Taki Sarah, Russell Catherine Georgina, Lymer Sharyn, Laws Rachel, Campbell Karen, Appleton Jessica, Ong Kok-Leong, Denney-Wilson Elizabeth
Health Promotion Unit, Population Health, Sydney Local Health District, Camperdown, NSW, Australia.
Sydney School of Public Health, Faculty of Medicine and Health, Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia.
Front Endocrinol (Lausanne). 2019 Jun 25;10:397. doi: 10.3389/fendo.2019.00397. eCollection 2019.
Mobile health (mHealth) interventions have great potential to promote health. To increase consumer engagement in mHealth interventions it is necessary to address factors that influence the target demographic. The Growing healthy (GH) program is the first obesity prevention program delivered via a smartphone app and website offering evidence-based information on infant feeding from birth until 9 months of age. This sub-study aimed to explore how the design features, quality of the app and participant characteristics influenced parents' engagement with the GH app. A sequential mixed methods design was used. The GH app participants (225/301) were considered for this sub-study. Participant app engagement was measured through a purpose-built Engagement Index (EI) using app metrics. Participants were categorized as low, moderately or highly engaged based on their EI score upon completing the 9 months program and were then invited to participate in semi-structured telephone interviews. Participants who used the app program, given an EI score and expressed interest to participate in these interviews were eligible. The interviews explored factors that influenced app engagement including delivery features and quality. Thematic analysis networks was used for analysis. 108/225 expressed interest and 18 interviews were conducted from low ( = 3), moderately ( = 7), or highly ( = 8) engaged participants based on purposeful sampling. Participants defined as highly engaged were likely to be a first-time parent, felt the app content to be trustworthy and the app design facilitated easy navigation and regularly opened the push notifications. Participants defined as having low or moderate engagement were likely to have experience from previous children, felt they had sufficient knowledge on infant feeding and the app did not provide further information, or experienced technological issues including app dysfunction due to system upgrades. This study demonstrated a novel approach to comprehensively analyse engagement in an mHealth intervention through quantitative (Engagement Index) and qualitative (interviews) methods. It provides an insight on maximizing data collected from these programs for measuring effectiveness and to understand users of various engagement levels interaction with program features. Measuring this can determine efficacy and refine programs to meet user requirements.
移动健康（mHealth）干预措施在促进健康方面具有巨大潜力。为了提高消费者对mHealth干预措施的参与度，有必要解决影响目标人群的因素。“健康成长”（GH）计划是首个通过智能手机应用程序和网站提供从出生到9个月大婴儿喂养循证信息的肥胖预防计划。这项子研究旨在探讨设计特点、应用程序质量和参与者特征如何影响家长对GH应用程序的参与度。研究采用了序列混合方法设计。本项子研究纳入了GH应用程序的参与者（225/301）。通过使用应用程序指标的专用参与指数（EI）来衡量参与者对应用程序的参与度。根据参与者在完成9个月计划后的EI得分，将其分为低参与度、中等参与度或高参与度，然后邀请他们参加半结构化电话访谈。使用应用程序计划、获得EI得分并表示有兴趣参加这些访谈者符合条件。访谈探讨了影响应用程序参与度的因素，包括提供的功能和质量。采用主题分析网络进行分析。基于目的抽样，108/225名参与者表示有兴趣，对低参与度（n = 3）、中等参与度（n = 7）或高参与度（n = 8）的参与者进行了18次访谈。被定义为高参与度的参与者可能是初为人父母者，认为应用程序内容值得信赖，应用程序设计便于操作且经常打开推送通知。被定义为低参与度或中等参与度的参与者可能有养育过孩子的经验，觉得自己对婴儿喂养有足够的了解，应用程序没有提供更多信息，或者遇到过技术问题，包括由于系统升级导致应用程序功能失调。这项研究展示了一种通过定量（参与指数）和定性（访谈）方法全面分析mHealth干预措施中参与度的新方法。它为最大限度地收集这些计划的数据以衡量有效性以及了解不同参与水平的用户与计划功能的交互提供了见解。对此进行测量可以确定效果并优化计划以满足用户需求。
