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 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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IntroductionPrevious work suggests low intakes of fruit and vegetables (FV) across the world, poor knowledge of the details of FV recommendations, and associations between the two. This work aimed to develop an interactive mobile phone application (app) to facilitate adherence to the UK 5-a-day FV recommendations, and reports on the findings and feedback from the first test of the prototype.Materials and MethodsRequirements for the app were first gained from previous research and potential end-users via four public engagement workshops, and prioritised using the MoSCoW method. A prototype app was then designed and developed using an agile approach. The prototype app was then tested in a randomized controlled pilot trial for impacts on FV knowledge and FV intake. Ninety-four adult volunteers were randomized to either receive (N = 50) or not receive the app (N = 44) for two or four weeks, and FV knowledge, self-report FV intakes, and FV behaviour (complimentary drink choice), were assessed at study start and study end. App use and feedback were also investigated.ResultsLow knowledge of the FV recommendations centred around portion sizes and the need for variety, and an interactive mobile phone app was considered a suitable tool for improving knowledge in a practical manner, that would be available both at time of consumption and outside of these times. Findings revealed improved FV behaviour in volunteers who received the app for two weeks at study end: 16 app users chose a fruit drink, compared to 4 app users who chose a non-fruit drink, where 4 control volunteers also chose a fruit drink and 6 control volunteers chose a non-fruit drink. App users also suggested increased FV intakes, but changes were small, and possibly masked in questionnaire measures. Improvements in FV knowledge (of approx. 10%) were also found, but with no differences between groups. App usage was low and feedback suggested a desire for reminder notifications and a wish to return to the input for a previous day due to forgetting. Increased awareness of low FV intakes was also offered as feedback.DiscussionOur prototype app was well received and of potential benefit. A final version of the app was subsequently developed incorporating the findings and feedback from the pilot test. Improvements in the final version of the app include a message to increase awareness of low intakes and an option to add notifications to increase use. Testing of the final app is now needed.