | | - Boateng Bannerman
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Frank Doyle
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Gloria Folson
- Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Rohit Gangupantulu
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Naureen Karachiwalla
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Bastien Kolt
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | - Peter McCloskey
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Giordano Palloni
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
| | | | | | - David Hughes
- College of Agricultural Sciences, Pennsylvania State University, State College, PA, United States
| | - Aulo Gelli
- Nutrition, Health and Diet, International Food Policy Research Institute, Washington, DC, United States
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Liu M, Guan X, Guo X, He Y, Liu Z, Ni S, Wu Y. Impact of Serious Games on Body Composition, Physical Activity, and Dietary Change in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:1290. [PMID: 38732536 PMCID: PMC11085665 DOI: 10.3390/nu16091290] [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: 03/11/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024] Open
Abstract
Over the past four decades, obesity in children of all ages has increased worldwide, which has intensified the search for innovative intervention strategies. Serious games, a youth-friendly form of intervention designed with educational or behavioral goals, are emerging as a potential solution to this health challenge. To analyze the effectiveness of serious games in improving body composition, physical activity, and dietary change, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, EMBASE, and Scopus databases. Pooled standardized mean differences (SMD) were calculated for 20 studies (n = 2238 the intervention group; n = 1983 in the control group) using random-effect models. The intervention group demonstrated a slightly better, although non-significant, body composition score, with a pooled SMD of -0.26 (95% CI: -0.61 to 0.09). The pooled effect tends to be stronger with longer duration of intervention (-0.40 [95% CI: -0.96, 0.16] for >3 months vs. -0.02 [95% CI: -0.33, 0.30] for ≤3 months), although the difference was not statistically significant (p-difference = 0.24). As for the specific pathways leading to better weight control, improvements in dietary habits due to serious game interventions were not significant, while a direct positive effect of serious games on increasing physical activity was observed (pooled SMD = 0.61 [95% CI: 0.04 to 1.19]). While the impact of serious game interventions on body composition and dietary changes is limited, their effectiveness in increasing physical activity is notable. Serious games show potential as tools for overweight/obesity control among children and adolescents but may require longer intervention to sustain its effect.
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Affiliation(s)
- Mingchang Liu
- Institute for Hospital Management, School of Medicine, Tsinghua University, Beijing 100084, China; (M.L.); (X.G.); (Z.L.)
| | - Xinyue Guan
- Institute for Hospital Management, School of Medicine, Tsinghua University, Beijing 100084, China; (M.L.); (X.G.); (Z.L.)
| | - Xueqing Guo
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA 02215, USA;
| | - Yixuan He
- Department of Bioengineering, East China University of Science and Technology, Shanghai 200237, China;
| | - Zeqi Liu
- Institute for Hospital Management, School of Medicine, Tsinghua University, Beijing 100084, China; (M.L.); (X.G.); (Z.L.)
| | - Shiguang Ni
- Shenzhen International Graduate School, Tsinghua University, Shenzhen 518055, China;
| | - You Wu
- Institute for Hospital Management, School of Medicine, Tsinghua University, Beijing 100084, China; (M.L.); (X.G.); (Z.L.)
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
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dos Santos TT, Ríos MP, de Medeiros GCBS, Mata ÁNDS, Silva Junior DDN, Guillen DM, Piuvezam G. Gamification as a health education strategy of adolescents at school: Protocol for a systematic review and meta-analysis. PLoS One 2023; 18:e0294894. [PMID: 38033047 PMCID: PMC10688727 DOI: 10.1371/journal.pone.0294894] [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: 02/17/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023] Open
Abstract
The objective of the study is to present a systematic review and meta-analysis protocol for evaluating the effects of health education gamification-based interventions, on health parameters (food consumption, sleep quality and physical activity) of adolescent students. This protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022373833). The search will be performed in the following databases: MEDLINE, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, APA, and ADOLEC. Intervention studies (clinical trials - randomized or non-randomized) and quasi-experimental studies will be included. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomized controlled trials, non- randomized controlled trials and quasi-experimental trials. Two independent researchers will conduct all assessments, and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be analyzed using RevMan 5.4.1 software. We will conduct the study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guideline. The review will summarize the current evidence on gamification health education changes in parameters related to the health of adolescents. Gamification has been used to verify the increase in adherence to healthy habits or the development of health-related skills, but there are still few results for the adolescent population. We expect that the systematic review could indicate strategies with gamification interventions and also determine how these strategies can improve health parameters of adolescent students, and they will be available as a reference for these interventions.
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Affiliation(s)
- Thais Teixeira dos Santos
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Gidyenne Christine Bandeira Silva de Medeiros
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ádala Nayana de Sousa Mata
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Multicampi School of Medical Sciences of Rio Grande do Norte (EMCM), Federal University of Rio Grande do Norte, Caicó, Brazil
| | - Danyllo do Nascimento Silva Junior
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Grasiela Piuvezam
- Post-Graduation Program in Public Health, Federal University of Rio Grande do Norte, Natal, Brazil
- Sistematic Review and Meta-analisys Laboratory (Lab-Sys/CNPq), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Public Health, Federal University of Rio Grande do Norte (UFRN-Brazil), Natal, Brazil
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Bucher Della Torre S, Lages M, Dias SS, Guarino MP, Braga-Pontes C. Translating and Testing a Digital Game Promoting Vegetable Consumption in Young Children: Usability Study. JMIR Serious Games 2023; 11:e43843. [PMID: 37788064 PMCID: PMC10582818 DOI: 10.2196/43843] [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: 10/28/2022] [Revised: 03/31/2023] [Accepted: 08/31/2023] [Indexed: 10/04/2023] Open
Abstract
BACKGROUND Promoting healthy eating in children is key to preventing chronic diseases, and vegetable consumption is notably lower than recommended in this population. Among the interventions tested, gamification has shown promise in promoting familiarization, increasing knowledge, and potentially increasing vegetable intake. OBJECTIVE This pilot study aimed first to translate the digital game "Veggies4myHeart" into French and to assess its influence on young children's preferences and willingness to taste vegetables when combined with repeated tasting and education. We also aimed to investigate the acceptability and applicability of the game in 2 classrooms. METHODS During 5 consecutive weekly sessions, children from 2 elementary classes played the digital game consisting of 5 mini games on different vegetables (lettuce, carrot, red cabbage, cucumber, and tomato) in pairs for 10-15 minutes. In addition, they discussed one of the vegetables and tasted the 5 vegetables in each session. Pretest and posttest food preferences and willingness to taste the vegetables were compared. Teachers participated in a semistructured interview. RESULTS A total of 45 children aged 5 to 6 years tested the French version of the digital game. The children's declared food preferences were already high for carrot, cucumber, and tomato, with scores higher than 4 out of a maximum of 5. The scores did not change significantly after the intervention, except for red cabbage (pretest: mean 2.52, SD 1.49; posttest: mean 3.29, SD 1.67; P=.006) and a composite score (pretest: mean 3.76, SD 1.06; posttest: mean 4.05, SD 1.03; P=.001). Before the intervention, 18 (44%), 30 (73%), 16 (39%), 29 (71%), and 26 (63%) children out of 41 were willing to taste lettuce, carrot, red cabbage, cucumber, and tomato, respectively. After the intervention, no significant statistical differences were observed, with 23 (51%), 36 (80%), 24 (53%), 33 (73%), and 29 (64%) children out of 45 willing to taste lettuce, carrot, red cabbage, cucumber, and tomato, respectively. Teachers supported this tool combined with repeated tasting and education and highlighted facilitators and barriers that should be anticipated to improve implementation in schools. CONCLUSIONS In this study, we translated an existing digital game applicable and acceptable to both children and teachers. A larger study is warranted to confirm the effectiveness of interventions using the digital game to promote vegetable preference, willingness to taste, and intake.
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Affiliation(s)
- Sophie Bucher Della Torre
- Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Carouge, Switzerland
| | - Marlene Lages
- ciTechCare- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
| | - Sara S Dias
- ciTechCare- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Maria P Guarino
- ciTechCare- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
| | - Cátia Braga-Pontes
- ciTechCare- Center for Innovative Care and Health Technology, Polytechnic of Leiria, Leiria, Portugal
- School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal
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Braga BC, Cash SB, Sarson K, Chang R, Mosca A, Wilson NLW. The gamification of nutrition labels to encourage healthier food selection in online grocery shopping: A randomized controlled trial. Appetite 2023; 188:106610. [PMID: 37269883 DOI: 10.1016/j.appet.2023.106610] [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: 02/17/2023] [Revised: 05/05/2023] [Accepted: 05/16/2023] [Indexed: 06/05/2023]
Abstract
Food purchase choices, one of the main determinants of food consumption, is highly influenced by food environments. Given the surge in online grocery shopping because of the COVID-19 pandemic, interventions in digital environments present more than ever an opportunity to improve the nutritional quality of food purchase choices. One such opportunity can be found in gamification. Participants (n = 1228) shopped for 12 items from a shopping list on a simulated online grocery platform. We randomized them into four groups in a 2 × 2 factorial design: presence vs. absence of gamification, and high vs. low budget. Participants in the gamification groups saw foods with 1 (least nutritious) to 5 (most nutritious) crown icons and a scoreboard with a tally of the number of crowns the participant collected. We estimated ordinary least squares and Poisson regression models to test the impact of the gamification and budget on the nutritional quality of the shopping basket. In the absence of gamification and low budget, participants collected 30.78 (95% CI [30.27; 31.29]) crowns. In the gamification and low budget condition, participants increased the nutritional quality of their shopping basket by collecting more crowns (B = 4.15, 95% CI [3.55; 4.75], p < 0.001). The budget amount ($50 vs. $30) did not alter the final shopping basket (B = 0.45, 95% CI [-0.02; 1.18], p = 0.057), nor moderated the gamification effect. Gamification increased the nutritional quality of the final shopping baskets and nine of 12 shopping list items in this hypothetical experiment. Gamifying nutrition labels may be an effective strategy to improve the nutritional quality of food choices in online grocery stores, but further research is needed.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Sean B Cash
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Katrina Sarson
- Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Avenue, Boston, MA, 02111, USA.
| | - Remco Chang
- Computer Science, Halligan Hall, Tufts University, 161 College Avenue, Medford, MA, 02155, USA.
| | - Ab Mosca
- Khoury College of Computer Sciences, Northeastern University, 440 Huntington Avenue, 202 West Village H, Boston, MA, 02115, USA.
| | - Norbert L W Wilson
- Divinity School and Sanford School of Public Policy, 304 Gray, 407 Chapel Drive, Duke Box, #90968, Durham, NC, 27708-0968, USA.
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6
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Francis L, Spaulding EM, Bloom I, Patel A, Perrin N. A systematic appraisal of the information, engagement, aesthetic and functional quality of nutrition-related smartphone apps for children and adolescents. Public Health Nutr 2023; 26:1368-1379. [PMID: 36912110 PMCID: PMC10346071 DOI: 10.1017/s1368980023000526] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 01/09/2023] [Accepted: 02/24/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVE Nutrition-related smartphone applications (apps) could improve children's nutrition knowledge and skills. However, little is known about the quality of nutrition-related apps for children. This study aimed to identify and evaluate the quality of nutrition-related smartphone apps designed for children ages 4-17. DESIGN This systematic appraisal is guided by the Protocol for App Store Systematic Reviews. SETTING Using Google's Advanced Search, we identified 1814 apps/1184 additional apps in an updated search on iOS, of which twenty-four were eligible. The apps' objective and subjective quality were evaluated using the twenty-three-item, five-point Mobile App Rating Scale. The objective quality scale consists of four subscales: engagement, functionality, aesthetics and information. RESULTS Most of the apps (75 %) focussed solely on promoting nutrition skills, such as making food dishes, rather than nutrition knowledge. Of the twenty-four apps, 83 % targeted children 4-8 years old. The app objective quality mean score was 3·60 ± 0·41. The subscale mean scores were 3·20 ± 0·41 for engagement, 4·24 ± 0·47 for functionality, 4·03 ± 0·51 for aesthetics and 2·94 ± 0·62 for information. The app subjective quality mean score was 2·10 ± 0·90. CONCLUSIONS More robust approaches to app development leveraging co-design approaches, including involving a multidisciplinary team of experts to provide evidence-based nutrition information, are warranted.
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Affiliation(s)
- Lucine Francis
- Center for Community Programs, Innovation, and Scholarship, Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Erin M Spaulding
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
- Digital Health Innovation Laboratory, Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, The Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD21205, USA
| | - India Bloom
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Alisha Patel
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, Baltimore, MD21205, USA
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Ybarra ML, Mitchell KJ, Oppenheim JK. Violent Media in Childhood and Seriously Violent Behavior in Adolescence and Young Adulthood. J Adolesc Health 2022; 71:285-292. [PMID: 35550330 PMCID: PMC10177625 DOI: 10.1016/j.jadohealth.2022.03.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/16/2022] [Accepted: 03/09/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE To quantify the relative odds of self-reported seriously violent behavior in adolescence and young adulthood given one's self-reported violent media diet in childhood. METHODS Baseline data were collected nationally online from 1,586 youth 10-15 years of age in 2006. Follow-up data were collected in 2010-2011 and 2016. Children reported the amount of music, video games, television, websites with real people, and cartoons that depicted "physical fighting, hurting, shooting, or killing." Seriously violent behavior was assessed 5 and 10 years later. RESULTS 887 adolescents completed the survey at baseline and 5-year follow-up. The relative odds of reporting seriously violent behavior over time were 2.45-fold higher (p < .001) with each incremental increase in one's baseline violent media diet. After adjusting for other potentially influential characteristics, results persisted (aOR = 1.70, p = .01). The relative odds also were elevated for those frequently exposed to violence in music (aOR = 3.28, p = .03), television (aOR = 3.51, p < .001), and video games (aOR = 3.27, p = .02). 760 young adults completed measures at baseline and 10-year follow-up. The relative odds of seriously violent behavior increased 2.18-fold (p = .001) with each incremental increase in one's baseline violent media diet. After adjusting for other factors, the association persisted (aOR = 1.72, p = .03). Frequent exposure to violence in video games (aOR = 3.28, p = .03) and television (aOR = 3.14, p = .02) also were implicated. DISCUSSION Exposure to violent media in childhood may be one modifiable influence on seriously violent behavior in adolescence and adulthood, even for those who have other risk factors.
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Affiliation(s)
- Michele L Ybarra
- Center for Innovative Public Health Research, San Clemente, California.
| | - Kimberly J Mitchell
- Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire
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C Braga B, Nguyen PH, Aberman NL, Doyle F, Folson G, Hoang N, Huynh P, Koch B, McCloskey P, Tran L, Hughes D, Gelli A. Exploring an Artificial Intelligence–Based, Gamified Phone App Prototype to Track and Improve Food Choices of Adolescent Girls in Vietnam: Acceptability, Usability, and Likeability Study. JMIR Form Res 2022; 6:e35197. [PMID: 35862147 PMCID: PMC9353675 DOI: 10.2196/35197] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/22/2022] [Accepted: 06/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background
Adolescents’ consumption of healthy foods is suboptimal in low- and middle-income countries. Adolescents’ fondness for games and social media and the increasing access to smartphones make apps suitable for collecting dietary data and influencing their food choices. Little is known about how adolescents use phones to track and shape their food choices.
Objective
This study aimed to examine the acceptability, usability, and likability of a mobile phone app prototype developed to collect dietary data using artificial intelligence–based image recognition of foods, provide feedback, and motivate users to make healthier food choices. The findings were used to improve the design of the app.
Methods
A total of 4 focus group discussions (n=32 girls, aged 15-17 years) were conducted in Vietnam. Qualitative data were collected and analyzed by grouping ideas into common themes based on content analysis and ground theory.
Results
Adolescents accepted most of the individual- and team-based dietary goals presented in the app prototype to help them make healthier food choices. They deemed the overall app wireframes, interface, and graphic design as acceptable, likable, and usable but suggested the following modifications: tailored feedback based on users’ medical history, anthropometric characteristics, and fitness goals; new language on dietary goals; provision of information about each of the food group dietary goals; wider camera frame to fit the whole family food tray, as meals are shared in Vietnam; possibility of digitally separating food consumption on shared meals; and more appealing graphic design, including unique badge designs for each food group. Participants also liked the app’s feedback on food choices in the form of badges, notifications, and statistics. A new version of the app was designed incorporating adolescent’s feedback to improve its acceptability, usability, and likability.
Conclusions
A phone app prototype designed to track food choice and help adolescent girls from low- and middle-income countries make healthier food choices was found to be acceptable, likable, and usable. Further research is needed to examine the feasibility of using this technology at scale.
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Affiliation(s)
- Bianca C Braga
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Phuong H Nguyen
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
| | - Noora-Lisa Aberman
- The Global Alliance for Improved Nutrition, Washington, DC, United States
| | - Frank Doyle
- College of Agricultural Sciences, Pennsylvania State University, University Park, PA, United States
| | - Gloria Folson
- Department of Nutrition, College of Health Sciences, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana
| | - Nga Hoang
- National Institute of Nutrition, Ha Noi, Vietnam
| | - Phuong Huynh
- National Institute of Nutrition, Ha Noi, Vietnam
| | - Bastien Koch
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
| | - Peter McCloskey
- College of Agricultural Sciences, Pennsylvania State University, University Park, PA, United States
| | - Lan Tran
- Hubert Department of Global Health, Rolling School of Public Health, Emory University, Atlanta, GA, United States
| | - David Hughes
- College of Agricultural Sciences, Pennsylvania State University, University Park, PA, United States
| | - Aulo Gelli
- Poverty, Health, and Nutrition Division, International Food Policy Research Institute, Washington, DC, United States
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Newbury JW, Foo WL, Cole M, Kelly AL, Chessor RJ, Sparks SA, Faghy MA, Gough HC, Gough LA. Nutritional intakes of highly trained adolescent swimmers before, during, and after a national lockdown in the COVID-19 pandemic. PLoS One 2022; 17:e0266238. [PMID: 35381043 PMCID: PMC8982883 DOI: 10.1371/journal.pone.0266238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/16/2022] [Indexed: 12/28/2022] Open
Abstract
Strict lockdown measures were introduced in response to the COVID-19 pandemic, which caused mass disruption to adolescent swimmers’ daily routines. To measure how lockdown impacted nutritional practices in this cohort, three-day photograph food diaries were analysed at three time points: before (January), during (April), and after (September) the first UK lockdown. Thirteen swimmers (aged 15 ± 1 years) from a high-performance swimming club submitted satisfactory food diaries at all time points. During lockdown, lower amounts of energy (45.3 ± 9.8 vs. 31.1 ± 7.7 kcal∙kg BM∙day-1, p<0.001), carbohydrate (5.4 ± 1.2 vs. 3.5 ± 1.1 g∙kg BM∙day-1, p<0.001), protein (2.3 ± 0.4 vs. 1.7 ± 0.4 g∙kg BM∙day-1, p = 0.002), and fat (1.6 ± 0.4 vs. 1.1 ± 0.3 g∙kg BM∙day-1, p = 0.011) were reported. After lockdown, no nutritional differences were found in comparison compared to before lockdown (energy: 44.0 ± 12.1 kcal∙kg BM∙day-1; carbohydrate: 5.4 ± 1.4 g∙kg BM∙day-1; protein: 2.1 ± 0.6 g∙kg BM∙day-1; fat: 1.5 ± 0.6 g ∙kg BM∙day-1, all p>0.05), despite fewer training hours being completed (15.0 ± 1.4 vs. 19.1 ± 2.2 h∙week-1, p<0.001). These findings highlight the ability of adolescent swimmers to alter their nutrition based on their changing training circumstances when receiving sport nutrition support. However, some individuals displayed signs of suboptimal nutrition during lockdown that were not corrected once training resumed. This warrants future research to develop interactive education workshops that maintain focus and motivation towards optimal nutrition practices in isolated periods away from training.
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Affiliation(s)
- Josh W. Newbury
- Department of Sport and Exercise, Human Performance and Health Research Group, Centre for Life and Sport Sciences (CLaSS), Birmingham City University, Birmingham, United Kingdom
| | - Wee Lun Foo
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Matthew Cole
- Department of Sport and Exercise, Human Performance and Health Research Group, Centre for Life and Sport Sciences (CLaSS), Birmingham City University, Birmingham, United Kingdom
| | - Adam L. Kelly
- Department of Sport and Exercise, Human Performance and Health Research Group, Centre for Life and Sport Sciences (CLaSS), Birmingham City University, Birmingham, United Kingdom
| | - Richard J. Chessor
- Sport Science and Sport Medicine Team, British Swimming, Loughborough, Leicestershire, United Kingdom
| | - S. Andy Sparks
- Department of Sport and Physical Activity, Sports Nutrition and Performance Research Group, Edge Hill University, Ormskirk, United Kingdom
- * E-mail:
| | - Mark A. Faghy
- School of Science, Sport and Exercise, University of Derby, Derby, United Kingdom
| | | | - Lewis A. Gough
- Department of Sport and Exercise, Human Performance and Health Research Group, Centre for Life and Sport Sciences (CLaSS), Birmingham City University, Birmingham, United Kingdom
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10
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Velázquez AL, Galler M, Vidal L, Varela P, Ares G. Co-creation of a healthy dairy product with and for children. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2021.104414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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11
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Koeder C, Kranz RM, Anand C, Husain S, Alzughayyar D, Schoch N, Hahn A, Englert H. Effect of a 1-Year Controlled Lifestyle Intervention on Body Weight and Other Risk Markers (the Healthy Lifestyle Community Programme, Cohort 2). Obes Facts 2022; 15:228-239. [PMID: 34923493 PMCID: PMC9021650 DOI: 10.1159/000521164] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The prevalence of obesity is high and increasing worldwide. Obesity is generally associated with an increased risk of chronic disease and mortality. The objective of the study was to test the effect of a lifestyle intervention on body weight and other chronic disease risk markers. METHODS A non-randomized controlled trial was conducted, including mostly middle-aged and elderly participants recruited from the general population in rural northwest Germany (intervention: n = 114; control: n = 87). The intervention consisted of a 1-year lifestyle programme, focussing on four key areas: a largely plant-based diet (strongest emphasis), physical activity, stress management, and community support. Parameters were assessed at baseline, 10 weeks, 6 months, and 1 year. The control group received no intervention. RESULTS Compared to the control, in the intervention group, significantly lower 1-year trajectories were observed for body weight, body mass index (BMI), waist circumference (WC), total cholesterol, calculated LDL cholesterol, non-HDL cholesterol, remnant cholesterol (REM-C), glucose, HbA1c, and resting heart rate (RHR). However, between-group differences at 1 year were small for glucose, HbA1c, and cholesterol (apart from REM-C). No significant between-group differences were found for 1-year trajectories of measured LDL cholesterol, HDL cholesterol, triglycerides, insulin, blood pressure, and pulse pressure. CONCLUSION The intervention successfully reduced body weight, BMI, WC, REM-C, and RHR. However, at 1 year, effectiveness of the intervention regarding other risk markers was either very modest or could not be shown.
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Affiliation(s)
- Christian Koeder
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
- *Christian Koeder,
| | - Ragna-Marie Kranz
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Corinna Anand
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Sarah Husain
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Dima Alzughayyar
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Nora Schoch
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
| | - Andreas Hahn
- Institute of Food Science and Human Nutrition, Leibniz University Hannover, Hannover, Germany
| | - Heike Englert
- Department of Nutrition, University of Applied Sciences Münster, Münster, Germany
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12
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Sattar N, Forouhi NG. More Evidence for 5-a-Day for Fruit and Vegetables and a Greater Need for Translating Dietary Research Evidence to Practice. Circulation 2021; 143:1655-1658. [PMID: 33900834 DOI: 10.1161/circulationaha.121.053293] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (N.S.)
| | - Nita G Forouhi
- MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, United Kingdom (N.G.F.)
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