RTI International, Research Triangle Park, NC, United States.
Winston-Salem State University, Winston-Salem, NC, United States.
JMIR Mhealth Uhealth. 2020 Aug 5;8(8):e15156. doi: 10.2196/15156.
With the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise.
We developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population.
We developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected.
Of the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period.
Rams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.
随着移动设备上网和应用程序主要计算系统的使用日益增加，移动健康应用程序的市场越来越大，为自我保健提供建议。例如，需要检查它们在饮食和健身跟踪方面的有效性。大多数美国成年人无法满足健康行为的日常建议。在受控环境中测试用户对应用程序的参与度，可以深入了解专注于改善饮食和运动的应用程序中哪些有效，哪些无效。
我们开发了 Rams Have Heart，这是一款移动应用程序，用于支持心血管疾病 (CVD) 干预课程。该应用程序全天跟踪健康行为，包括水果和蔬菜的摄入以及身体活动。本文旨在介绍其功能，并评估非裔美国大学生人群的依从性。
我们使用个人健康信息学和干预工具包（一种软件框架）开发了该应用程序。Rams Have Heart 将自我报告的健康筛查与健康教育、日记跟踪和用户反馈模块集成在一起，以获取数据并评估进展情况。该研究的母项在美国东南部的一所历史上的黑人学院和大学指定机构进行，是一个为期一个学期的干预课程，作为秋季的一门学术课程连续三个学年进行。在队列 1 试点研究后进行了更改，因此结果仅包括队列 2 和 3，共 115 名学生（n=55 名干预参与者和 n=54 名对照组参与者），年龄在 17 至 24 岁之间。研究期间收集的数据使用安全的超文本传输协议安全协议传输，并存储在仅授权人员可访问的安全结构化查询语言服务器数据库中。使用 SAS 软件分析整体应用程序使用情况和收集的具体结果。
在干预组的 55 名学生中，队列 2 的 27 名（49%）和队列 3 的 25 名（45%）学生至少使用过一次 Rams Have Heart 应用程序。在秋季学期期间，应用程序的参与度逐渐下降，直到考试周，大多数学生不再参与。水果和蔬菜的摄入量略有增加，而活动水平在研究期间下降。
Rams Have Heart 的开发是为了允许日常跟踪水果和蔬菜的摄入量以及身体活动，以支持针对易患肥胖、心脏病和 2 型糖尿病的学生人群的 CVD 风险干预。我们对应用程序的使用、功能和用户结果进行了分析。尽管移动应用程序为用户参与研究提供了隐私和灵活性，但 Rams Have Heart 并没有提高依从性或用户结果。需要进一步评估依赖应用程序支持用户目标的以健康为导向的研究。
