Describing the Process and Tools Adopted to Cocreate a Smartphone App for Obesity Prevention in Childhood: Mixed Method Study

Abstract

Background Childhood obesity prevention is a public health priority in industrialized countries. The Reggio Emilia Local Health Authority has implemented a program involving primary and secondary prevention as well as the care of obese children. There are many health-promoting mobile apps, but few are targeted to children and very few are sponsored by public health agencies. Objective The goal of the research was to describe the process and tools adopted to cocreate a mobile app sponsored by the Reggio Emilia Local Health Authority to be installed in parents’ phones aimed at promoting child health and preventing obesity. Methods After stakeholder mapping, a consulting committee including relevant actors, stakeholders, and users was formed. Key persons for childhood obesity prevention were interviewed, focus groups with parents and pediatricians were conducted, and community reporting storytelling was collected. The results of these activities were presented to the consulting committee in order to define the functionalities and contents of the mobile app. Results Three key trends emerged from community reporting: being active, playing, and being outdoors; time for oneself, family, and friends; and the pressures of life and work and not having time to be active and socialize. In focus groups, interviews, and labs, mothers showed a positive attitude toward using an app to manage their children's weight, while pediatricians expressed concerns that the app could increase their workload. When these findings were explored by the consulting committee, four key themes were extracted: strong relationships with peers, family members, and the community; access to safe outdoor spaces; children’s need for age-appropriate independence; and professional support should be nonjudgmental and stigma-free. It should be a dialogue that promotes family autonomy. The app functions related to these needs include the following: (1) newsletter with anticipatory guidance, recipes, and vaccination and well-child visit reminders; (2) regional map indicating where physical activity can be done; (3) information on how to manage emergencies (eg, falls, burns, fever); (4) module for reinforcing the counseling intervention conducted by pediatricians for overweight children; and (5) a function to build a balanced daily diet. Conclusions The pilot study we conducted showed that cocreation in health promotion is feasible, with the consulting committee being the key co-governance and cocreation tool. The involvement of stakeholders in this committee made it possible to expand the number of persons and institutions actively contributing to the project.

Factors influencing user acceptance of weight management apps among Chinese obese individuals during the COVID-19 pandemic

“…Health awareness, as a new construct in the theoretical model of user adoption of health management apps, did not release a significant effect on behavioral intention. Health awareness determines behavioral intention in numerous situations from previous research literature on factors influencing health behavior, e.g., juvenile workers toward influenza vaccination, self-monitoring via digital health in weight loss interventions [5] , the adoption of mHealth services in a developing country [13] , and smartphone apps for obesity prevention in childhood [22] . Possible reasons why health awareness does not significantly affect the behavioral intention of overweight or obese patients using health management apps include: the nationwide awakening of health awareness among users in mainland China, so that the influence of health awareness on behavioral intention cannot be effectively distinguished [32] ; the survey data was collected from the 2-year period of the COVID-19 pandemic, and numerous users gradually shaped their intention to use health management apps, which did not happen in sync with health awareness.…”

“…In the context of user acceptance of eHealth systems, perceived risk includes multi-dimensional constructs such as financial risk, social risk, product risk, and security risk [21] . Most weight management apps require users to provide detailed information, including name, gender, age, address, weight, diet, real-time location, and the security of these sensitive private information is a serious concern for users [22] . Thus, we hypothesize:…”

Parents’ Perceptions of Children’s and Adolescents’ Use of Electronic Devices to Promote Physical Activity: Systematic Review of Qualitative Evidence

“…For data collection, 12 (67%) studies [30][31][32][33][34][35][36][37][38][39][40][41] used focus groups with semistructured interviews, 7 (39%) [20,30,[42][43][44][45][46] used individual interviews, and 1 (6%) [41] used nonparticipant observation. Regarding the electronic devices analyzed, 5 (28%) studies [20,30,38,41,42] used smartphone apps, 2 (11%) [37,40] used the Pokémon GO mobile game, 1 (6%) [45] used mobile text messages, 5 (28%) [31][32][33]39,44] used activity trackers, 4 (22%) [34][35][36]43] used active video games, and 1 (6%) [46] used virtual reality. [20,30,34,35,39,40,[43][44][45].…”

“…[20,30,34,35,39,40,[43][44][45]. Other limitations were that participants and their voices were not adequately represented in 3 (17%) studies [34,36,38] and that there was no congruity between the stated philosophical perspectives and the research questions or methodology [34,35].…”

“…Teacher support was found to be an important factor in engagement [44,45]. Parents said that goals [31,45] and rewards and new challenges [38,39,43,47] are important features-for example, different levels and new challenges to accomplish [47]. In that sense, many of the parents reported that an important feature is for an app to be fun [39,42,43].…”