Tham Xiang Cong, Whitton Clare, Müller-Riemenschneider Falk, Petrunoff Nicholas Alexander
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
School of Population Health, Curtin University, Perth, Australia.
JMIR Form Res. 2023 May 9;7:e38959. doi: 10.2196/38959.
A poor diet contributes substantially to the development of noncommunicable diseases. In Singapore, it is recommended to consume at least 2 servings of fruits and vegetables daily to reduce the risk of developing noncommunicable diseases. However, the adherence rate among young adults is low. The COVID-19 pandemic has led to frequent users of mobile food delivery apps (MFDAs) adopting unhealthy eating habits, including high consumption of sugar-sweetened beverages, making it crucial to gain a deeper understanding of the underlying factors driving their use patterns.
We aimed to examine the use patterns of MFDAs among young adults during the COVID-19 pandemic; investigate the association between MFDA use and sociodemographic factors, dietary factors, and BMI; identify the underlying reasons for the observed use patterns of MFDAs among users; and compare the influences of MFDA use between frequent and infrequent users.
A sequential mixed methods design was used involving a web-based survey and in-depth interviews with a subset of respondents. Poisson regression and thematic analysis were used to analyze the quantitative and qualitative data, respectively.
The quantitative results revealed that 41.7% (150/360) of participants reported using MFDAs frequently, defined as at least once a week. Although not substantial, the study found that frequent users were less likely to consume 2 servings of vegetables per day and more likely to drink sugar-sweetened beverages. Nineteen individuals who had participated in the quantitative component were selected for and completed the interviews. Qualitative analysis identified 4 primary themes: deliberations about other sources of meals versus meals purchased via MFDAs, convenience is vital, preference for unhealthy meals ordered from MFDAs most of the time, and cost is king. Before making any purchase, MFDA users consider all these themes at the same time, with cost being the most important influential factor. A conceptual framework based on these themes was presented. Lack of culinary skills and COVID-19 restrictions were also found to influence frequent use.
This study suggests that interventions should focus on promoting healthy dietary patterns in young adults who frequently use MFDAs. Teaching cooking skills, especially among young male individuals, and time management skills could be useful to reduce reliance on MFDAs. This study highlights the need for public health policies that make healthy food options more affordable and accessible. Given the unintended changes in behavior during the pandemic, such as reduced physical activity, sedentary behavior, and altered eating patterns, it is essential to consider behavior change in interventions aimed at promoting healthy lifestyles among young adults who frequently use MFDAs. Further research is needed to evaluate the effectiveness of interventions during COVID-19 restrictions and assess the impact of the post-COVID-19 new normal on dietary patterns and physical activity levels.
不良饮食在很大程度上导致了非传染性疾病的发生。在新加坡，建议每日至少食用两份水果和蔬菜，以降低患非传染性疾病的风险。然而，年轻人中的依从率较低。2019冠状病毒病疫情导致移动食品配送应用程序（MFDAs）的频繁使用者养成了不健康的饮食习惯，包括大量饮用含糖饮料，因此深入了解驱动其使用模式的潜在因素至关重要。
我们旨在研究2019冠状病毒病疫情期间年轻人对MFDAs的使用模式；调查使用MFDAs与社会人口学因素、饮食因素和体重指数之间的关联；确定使用者中观察到的MFDAs使用模式的潜在原因；并比较频繁使用者和不频繁使用者之间使用MFDAs的影响。
采用序贯混合方法设计，包括基于网络的调查和对部分受访者的深入访谈。分别使用泊松回归和主题分析来分析定量和定性数据。
定量结果显示，41.7%（150/360）的参与者报告经常使用MFDAs，定义为每周至少一次。尽管影响不大，但研究发现，频繁使用者每天食用两份蔬菜的可能性较小，而饮用含糖饮料的可能性较大。19名参与定量部分的个体被选中并完成了访谈。定性分析确定了4个主要主题：关于其他用餐来源与通过MFDAs购买的餐食的考量、便利性至关重要、大多数时候偏爱从MFDAs订购的不健康餐食以及成本至上。在进行任何购买之前，MFDAs使用者会同时考虑所有这些主题，其中成本是最重要的影响因素。基于这些主题提出了一个概念框架。还发现缺乏烹饪技能和2019冠状病毒病限制措施会影响频繁使用。
本研究表明，干预措施应侧重于促进频繁使用MFDAs的年轻人形成健康的饮食模式。教授烹饪技能，尤其是在年轻男性中，并教授时间管理技能，可能有助于减少对MFDAs的依赖。本研究强调了制定公共卫生政策的必要性，这些政策应使健康食品选择更实惠且更容易获得。鉴于疫情期间行为的意外变化，如身体活动减少、久坐行为和饮食模式改变，在旨在促进频繁使用MFDAs的年轻人健康生活方式的干预措施中考虑行为改变至关重要。需要进一步研究来评估2019冠状病毒病限制措施期间干预措施的有效性，并评估后疫情时代新常态对饮食模式和身体活动水平的影响。
