Background: Childhood obesity is a serious public health issue among minority youth in the United States. Technology-enhanced approaches can be effective for promoting healthy behavior change.Objective: The purpose of this study was to test the usability of prototypes of a web-based interactive tool promoting healthy dietary behaviors to reduce childhood obesity risk in urban minority youth. The web-based tool comprised a manga-style comic with interactive features (e.g. sound effects, clickable pop-ups), tailored messaging, and goal-setting, and was optimized for use on tablet devices. Methods:Latino and Black/African-American (AA) children ages 9 to 13 years were recruited to participate in two rounds of usability testing. A modified think-aloud method was utilized. Self-reported surveys and field notes were collected. Audio recordings and field notes from usability testing sessions were systematically reviewed by extracting and coding user feedback as either positive comments or usability/negative issues. The quantitative data from selfreported questionnaires were analyzed using descriptive statistics.Results: Twelve children (4 female; 8 Black/AA), with a mean age of 10.92 ±1.16 years participated. Testing highlighted overall positive experiences with the web-based interactive tool, especially related to storyline, sound effects, and color schemes. Specific usability issues were classified into six themes: appearance, content, special effects, storyline, terminology, and navigation. Changes to the web-based tool after Round 1 included adding a navigation guide, making clickable icons more visible, improving graphic designs, and fixing programming errors. In Round 2 of testing (after modifications to the web-based were incorporated), many of the usability issues that were identified in Round 1 did not emerge. Conclusions:Results of testing will inform further development and finalization of the tool, which will be tested using a two-group pilot randomized study, with the goal of reducing childhood obesity risk in minority, low-income youth.
BackgroundChildhood obesity is a public health crisis, particularly in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. However, such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content.ObjectiveThe objectives of this study include assessing the feasibility and acceptability and exploring the potential impact of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which is focused on decreasing childhood obesity risk in black/African American and Latino children aged 9 to 12 years.MethodsIntervention INC is underpinned by the narrative transportation theory, social cognitive theory, and health belief model, and it was co-developed by children and parents from the intended population. The child component consists of a 6-chapter interactive nutrition comic optimized for use on tablet devices, a goal-setting and self-assessment feature, and weekly text/email messages and reminders. The parental component consists of 6 Web-based newsletters, access to the child comic, and weekly text/email messages and reminders. The tool was evaluated using a pilot, single-blind, 2-group randomized controlled study design. Child-parent dyads were randomized to either the experimental or comparison group and assigned to a targeted behavior (increase fruit/vegetable or water intake) based on initial screening questions. Data were collected at 4 time points: baseline (T1), intervention midpoint (T2), intervention endpoint (T3), and 3 months postintervention (T4). Primary measures comprise usage, usability, and feasibility of the Web-based tool. Secondary measures comprise dietary knowledge, preferences, and intake and anthropometric measures (for child) and feeding practices and home food environment (for parent).ResultsStudy enrollment was completed in November 2017. A total of 89 child-parent dyads were randomized to either the experimental (n=44) or comparison (n=45) group. Data analysis is currently being conducted.ConclusionsThis study aims to implement and assess an innovative approach to deliver health messages and resources to at-risk minority preadolescents and their parents. If found to be acceptable, engaging, feasible, and a potential approach to improve dietary behaviors, a full-fledged randomized controlled trial will be conducted to assess its efficacy and potential impact.Trial RegistrationClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/ct2/show/NCT03165474 (Archived by WebCite at http://www.webcitation.org/73122IjgP)International Registered Report Identifier (IRRID)RR1-10.2196/10682
Objective: This study examines the association between acculturative stress and psychological distress among Mexican immigrants living in New York City. It takes account factors such as language barriers, legal status, fear of deportation, and avoidance of social health and human services, and how these factors are implicated in the mental health status of the study population. Design: Study draws from a community-based sample of Mexican American adults from the Social Network of Mexican Americans study recruited from a church-based community center in the Bronx, New York. Eighty Mexican immigrants were included in this analysis. Descriptive statistics were used to display participants' characteristics. Pearson correlation and multiple regressions were run to determine the relationship between acculturative stress and psychological distress, and also with each of the items from the acculturative stress scale. Both scales have been validated among Spanish-speaking Latino immigrants. Results: A significant moderate positive relationship was found between acculturative stress and psychological distress. Within the acculturative stress scale, those items related to language discrimination, evasion of health services, and feeling guilty for leaving family/friends in home country had significant associations with increased psychological distress. Conclusion: The findings support the need for interventions that account for the major stressors associated with being a Mexican immigrant in the United States to prevent psychological distress, especially given the anti-immigration policies.
BACKGROUND Childhood obesity is a public health crisis, particularly in low-income, minority populations in the United States. Innovative and technology-enhanced interventions may be an engaging approach to reach at-risk youth and their parents to improve dietary behaviors and feeding practices. However, such tools are limited, especially ones that are theory-based; co-developed with user-centered approaches; tailored to low-income, minority preadolescents; and include parent-focused content. OBJECTIVE The objectives of this study include assessing the feasibility and acceptability and exploring the potential impact of the Intervention INC (Interactive Nutrition Comics for urban, minority preadolescents) Web-based tool, which is focused on decreasing childhood obesity risk in black/African American and Latino children aged 9 to 12 years. METHODS Intervention INC is underpinned by the narrative transportation theory, social cognitive theory, and health belief model, and it was co-developed by children and parents from the intended population. The child component consists of a 6-chapter interactive nutrition comic optimized for use on tablet devices, a goal-setting and self-assessment feature, and weekly text/email messages and reminders. The parental component consists of 6 Web-based newsletters, access to the child comic, and weekly text/email messages and reminders. The tool was evaluated using a pilot, single-blind, 2-group randomized controlled study design. Child-parent dyads were randomized to either the experimental or comparison group and assigned to a targeted behavior (increase fruit/vegetable or water intake) based on initial screening questions. Data were collected at 4 time points: baseline (T1), intervention midpoint (T2), intervention endpoint (T3), and 3 months postintervention (T4). Primary measures comprise usage, usability, and feasibility of the Web-based tool. Secondary measures comprise dietary knowledge, preferences, and intake and anthropometric measures (for child) and feeding practices and home food environment (for parent). RESULTS Study enrollment was completed in November 2017. A total of 89 child-parent dyads were randomized to either the experimental (n=44) or comparison (n=45) group. Data analysis is currently being conducted. CONCLUSIONS This study aims to implement and assess an innovative approach to deliver health messages and resources to at-risk minority preadolescents and their parents. If found to be acceptable, engaging, feasible, and a potential approach to improve dietary behaviors, a full-fledged randomized controlled trial will be conducted to assess its efficacy and potential impact. CLINICALTRIAL ClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/ct2/show/NCT03165474 (Archived by WebCite at http://www.webcitation.org/73122IjgP) INTERNATIONAL REGISTERED REPOR RR1-10.2196/10682
Background: Childhood obesity is a serious public health issue among minority youth in the United States. Technology-enhanced approaches can be effective for promoting healthy behavior change.
BACKGROUND In the United States, childhood obesity prevalence is highest among preadolescents and adolescents. Research has increasingly highlighted the role of parenting, parental modeling and feeding practices, and the home environment in behavioral interventions for childhood obesity. OBJECTIVE As part of the development of a technology-enhanced intervention to promote healthy eating among urban minority preadolescents, research was concurrently conducted to develop a parent-focused health promotion tool to support positive feeding behaviors and the home food environment. METHODS Parents (n=25; 96% female; mean age=41 years; 60% Hispanic/Latino, 40% Black/African-American) were recruited from a child-focused community-based organization in New York City. Formative research (focus groups and parent-child dyad interviews) was conducted to identify barriers/facilitators to healthy feeding behaviors and characterize technology use (Summer 2016). Findings informed the design of a web-based health promotion tool, which was iteratively developed and assessed utilizing user-centered approaches to: confirm/finalize content (Fall 2016), assess the website wireframe (Winter 2016), and conduct usability testing (Spring-Summer 2017). Session notes and audio-recordings were reviewed throughout development to design and improve prototypes. RESULTS From formative research, parents preferred reading/looking up health-related information on larger laptop/tablet screens, but preferred smartphones when reading “on-the-go.” Suggestions for an online health tool included quick/easy/low-cost recipes, healthy tips for health feeding and involving their children around healthy dietary-related behaviors, clear tool navigation, and using pictures/visuals. When finalizing the tool wireframe and content, parents preferred a variety of motivational healthy feeding tips that encouraged positive interaction with their child, local family-oriented community events, and a simple, colorful layout with minimal clicking to access links. During usability testing, parents responded positively to the content (healthy feeding tips, recipes, coupon, and free community event) and clean layout, especially the use of bright color schemes and easy navigation. Suggestions included incorporating more fruit/vegetable images and directed action words (“click here”) to draw attention to coupon/community event links. CONCLUSIONS Formative research and user-centered approaches with parents of at-risk preadolescents resulted in a web-based, mobile-friendly health promotion tool. It will be tested as part of a larger technology-enhanced intervention using a two-group pilot randomized study, with the aim of reducing childhood obesity risk.
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