Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia.
Pattern Health, Durham, North Carolina.
Games Health J. 2020 Aug;9(4):279-289. doi: 10.1089/g4h.2019.0060. Epub 2020 May 8.
Smartphone applications ("apps") can be used to promote health behavior change and expand the reach of behavioral interventions. To date, only a few existing apps have been developed for health promotion among adolescent survivors of childhood cancer. To address this gap, we developed an app-based intervention, using game design characteristics, theory-based behavioral strategies, and assistance from a health coach to motivate health behavior change for adolescent survivors of childhood cancer. This article describes the development and initial feasibility evaluation of the intervention. Using a theoretical framework and an extensive formative process, we developed an app-based game ("Mila Blooms") that promotes healthy eating and physical activity among adolescent survivors of childhood cancer. A single-arm 8-week intervention, using this app-based game, with assistance from a health coach, was conducted among a sample of pediatric cancer survivors ( = 15) to evaluate its initial feasibility for promoting health behavior change. Results from the feasibility evaluation were encouraging. The majority of enrolled participants were retained throughout the 8-week intervention (93.8%). Participant satisfaction feedback indicated positive experiences, related to ease of use and enjoyment of the app. Although there was little evidence for behavior change attributable to the app in this first stage of development, there was a solid demonstration of the viability and appeal of the game features, and there were no adverse side effects. Results provide insights into how gamification can be used to promote health behaviors through an app-based intervention. Mila Blooms holds promise for promoting health behavior change. Lessons learned from our experiences could be useful for the future development and implementation of app-based adolescent health interventions.
智能手机应用程序（“apps”）可用于促进健康行为改变，并扩大行为干预的范围。迄今为止，只有少数现有的应用程序是为儿童癌症幸存者的健康促进而开发的。为了解决这一差距，我们开发了一种基于应用程序的干预措施，使用游戏设计特点、基于理论的行为策略以及健康教练的帮助，激发儿童癌症幸存者的健康行为改变。本文描述了该干预措施的开发和初步可行性评估。我们使用理论框架和广泛的形成性过程，开发了一种基于应用程序的游戏（“Mila Blooms”），以促进儿童癌症幸存者青少年的健康饮食和身体活动。一项为期 8 周的单臂干预措施，使用基于应用程序的游戏，并由健康教练提供帮助，在一组儿科癌症幸存者（n=15）中进行，以评估其促进健康行为改变的初步可行性。可行性评估的结果令人鼓舞。大多数入组参与者在整个 8 周的干预期间都得到了保留（93.8%）。参与者的满意度反馈表明，他们对应用程序的易用性和趣味性有积极的体验。虽然在这个开发的第一阶段，没有证据表明应用程序可以改变行为，但游戏功能具有很强的可行性和吸引力，而且没有不良的副作用。结果提供了关于如何通过基于应用程序的干预来促进健康行为的见解。Mila Blooms 有潜力促进健康行为改变。从我们的经验中吸取的教训可能对未来基于应用程序的青少年健康干预措施的开发和实施有用。
