BackgroundFruit and vegetable consumption is important for health, but many individuals fail to consume adequate amounts for health benefits. Although many individuals are aware of current fruit and vegetable consumption recommendations, research suggests that adherence to these is hampered by low knowledge of the details of these recommendations.ObjectiveThis paper reports the development and details of a pilot randomized controlled test of a novel interactive mobile phone app for addressing low knowledge of the UK 5-a-day fruit and vegetable recommendations.MethodsRequirements for the app were first defined by researchers and potential end users and prioritized using the MoSCoW (Must have, Should have, Could have, Won’t have) method. Second, a prototype mobile phone app was developed using an agile approach. Third, the prototype app was tested in a randomized controlled pilot trial for impacts on knowledge and intake of fruit and vegetables. Volunteers were randomized to either receive (n=50) or not receive the app (n=44) for 2 or 4 weeks, and fruit and vegetable knowledge, intake, and behavior were assessed at the beginning of the study and after 1 and 2 weeks or after 2 and 4 weeks, respectively. App usage and qualitative feedback were also investigated. All findings then informed the development of a final app.ResultsLow knowledge of consumption recommendations centered around portion sizes and the need for variety, and an interactive mobile phone app was considered a suitable tool for improving this knowledge in a practical manner that would be available both at time of consumption and outside of these times. The pilot test revealed improved behavior after 2 weeks compared with baseline in volunteers who received the app, but improvements in knowledge on fruit and vegetable recommendations were found in both groups, and no improvements in fruit and vegetable intakes were found in formal measures. Patterns of app usage and qualitative feedback also suggested a number of modifications. The resultant final app incorporates several behavior change techniques (goal-setting, self-monitoring, and personalized feedback) as well as aiming to improve knowledge.ConclusionsA novel interactive mobile phone app was successfully developed based on requirements, and when tested in a pilot randomized controlled trial, this app was found to have some impacts on fruit and vegetable outcomes. Although benefits from the app were small, impacts will likely increase as a result of recent modifications. The final SMART 5-A-DAY app is available in the Google Play Store and now needs testing in the target population.Trial RegistrationClinicalTrials.gov NCT02779491; https://www.clinicaltrials.gov/ct2/show/NCT02779491
BACKGROUND Fatigue is one of the most common and debilitating symptoms of Multiple Sclerosis - experienced by over 80 per cent of people with MS (pwMS). By 2015 more than 1,500 pwMS had received the FACETS programme - a face-to-face group-based fatigue management programme for pwMS - but it is not available in all areas and a face-to-face format may not be suitable for or appeal to everyone. For these reasons, the MS Society funded a consultation to explore an alternative online model of service delivery. During the consultation it became apparent that there were no high quality free apps that would support digital completion of the FACETS homework tasks. A key recommendation was to initiate a separate project to create a stand-alone digital toolkit focusing on the homework elements of the FACETS programme. OBJECTIVE The purpose of this mixed methods study was to create a digital toolkit comprising the homework tasks (e.g. activity diary, goal planner and thought diary) of the FACETS programme for pwMS. Particular consideration was given to the unique requirements of people with MS when designing, building and prototyping the solution. METHODS Phase 1 involved the elicitation of user requirements and wireframing. Phase 2 involved several iterations of prototyping via detailed supervised usability testing sessions with service users (n=11). The sessions included going through test scenarios with video-capture and concurrent think-aloud, semi-structured interviews and completion of the System Usability Scale. RESULTS A number of usability and design issues (such as simplifying overall screen flow to better meet users’ needs) and suggestions for improvements (such as utilising location-based services, documenting accessed sections via tracking, displaying personalised information and progress via a central dashboard) were addressed and implemented. CONCLUSIONS The ongoing participation of people with MS in the development cycle - working to a human-centred design methodology - enabled a considered and MS-centred solution. In the longer term, the toolkit offers possibilities for longitudinal symptom/self-monitoring and data sharing, greater integration of self-management strategies into daily life and has potential applicability to other long-term conditions.
BACKGROUND Fruit and vegetable consumption is important for health, but many individuals fail to consume adequate amounts for health benefits. Although many individuals are aware of current fruit and vegetable consumption recommendations, research suggests that adherence to these is hampered by low knowledge of the details of these recommendations. OBJECTIVE This paper reports the development and details of a pilot randomized controlled test of a novel interactive mobile phone app for addressing low knowledge of the UK 5-a-day fruit and vegetable recommendations. METHODS Requirements for the app were first defined by researchers and potential end users and prioritized using the MoSCoW (Must have, Should have, Could have, Won’t have) method. Second, a prototype mobile phone app was developed using an agile approach. Third, the prototype app was tested in a randomized controlled pilot trial for impacts on knowledge and intake of fruit and vegetables. Volunteers were randomized to either receive (n=50) or not receive the app (n=44) for 2 or 4 weeks, and fruit and vegetable knowledge, intake, and behavior were assessed at the beginning of the study and after 1 and 2 weeks or after 2 and 4 weeks, respectively. App usage and qualitative feedback were also investigated. All findings then informed the development of a final app. RESULTS Low knowledge of consumption recommendations centered around portion sizes and the need for variety, and an interactive mobile phone app was considered a suitable tool for improving this knowledge in a practical manner that would be available both at time of consumption and outside of these times. The pilot test revealed improved behavior after 2 weeks compared with baseline in volunteers who received the app, but improvements in knowledge on fruit and vegetable recommendations were found in both groups, and no improvements in fruit and vegetable intakes were found in formal measures. Patterns of app usage and qualitative feedback also suggested a number of modifications. The resultant final app incorporates several behavior change techniques (goal-setting, self-monitoring, and personalized feedback) as well as aiming to improve knowledge. CONCLUSIONS A novel interactive mobile phone app was successfully developed based on requirements, and when tested in a pilot randomized controlled trial, this app was found to have some impacts on fruit and vegetable outcomes. Although benefits from the app were small, impacts will likely increase as a result of recent modifications. The final SMART 5-A-DAY app is available in the Google Play Store and now needs testing in the target population. CLINICALTRIAL ClinicalTrials.gov NCT02779491; https://www.clinicaltrials.gov/ct2/show/NCT02779491
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