How can weight‐loss app designers' best engage and support users? A qualitative investigation

Abstract

Abstract:Objectives. This study explored young adults' experiences of using e-health internetbased computer or mobile phone applications (apps) and what they valued about those apps.Design and methods. A qualitative design was used. Semi-structured interviews were conducted with a community sample of 19 young adults who had used a publiclyavailable phone or internet-based application. Transcripts were analysed using thematic analysis.Results. Participants valued an attractive user interface. Structure, ease of use, personalised features and accessibility (including dual phone-computer access) were all important to participants and users indicated that continued use depended on these design features. Many believed that a focus on calorie counting was too limiting. Some users mentioned behaviour change strategies and known behaviour change techniques utilised by apps including; self-monitoring, goal setting and behavioural feedback. Only a few users reported positive changes in physical activity levels.Conclusions. Use of particular design features and application of evidence-based behaviour change techniques could optimise continued use and the effectiveness of internet/smart phone interventions. British Journal of Health PsychologyThank you for your comments and the opportunity to revise and re-submit our paper. We have been able to respond positively to all your comments.Our response to each comment (in red font) explains how we revised our paper, where necessary. We have highlighted changed text in the manuscript in red font and noted page numbers in our responses to each of the comments.We hope that our revised paper will be suitable for publication in British Journal of Health Psychology and look forward to hearing from you. Comments 1. Please add some further details about the data analysis conducted. It is not currently clear whether the themes were pre-determined and used as a basis for the analysis or if these were derived from the data. If they were predetermined -why?We employed a topic guide to ensure that participants did not stray off topic or fail to address our research questions. The themes identified emerged from the data and were not predetermined -as described in our data analysis section. We have added a sentence in the second paragraph of the results section (p6) to clarify this point.2. You refer to 'calorie counting' in the text on page 11. Please change this to e.g. selfmonitoring of calorie intake.We have now omitted 'calorie counting' in the text and replaced this with "calorie-intake monitoring" (p11, 12).3. Please rephrase the second sentence which was added to the data collection section in this revision. It is currently poorly phrased.We have now amended this sentence by dividing it into two simple sentences (p5).

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review

“…Of the 4818 titles identified from the database search, 64 articles were included: 9 reporting dietary self-monitoring trials (38)(39)(40)(41)(42)(43)(44)(45)(46), 18 reporting nutritionimprovement trials (36,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63), 30 reporting applicationdevelopment projects (37,, and 7 reporting qualitative studies with consumers (93)(94)(95)(96)(97)(98)(99). Five reports were published in 2016, 16 each in 2015 and 2014, 11 in 2013, and 16 between 2008 and 2012.…”

“…All 7 dietary self-monitoring trials (38-44), 13 nutritionimprovement trials (36, 47, 48, 50-53, 56-58, 60, 62, 63), 21 discreet application-development projects (64, 65, 68, 70, 72-80, 83, 85, 86, 88-92), and 6 qualitative application-development studies included applications with or a discussion of nutrition-relevant features (93,(95)(96)(97)(98)(99). Table 2 demonstrates the great diversity in the application features used and lists all features found within the reports.…”

“…Interactive features, an attractive user interface, and nonrepetitive images and colors were particularly important to low-SES and youngadult populations for maintaining application engagement (73,74,77,95,98). Separate interfaces for care givers and children were valued by care givers but not children (50,77).…”

“…Separate interfaces for care givers and children were valued by care givers but not children (50,77). The importance of the application being functional without an internet connection was expressed by all population groups (36,40,45,68,90,95,98), with data access particularly limited for adolescents (40). Excessive data entry for setup and logins was reportedly undesirable (36,93,98,99).…”

“…The importance of the application being functional without an internet connection was expressed by all population groups (36,40,45,68,90,95,98), with data access particularly limited for adolescents (40). Excessive data entry for setup and logins was reportedly undesirable (36,93,98,99). Crowdsourcing data from users was useful for providing a comprehensive back-end food database (53,58) and tailoring feedback on meal healthiness (62).…”