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Targeting parents for childhood weight management : development of a theory-driven and user-centered healthy eating app

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Curtis, Kristina E., Lahiri, Sudakshina and Brown, Katherine Elizabeth (2015) Targeting parents for childhood weight management : development of a theory-driven and user-centered healthy eating app. JMIR mHealth and uHealth, 3 (2). pp. 1-18. e69. doi:10.2196/mhealth.3857 ISSN 2291-5222.

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Official URL: http://dx.doi.org/10.2196/mhealth.3857

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Abstract

Background:
The proliferation of health promotion apps along with mobile phones' array of features supporting health behavior change offers a new and innovative approach to childhood weight management. However, despite the critical role parents play in children's weight related behaviors, few industry-led apps aimed at childhood weight management target parents. Furthermore, industry-led apps have been shown to lack a basis in behavior change theory and evidence. Equally important remains the issue of how to maximize users' engagement with mobile health (mHealth) interventions where there is growing consensus that inputs from the commercial app industry and the target population should be an integral part of the development process.

Objective:
The aim of this study is to systematically design and develop a theory and evidence-driven, user-centered healthy eating app targeting parents for childhood weight management, and clearly document this for the research and app development community.

Methods:
The Behavior Change Wheel (BCW) framework, a theoretically-based approach for intervention development, along with a user-centered design (UCD) philosophy and collaboration with the commercial app industry, guided the development process. Current evidence, along with a series of 9 focus groups (total of 46 participants) comprised of family weight management case workers, parents with overweight and healthy weight children aged 5-11 years, and consultation with experts, provided data to inform the app development. Thematic analysis of focus groups helped to extract information related to relevant theoretical, user-centered, and technological components to underpin the design and development of the app.

Results:
Inputs from parents and experts working in the area of childhood weight management helped to identify the main target behavior: to help parents provide appropriate food portion sizes for their children. To achieve this target behavior, the behavioral diagnosis revealed the need for eliciting change in parents' capability, motivation, and opportunity in 10-associated Theoretical Domains Framework (TDF) domains. Of the 9 possible intervention functions, 6 were selected to bring about this change which guided the selection of 21 behavior change techniques. Parents' preferences for healthy eating app features revolved around four main themes (app features, time saving and convenience, aesthetics, and gamification) whereupon a criterion was applied to guide the selection on which preferences should be integrated into the design of the app. Collaboration with the app company helped to build on users' preferences for elements of gamification such as points, quizzes, and levels to optimize user engagement. Feedback from parents on interactive mock-ups helped to inform the final development of the prototype app.

Conclusions:
Here, we fully explicate a systematic approach applied in the development of a family-oriented, healthy eating health promotion app grounded in theory and evidence, and balanced with users' preferences to help maximize its engagement with the target population.

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Science, Engineering and Medicine > Engineering > WMG (Formerly the Warwick Manufacturing Group)
Library of Congress Subject Headings (LCSH): Eating disorders in children, Obesity in children, Children -- Health and hygiene, Child health services
Journal or Publication Title: JMIR mHealth and uHealth
Publisher: JMIR Publications
ISSN: 2291-5222
Official Date: 18 June 2015
Dates:
DateEvent
18 June 2015Published
2 March 2015Accepted
11 September 2014Submitted
Volume: 3
Number: 2
Number of Pages: 18
Page Range: pp. 1-18
Article Number: e69
DOI: 10.2196/mhealth.3857
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 28 July 2016
Date of first compliant Open Access: 28 July 2016
Funder: Engineering and Physical Sciences Research Council (EPSRC)
Grant number: GR/T11371/01 (EPSRC)

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