1
|
Alghamdi AS, Bitar HH. The positive impact of gamification in imparting nutritional knowledge and combating childhood obesity: A systematic review on the recent solutions. Digit Health 2023. [DOI: 10.1177/20552076231154380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Objective This paper reviews the recent gamified interventions that focus on the dietary factor to explore the effectiveness of using gaming elements in combating the prevalence of childhood obesity. Methods Two electronic databases were searched (PubMed and ProQuest); to identify the relevant papers published between 2018 and 2021. The keywords that use to search the entire selected databases were gamification and obesity. There were no restrictions regarding the language. Two independent reviewers screened the titles, abstracts, and keywords for relevance. Results 407 papers were identified initially, while only 18 articles met the inclusion criteria. Most of the included articles indicated the positive impact of gamification on changing children eating behaviors. This systematic review summarizes the theories followed in developing such interventions and suggests some other theories to use and follow. Moreover, we synthesized the main findings into six recommendations that would assist in combating the global concern regarding childhood obesity if IS/IT researchers and other implement them during the development of any IT intervention. Conclusions Using gamification and gaming elements in imparting nutritional knowledge to children and improving their eating habits and behaviors is considered effective generally. It provides them with the needed knowledge and promotes the acquisition of better habits within enjoyable environment.
Collapse
Affiliation(s)
- Athir S Alghamdi
- Department of Information Systems, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hind H Bitar
- Department of Information Systems, King Abdulaziz University, Jeddah, Saudi Arabia
| |
Collapse
|
2
|
Aboye GT, Vande Walle M, Simegn GL, Aerts JM. mHealth in sub-Saharan Africa and Europe: A systematic review comparing the use and availability of mHealth approaches in sub-Saharan Africa and Europe. Digit Health 2023; 9:20552076231180972. [PMID: 37377558 PMCID: PMC10291558 DOI: 10.1177/20552076231180972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Background mHealth can help with healthcare service delivery for various health issues, but there's a significant gap in the availability and use of mHealth systems between sub-Saharan Africa and Europe, despite the ongoing digitalization of the global healthcare system. Objective This work aims to compare and investigate the use and availability of mHealth systems in sub-Saharan Africa and Europe, and identify gaps in current mHealth development and implementation in both regions. Methods The study adhered to the PRISMA 2020 guidelines for article search and selection to ensure an unbiased comparison between sub-Saharan Africa and Europe. Four databases (Scopus, Web of Science, IEEE Xplore, and PubMed) were used, and articles were evaluated based on predetermined criteria. Details on the mHealth system type, goal, patient type, health concern, and development stage were collected and recorded in a Microsoft Excel worksheet. Results The search query produced 1020 articles for sub-Saharan Africa and 2477 articles for Europe. After screening for eligibility, 86 articles for sub-Saharan Africa and 297 articles for Europe were included. To minimize bias, two reviewers conducted the article screening and data retrieval. Sub-Saharan Africa used SMS and call-based mHealth methods for consultation and diagnosis, mainly for young patients such as children and mothers, and for issues such as HIV, pregnancy, childbirth, and child care. Europe relied more on apps, sensors, and wearables for monitoring, with the elderly as the most common patient group, and the most common health issues being cardiovascular disease and heart failure. Conclusion Wearable technology and external sensors are heavily used in Europe, whereas they are seldom used in sub-Saharan Africa. More efforts should be made to use the mHealth system to improve health outcomes in both regions, incorporating more cutting-edge technologies like wearables internal and external sensors. Undertaking context-based studies, identifying determinants of mHealth systems use, and considering these determinants during mHealth system design could enhance mHealth availability and utilization.
Collapse
Affiliation(s)
- Genet Tadese Aboye
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
- School of Biomedical Engineering, Jimma University, Jimma, Ethiopia
| | - Martijn Vande Walle
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| | | | - Jean-Marie Aerts
- M3-BIORES (Measure, Model & Manage Bioreponses), Division of Animal and Human Health Engineering, Department of Biosystems, KU Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Caon M, Prinelli F, Angelini L, Carrino S, Mugellini E, Orte S, Serrano JCE, Atkinson S, Martin A, Adorni F. PEGASO e-Diary: User Engagement and Dietary Behavior Change of a Mobile Food Record for Adolescents. Front Nutr 2022; 9:727480. [PMID: 35369096 PMCID: PMC8970185 DOI: 10.3389/fnut.2022.727480] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Background Obesity amongst children and adolescents is becoming a major health problem globally and mobile food records can play a crucial role in promoting healthy dietary habits. Objective To describe the methodology for the implementation of the e-Diary mobile food record, to assess its capability in promoting healthy eating habits, to evaluate the factors associated with its usage and engagement. Methods This is a descriptive study that compared the characteristics of participants engaged in the e-Diary, which was part of the PEGASO project in which an app to provide proactive health promotion was given to 365 students at 4 European sites enrolled during October to December 2016: England (UK), Scotland (UK), Lombardy (Italy), and Catalonia (Spain). The e-Diary tracked the users' dietary habits in terms of food groups, dietary indexes, and 6 dietary target behaviors relating to consumption of: fruit; vegetable; breakfast; sugar-sweetened beverages; fast-food; and snacks. The e-Diary provided also personalized suggestions for the next meal and gamification. Results The e-Diary was used for 6 months by 357 adolescents (53.8% females). The study showed that females used the e-Diary much more than males (aOR 3.8, 95% CI 1.6-8.8). Participants aged 14 years were more engaged in the e-Diary than older age groups (aOR 5.1, 95% CI 1.4-18.8) as were those with a very good/excellent self-perceived health status compared to their peers with fair/poor health perception (aOR 4.2, 95% CI 1.3-13.3). Compared to the intervention sites, those living in Catalonia (aOR 13.2 95% CI 2.5-68.8) were more engaged. In terms of behavior change, a significant positive correlation between fruit (p < 0.0001) and vegetables (p = 0.0087) intake was observed in association with increased engagement in the e-Diary. Similarly, adolescents who used the app for more than 2 weeks had significantly higher odds of not skipping breakfast over the study period (aOR 2.5, 95% CI 1.0-6.3). Conclusions The users highly engaged with the e-Diary were associated with improved dietary behaviors: increased consumption of fruit and vegetables and reduced skipping of breakfast. Although the overall usage of the e-Diary was high during the first weeks, it declined thereafter. Future applications should foster user engagement, particularly targeting adolescents at high risk. Clinical Trial Registration https://www.clinicaltrials.gov/, identifier: NCT02930148.
Collapse
Affiliation(s)
- Maurizio Caon
- School of Management, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland,*Correspondence: Maurizio Caon
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| | - Leonardo Angelini
- School of Management, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland,College of Engineering, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Stefano Carrino
- Haute Ecole Arc Ingénierie, University of Applied Sciences and Arts Western Switzerland (HES-SO), St. Imier, Switzerland
| | - Elena Mugellini
- College of Engineering, University of Applied Sciences and Arts Western Switzerland (HES-SO), Fribourg, Switzerland
| | - Silvia Orte
- eHealth Unit, Center Tecnològic de Catalunya (Eurecat), Barcelona, Spain
| | | | - Sarah Atkinson
- Human Factors Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Anne Martin
- United Kingdom Medical Research Council/Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Fulvio Adorni
- Institute of Biomedical Technologies, National Research Council, Segrate, Italy
| |
Collapse
|
4
|
Puigdomenech E, Martin A, Lang A, Adorni F, Gomez SF, McKinstry B, Prinelli F, Condon L, Rashid R, Caon M, Atkinson S, Lafortuna CL, Ciociola V, Hanley J, McCloughan L, Castell C, Espallargues M. Correction to: Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial. BMC Med Inform Decis Mak 2021; 21:337. [PMID: 34847949 PMCID: PMC8630892 DOI: 10.1186/s12911-021-01686-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Elisa Puigdomenech
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Catalan Department of Health, Roc Boronat 81-95, 2nd floor, 08005, Barcelona, Spain.
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, Roc Boronat 81-95, 2nd floor, 08005, Barcelona, Spain.
| | - Anne Martin
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, 200 Renfield Street, Glasgow, G2 3AX, UK
| | - Alexandra Lang
- Human Factors Research Group, Faculty of Engineering, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Fulvio Adorni
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi, 93, 20090, Segrate, MI, Italy
| | - Santiago Felipe Gomez
- Programs Department Gasol Foundation, 26-28 Jaume I street, 08830, Sant Boi de Llobregat, Spain
- GREpS. Health Education Research Group, Nursing and Phisiotherapy Department, University of Lleida, 2 Montserrat Roig street, 25198, Lleida, Spain
| | - Brian McKinstry
- Usher Institute, University of Edinburgh, NINE Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
| | - Federica Prinelli
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi, 93, 20090, Segrate, MI, Italy
| | - Laura Condon
- PRISM Research Group, Division of Primary Care, School of Medicine, University of Nottingham, Room 1404, Tower Building, University Park, Nottingham, NG7 2RD, UK
| | - Rajeeb Rashid
- Deanery of Clinical Sciences, College of Medicine and Veterinary Medicine, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh BioQuarter, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Maurizio Caon
- College of Engineering and School of Management, University of Applied Sciences and Arts Western Switzerland (HES-SO), chemin du musée 4n, 1700, Fribourg, Switzerland
| | - Sarah Atkinson
- Human Factors Research Group, Faculty of Engineering, The University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Claudio L Lafortuna
- Consiglio Nazionale delle Ricerche, Istituto di Fisiologia Clinica, Piazza Ospedale Maggiore, 3, 20162, Milano, Italy
| | - Valentina Ciociola
- National Research Council, Institute of Biomedical Technologies, Via Fratelli Cervi, 93, 20090, Segrate, MI, Italy
| | - Janet Hanley
- School of Health and Social Care, Edinburgh Napier University, Sighthill Court, Edinburgh, EH41 3ND, UK
| | - Lucy McCloughan
- Usher Institute, University of Edinburgh, NINE Edinburgh BioQuarter, 9 Little France Road, Edinburgh, EH16 4UX, UK
| | - Conxa Castell
- Catalonia Public Health Agency, Catalan Department of Health, Roc Boronat 81-95, 3rd floor, 08005, Barcelona, Spain
| | - Mireia Espallargues
- Agency for Health Quality and Assessment of Catalonia (AQuAS), Catalan Department of Health, Roc Boronat 81-95, 2nd floor, 08005, Barcelona, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, Roc Boronat 81-95, 2nd floor, 08005, Barcelona, Spain
| |
Collapse
|
5
|
Schwarz A, Cardon G, Chastin S, Stragier J, De Marez L, DeSmet A. Does Dynamic Tailoring of A Narrative-Driven Exergame Result in Higher User Engagement among Adolescents? Results from A Cluster-Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147444. [PMID: 34299895 PMCID: PMC8305797 DOI: 10.3390/ijerph18147444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/29/2021] [Accepted: 07/08/2021] [Indexed: 11/25/2022]
Abstract
Physical activity interventions for youth are direly needed given low adherence to physical activity guidelines, but many interventions suffer from low user engagement. Exergames that require bodily movement while played may provide an engaging form of physical activity intervention but are not perceived as engaging to all. This study aimed to evaluate whether dynamic tailoring in a narrative-driven mobile exergame for adolescents played in leisure settings, can create higher user engagement compared to a non-tailored exergame. A cluster-randomized controlled trial assessed differences in user engagement between a dynamically tailored (based on an accelerometer sensor integrated in a T-shirt) and non-tailored condition. In total, 94 participants (M age = 14.61 ± 1.93; 35% female) participated and were assigned to one of the two conditions. User engagement was measured via a survey and game metric data. User engagement was low in both conditions. Narrative sensation was higher in the dynamically tailored condition, but the non-tailored condition showed longer play-time. User suggestions to create a more appealing game included simple and more colorful graphics, avoiding technical problems, more variety and shorter missions and multiplayer options. Less cumbersome or more attractive sensing options than the smart T-shirt may offer a more engaging solution, to be tested in future research.
Collapse
Affiliation(s)
- Ayla Schwarz
- Consumption and Healthy Lifestyles, Faculty of Social Sciences, Wageningen University & Research, 6708 PB Wageningen, The Netherlands;
| | - Greet Cardon
- Department of Movement and Sport Sciences, Ghent University, 9000 Ghent, Belgium;
| | - Sebastien Chastin
- School of Health and Life Science, Caledonian University, Glasgow G4 0BA, UK;
| | - Jeroen Stragier
- IMEC-MICT, Department of Communication Sciences, Ghent University, 9000 Ghent, Belgium; (J.S.); (L.D.M.)
| | - Lieven De Marez
- IMEC-MICT, Department of Communication Sciences, Ghent University, 9000 Ghent, Belgium; (J.S.); (L.D.M.)
| | - Consortium SmartLife
- KnowledgeBizConsulting, and Faculdade de Ciências e Tecnologia, Universidade NOVA, 1099-085 Lisbon, Portugal;
| | - Ann DeSmet
- Research Center for the Promotion of Health, Prosocial Behavior and Wellbeing PACE, Faculty of Psychological and Educational Sciences, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Department of Communication Studies, University of Antwerp, 2000 Antwerp, Belgium
- Correspondence: ; Tel.: +32-(26)-503282
| |
Collapse
|
6
|
Carmo TRGD, Santos RLD, Magalhães BDC, Silva RA, Dantas MB, Silva VMD. Competencies in health promotion by nurses for adolescents. Rev Bras Enferm 2021; 74Suppl 4:e20200118. [PMID: 34105643 DOI: 10.1590/0034-7167-2020-0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 08/30/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to describe the health promotion competency domains, performed by nurses, for adolescents, according to the Galway Consensus. METHOD a qualitative study based on the Galway Consensus theoretical methodological framework. Fifteen nurses from northeastern Brazil participated. Data were collected between April and May 2017 through pre-structured interviews, submitted to the content analysis technique and analyzed according to the Galway Consensus dimensions. RESULTS the following competency areas were found: catalyzing changes, leadership, needs assessment, planning, implementation, and partnerships. These competencies were contemplated from embracement of adolescents at health unit, guidance, teamwork, educational activities and lectures, as well as active search. CONCLUSION most health promotion domains were observed; however, it is still suggested that there are challenges to an effective performance of health promotion among adolescents because some competency domains in health promotion have not been evidenced.
Collapse
Affiliation(s)
| | | | | | - Renan Alves Silva
- Universidade Federal do Espírito Santo. São Mateus, Espírito Santo, Brazil
| | | | | |
Collapse
|
7
|
Zmora N, Elinav E. Harnessing SmartPhones to Personalize Nutrition in a Time of Global Pandemic. Nutrients 2021; 13:nu13020422. [PMID: 33525593 PMCID: PMC7911023 DOI: 10.3390/nu13020422] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/10/2023] Open
Abstract
The soar in COVID-19 cases around the globe has forced many to adapt to social distancing and self-isolation. In order to reduce contact with healthcare facilities and other patients, the CDC has advocated the use of telemedicine, i.e., electronic information and telecommunication technology. While these changes may disrupt normal behaviors and routines and induce anxiety, resulting in decreased vigilance to healthy diet and physical activity and reluctance to seek medical attention, they may just as well be circumvented using modern technology. Indeed, as the beginning of the pandemic a plethora of alternatives to conventional physical interactions were introduced. In this Perspective, we portray the role of SmartPhone applications (apps) in monitoring healthy nutrition, from their basic functionality as food diaries required for simple decision-making and nutritional interventions, through more advanced purposes, such as multi-dimensional data-mining and development of machine learning algorithms. Finally, we will delineate the emerging field of personalized nutrition and introduce pioneering technologies and concepts yet to be incorporated in SmartPhone-based dietary surveillance.
Collapse
Affiliation(s)
- Niv Zmora
- Immunology Department, Weizmann Institute of Science, Rehovot 7610001, Israel;
- The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel
- The Research Center for Digestive Tract and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv 6423906, Israel
| | - Eran Elinav
- Immunology Department, Weizmann Institute of Science, Rehovot 7610001, Israel;
- Division of Cancer-Microbiome Research, DKFZ, 69120 Heidelberg, Germany
- Correspondence: or
| |
Collapse
|
8
|
Perego P, Rashid R, Gluud C, Jakobsen JC, Andreoni G, Lissau I. Comparison of different mobile health applications for intervention in children and adolescent with overweight: a protocol for systematic review with meta-analysis and trial sequential analysis. BMJ Open 2020; 10:e032570. [PMID: 33293302 PMCID: PMC7722812 DOI: 10.1136/bmjopen-2019-032570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/07/2020] [Accepted: 08/12/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Overweight in children is increasing worldwide. Innovative smartphone health applications (mHealth apps) have either sought to deliver single or multi-component interventions for the management of overweight in children. However, the clinical effects of these apps are poorly explored. The objective of the review will be to compare the benefits and harms of different categories of mHealth apps for intervention of overweight in children. METHODS AND ANALYSIS We will include randomised clinical trials irrespective of publication type, year, status or language. Children and adolescents between 0 to 18 years will be referred to as children in the remaining part of the paper. Children with all degrees of overweight included obesity and morbidly obese in the remaining part of the paper will be referred to as overweight. We plan to classify different apps according to type of intervention, measurement device, coaching and reward system. The following databases will be used: Cochrane Library, Excerpta Medica database (Embase), PsycINFO, PubMed, IEEE Explore and Web of Science, CINAHL and LILACS. Primary outcomes will be body mass index z-score, quality of life and serious adverse event. Secondary outcomes will be body weight, self-efficacy, anxiety, depression and adverse event not considered serious. Study inclusion, data extraction and bias risk assessment will be conducted independently by at least two authors. We will assess the risk of bias through eight domains and control risks of random errors with Trial Sequential Analysis. The quality of the evidence will be assessed using Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE). ETHICS AND DISSEMINATION As the protocol is for a systematic reviews, we have not included any patient data and we do not require ethical approval. This review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42019120266.
Collapse
Affiliation(s)
- Paolo Perego
- Design Department, Politecnico di Milano, Milano, MI, Italy
| | - Rajeeb Rashid
- Department of Child Life and Health, The University of Edinburgh, Edinburgh, UK
| | - Christian Gluud
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Janus C Jakobsen
- The Copenhagen Trial Unit, Centre for Clinical Intervention Research, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Cardiology, Holbaek Sygehus, Holbaek, Sjaelland, Denmark
| | | | - Inge Lissau
- Clinical Research Centre, University Hospital Copenhagen, Copenhagen, Hvidovre, Denmark
| |
Collapse
|
9
|
Martin A, Caon M, Adorni F, Andreoni G, Ascolese A, Atkinson S, Bul K, Carrion C, Castell C, Ciociola V, Condon L, Espallargues M, Hanley J, Jesuthasan N, Lafortuna CL, Lang A, Prinelli F, Puidomenech Puig E, Tabozzi SA, McKinstry B. A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study. JMIR Mhealth Uhealth 2020; 8:e14118. [PMID: 32130179 PMCID: PMC7076410 DOI: 10.2196/14118] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/20/2019] [Accepted: 12/16/2019] [Indexed: 02/06/2023] Open
Abstract
Background Promotion of physical activity, healthy eating, adequate sleep, and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of noncommunicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mobile health (mHealth) technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology. Objective This study aimed to describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future (F4F) mHealth intervention for adolescents from different cultural backgrounds. Methods A total of 74 adolescents aged 13 to 16 years from Spain, Italy, and the United Kingdom participated in the co-design of the PEGASO F4F technology. In 3 iterative cycles over 12 months, participants were involved in the co-design, refinement, and feasibility testing of a system consisting of diverse mobile apps with a variety of functions and facilities to encourage healthy weight–promoting behaviors. In the first iteration, participants attended a single workshop session and were presented with mock-ups or early-version prototypes of different apps for user requirements assessment and review. During the second iteration, prototypes of all apps were tested by participants for 1 week at home or school. In the third iteration, further developed prototypes were tested for 2 weeks. Participants’ user experience feedback and development ideas were collected through focus groups and completion of questionnaires. Results For the PEGASO F4F technology to be motivating and engaging, participants suggested that it should (1) allow personalization of the interface, (2) have age-appropriate and easy-to-understand language (of icons, labels, instructions, and notifications), (3) provide easily accessible tutorials on how to use the app or navigate through a game, (4) present a clear purpose and end goal, (5) have an appealing and self-explanatory reward system, (6) offer variation in gamified activities within apps and the serious game, and (7) allow to seek peer support and connect with peers for competitive activities within the technology. Conclusions Incorporating adolescents’ preferences, the PEGASO F4F technology combines the functions of a self-monitoring, entertainment, advisory, and social support tool. This was the first study demonstrating that it is possible to develop a complex mobile phone-based technological system applying the principles of co-design to mHealth technology with adolescents across 3 countries. The findings from this study informed the development of an mHealth system for healthy weight promotion to be tested in a controlled multinational pilot trial.
Collapse
Affiliation(s)
- Anne Martin
- UK Medical Research Council / Chief Scientist Office Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Maurizio Caon
- Haute Ecole de Gestion and Haute Ecole d'Ingénierie et d'Architecture, University of Applied Sciences and Arts of Western Switzerland, Fribourg, Switzerland
| | - Fulvio Adorni
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | | | | | - Sarah Atkinson
- Human Factors Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Kim Bul
- Centre for Innovative Research Across the Life Course, Coventry University, Coventry, United Kingdom
| | - Carme Carrion
- eHealth Lab Research eGroup, Universitat Oberta de Catalunya, Barcelona, Spain
| | | | - Valentina Ciociola
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Laura Condon
- Division of Primary Care, University of Nottingham, Nottingham, United Kingdom
| | - Mireia Espallargues
- Catalan Agency for Health Information, Assessment and Quality, Barcelona, Spain.,Health Services Research on Chronic Patients Network, Barcelona, Spain
| | - Janet Hanley
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Nithiya Jesuthasan
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Claudio L Lafortuna
- Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy
| | - Alexandra Lang
- Human Factors Research Group, University of Nottingham, Nottingham, United Kingdom
| | - Federica Prinelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Elisa Puidomenech Puig
- Catalan Agency for Health Information, Assessment and Quality, Barcelona, Spain.,Health Services Research on Chronic Patients Network, Barcelona, Spain
| | - Sarah A Tabozzi
- Institute of Molecular Bioimaging and Physiology, National Research Council, Milan, Italy
| | - Brian McKinstry
- Usher Institute for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|