Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention

Liu, Sam; Smith, Nicholas; Nuss, Kayla; Perdew, Megan; Adiputranto, Dimas; Naylor, Patti-Jean

doi:10.2196/36770

Cited by 3 publications

(5 citation statements)

References 31 publications

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“…The virtual delivery format has the potential to improve the flexibility and scalability of family-based lifestyle programs designed for children who are overweight or obese. The results from this study add to the existing body of literature showing the effectiveness of virtual and online health interventions [31,[34][35][36]. The family feedback received (eg, reminder sessions, portal tutorials, and maintenance programs) can help inform future virtual intervention designs.…”

Section: Discussionmentioning

confidence: 69%

“…In our previous study evaluating the dose-response relationship of the blended GH program, we showed that the online GH portal complemented the in-person GH sessions. Specifically, additional engagements with the portal were associated with greater improvements in child physical activity and parental support behaviors, habits, and identity for physical activity [34]. Future research is warranted to explore the dose-response relationship for the virtual GH program.…”

Section: Discussionmentioning

confidence: 98%

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Evaluating the Effectiveness of a Family-Based Virtual Childhood Obesity Management Program Delivered During the COVID-19 Pandemic in Canada: Prospective Study

Nuss¹,

DeSilva²,

Buenafe³

et al. 2022

JMIR Pediatr Parent

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Background Generation Health (GH) is a 10-week family-based lifestyle program designed to promote a healthy lifestyle for families with children who are off the healthy weight trajectory in British Columbia, Canada. GH uses a blended delivery format that involves 10 weekly in-person sessions, and self-guided lessons and activities on a web portal. The blended program was adapted to be delivered virtually due to the COVID-19 pandemic. Currently, the effectiveness of the virtual GH program compared with that of the blended GH program remains unclear. Objective We aimed to (1) compare the effectiveness of the virtual GH program delivered during the COVID-19 pandemic with that of the blended GH program delivered prior to the pandemic for changing child physical activity, sedentary and dietary behaviors, screen time, and parental support–related behaviors for child physical activity and healthy eating, and (2) explore virtual GH program engagement and satisfaction. Methods This study used a single-arm pre-post design. The blended GH program (n=102) was delivered from January 2019 to February 2020, and the virtual GH program (n=90) was delivered during the COVID-19 pandemic from April 2020 to March 2021. Families with children aged 8-12 years and considered overweight or obese (BMI ≥85th percentile according to age and sex) were recruited. Participants completed preintervention and postintervention questionnaires to assess the children’s physical activity, dietary and sedentary behaviors, and screen time, and the parent’s support behaviors. Intervention feedback was obtained by interviews. Repeated measures ANOVA was used to evaluate the difference between the virtual and blended GH programs over time. Qualitative interviews were analyzed using thematic analyses. Results Both the virtual and blended GH programs improved children’s moderate-to-vigorous physical activity (F1,380=18.37; P<.001; ηp2=0.07) and reduced screen time (F1,380=9.17; P=.003; ηp2=0.06). However, vegetable intake was significantly greater in the virtual GH group than in the blended GH group at the 10-week follow-up (F1,380=15.19; P<.001; ηp2=0.004). Parents in both groups showed significant improvements in support behaviors for children’s physical activity (F1,380=5.55; P=.02; ηp2=0.002) and healthy eating (F1,380=3.91; P<.001; ηp2=0.01), as well as self-regulation of parental support for children’s physical activity (F1,380=49.20; P<.001; ηp2=0.16) and healthy eating (F1,380=91.13; P<.001; ηp2=0.28). Families in both groups were satisfied with program delivery. There were no significant differences in attendance for the weekly in-person or group video chat sessions; however, portal usage was significantly greater in the virtual GH group (mean 50, SD 55.82 minutes) than in the blended GH group (mean 17, SD 15.3 minutes; P<.001). Conclusions The study findings suggested that the virtual GH program was as effective as the blended program for improving child lifestyle behaviors and parental support–related behaviors. The virtual program has the potential to improve the flexibility and scalability of family-based childhood obesity management interventions.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 98%

Evaluating the Effectiveness of a Family-Based Virtual Childhood Obesity Management Program Delivered During the COVID-19 Pandemic in Canada: Prospective Study

Nuss¹,

DeSilva²,

Buenafe³

et al. 2022

JMIR Pediatr Parent

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“…The 10-week hypertension management program was selected for adaptation for its proven success in improving PA levels (ie, daily steps) and blood pressure [30]. Furthermore, the research team evaluated the past success of the M-PAC framework in various web-based interventions that promote PA [31][32][33] and deemed this framework appropriate to guide an 8-week mHealth app.…”

Section: Steps 1 and 2: Empathize With Target Users And Specify Targe...mentioning

confidence: 99%

“…The second step of the integrate stage is to specify the target behavior to be used in the intervention. To do this, the research team reviewed the current public health guidelines [3,34] and conducted a literature search of empirical evidence to determine the optimal method for delivering an M-PAC PA intervention through a smartphone [31][32][33].…”

Section: Steps 1 and 2: Empathize With Target Users And Specify Targe...mentioning

confidence: 99%

The Development of a Hypertension Prevention and Financial-Incentive mHealth Program Using a “No-Code” Mobile App Builder: Development and Usability Study

Willms¹,

Rhodes²,

Liu³

2023

JMIR Form Res

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Background Regular physical activity (PA) is a key lifestyle component for hypertension prevention. Previous studies have shown that mobile health (mHealth) apps can be an effective tool for improving PA behaviors. However, adherence to and poor engagement with these apps is a challenge. A potential solution to overcome this challenge may be to combine financial incentives with innovative behavior theory, such as the Multiprocess Action Control (M-PAC) framework. Currently, there is a lack of PA financial incentive–driven M-PAC mHealth programs aimed at hypertension prevention. Objective We aimed to describe the process of developing an 8-week mHealth PA and financial-incentive hypertension education program (Healthy Hearts) and to evaluate usability of the Healthy Hearts program. Methods The first 2 stages of the Integrate, Design, Assess, and Share framework were used to guide the development of the Healthy Hearts program. The development process consisted of 2 phases. In phase 1, the research team met to discuss implementing the M-PAC framework to adopt an existing web-based hypertension prevention program to a mobile app. The app was developed using a no-code app development platform, Pathverse (Pathverse Inc), to help decrease overall development time. In phase 2, we created a prototype and conducted usability testing to evaluate lesson 1 of the Healthy Hearts program to further enhance the user experience. We used semistructured interviews and the mHealth App Usability Questionnaire to evaluate program acceptability and usability. Results Intervention development among the research team successfully created an 8-week financial-incentive hypertension education program for adults aged 40-65 years who did not currently meet the Canadian Physical Activity Guidelines (<150 minutes of moderate to vigorous PA per week). This program lasted 8 weeks and comprised 25 lessons guided by the M-PAC framework. The program used various behavior change techniques to further support PA adherence. Usability testing of the first lesson was successful, with 6 participants recruited for 2 rounds of testing. Feedback was gathered to enhance the content, layout, and design of the Healthy Hearts program to prepare the mHealth program for feasibility testing. Results of round 1 of usability testing suggested that the content delivered in the lessons was long. Therefore, the content was divided into multiple lessons before round 2 of usability testing, where feedback was only on design preferences. A minimum viable product was created with these results. Conclusions The iterative development process and the usability assessments suggested by the Integrate, Design, Assess, and Share framework enabled participants to provide valuable feedback on the content, design, and layout of the program before advancing to feasibility testing. Furthermore, the use of the “no-code” app development tool enabled our team to rapidly make changes to the app based on user feedback during the iterative design process.

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“…Importantly, continuance of PA requires the development of reflexive processes of action control via habit and identity formation. While the overall evidence for the M-PAC framework is accumulating across populations for PA promotion including cancer populations ( Liu et al, 2022a ; Trinh et al, 2021 ; Perdew et al, 2021 ; Vallerand et al, 2018 ), to our knowledge, no application (app) intervention has been developed based on this framework.…”

Section: Introductionmentioning

confidence: 99%

Development and usability testing of a technology-based intervention for promoting physical activity among post-treatment cancer survivors (WExercise) using the multi-process action control framework

Cheung,

Kwok,

Liu

et al. 2024

Internet Interventions

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Dose-Response Relationship of a Blended In-Person and Online Family-Based Childhood Obesity Management Program: Secondary Analysis of a Behavior Intervention

Cited by 3 publications

References 31 publications

Evaluating the Effectiveness of a Family-Based Virtual Childhood Obesity Management Program Delivered During the COVID-19 Pandemic in Canada: Prospective Study

Evaluating the Effectiveness of a Family-Based Virtual Childhood Obesity Management Program Delivered During the COVID-19 Pandemic in Canada: Prospective Study

The Development of a Hypertension Prevention and Financial-Incentive mHealth Program Using a “No-Code” Mobile App Builder: Development and Usability Study

Development and usability testing of a technology-based intervention for promoting physical activity among post-treatment cancer survivors (WExercise) using the multi-process action control framework

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