Milne-Ives Madison, Rahman Em, Bradwell Hannah, Baines Rebecca, Boey Timothy, Potter Alison, Lawrence Wendy, Helena van Velthoven Michelle, Meinert Edward
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
Centre for Health Technology, School of Nursing and Midwifery, University of Plymouth, Plymouth United Kingdom.
PLOS Digit Health. 2024 Mar 27;3(3):e0000481. doi: 10.1371/journal.pdig.0000481. eCollection 2024 Mar.
Childhood obesity is a growing global health concern. Although mobile health apps have the potential to deliver behavioural interventions, their impact is commonly limited by a lack of sufficient engagement. The purpose of this study was to explore barriers and facilitators to engagement with a family-focused app and its perceived impact on motivation, self-efficacy, and behaviour. Parents with at least one child under 18 and healthcare professionals working with children were recruited; all participants were allocated to use the NoObesity app over a 6-month period. The mixed-methods design was based on the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks. Qualitative and quantitative data were gathered through semi-structured interviews, questionnaires, and app use data (logins and in-app self-reported data). 35 parents were included in the final analysis; quantitative results were analysed descriptively and thematic analysis was conducted on the qualitative data. Key barriers to engagement were boredom, forgetting, and usability issues and key barriers to potential impact on behaviours were accessibility, lack of motivation, and family characteristics. Novelty, gamification features, reminders, goal setting, progress monitoring and feedback, and suggestions for healthy foods and activities were key facilitators to engagement with the app and behaviours. A key observation was that intervention strategies could help address many motivation and capability barriers, but there was a gap in strategies addressing opportunity barriers. Without incorporating strategies that successfully mitigate barriers in all three determinants of behaviour, an intervention is unlikely to be successful. We highlight key recommendations for developers to consider when designing the features and implementation of digital health interventions. Trial Registration: ClinicalTrials.gov (NCT05261555).
儿童肥胖是一个日益严重的全球健康问题。尽管移动健康应用程序有提供行为干预措施的潜力，但其影响通常因缺乏足够的参与度而受到限制。本研究的目的是探讨参与一款以家庭为中心的应用程序的障碍和促进因素，以及其对动机、自我效能感和行为的感知影响。招募了至少有一名18岁以下子女的家长以及从事儿童工作的医疗保健专业人员；所有参与者被分配在6个月的时间内使用NoObesity应用程序。混合方法设计基于非采用、放弃、扩大规模、传播和可持续性以及覆盖范围、有效性、采用、实施和维持框架。通过半结构化访谈、问卷调查和应用程序使用数据（登录和应用程序内自我报告数据）收集定性和定量数据。最终分析纳入了35名家长；对定量结果进行描述性分析，并对定性数据进行主题分析。参与的主要障碍是无聊、遗忘和可用性问题，对行为产生潜在影响的主要障碍是可及性、缺乏动机和家庭特征。新颖性、游戏化功能、提醒、目标设定、进度监测和反馈，以及对健康食品和活动的建议是参与该应用程序和行为的关键促进因素。一个关键观察结果是，干预策略可以帮助解决许多动机和能力障碍，但在解决机会障碍的策略方面存在差距。如果不纳入成功减轻行为所有三个决定因素中的障碍的策略，干预不太可能成功。我们强调了开发者在设计数字健康干预措施的功能和实施时应考虑的关键建议。试验注册：ClinicalTrials.gov（NCT05261555）。
