Development and Implementation of a Smartphone Application to Promote Physical Activity and Reduce Screen-Time in Adolescent Boys

Abstract

Purpose: To describe the development and implementation of a smartphone application (app) designed to promote physical activity and reduce screen-time in adolescent boys considered “at-risk” of obesity.Methods: An app was developed to support the delivery of a face-to-face school-based obesity prevention program known as the “Active Teen Leaders Avoiding Screen-time” (ATLAS) program. ATLAS was guided by self-determination theory and social cognitive theory and evaluated using a cluster randomized controlled trial with 361 boys (12.7 ± 0.5 years) in 14 secondary schools. Following the completion of the study, participants in the intervention group completed a process evaluation questionnaire and focus groups were conducted with 42 students to explore their general perceptions of the ATLAS program and their experience with the smartphone app. Barriers and challenges encountered in the development, implementation, and evaluation of the app are also described.Results: Participation in the study was not contingent on ownership of a smartphone, but 70% of participants in the intervention group reported having access to a smartphone or tablet device. Focus group participants reported an enjoyment of the program, and felt that it had provided them with new skills, techniques, and routines for the future. However, their engagement with the smartphone app was limited, due to a variety of reasons. Barriers to the implementation and evaluation of the app included limited access to smartphone devices, technical problems with the push notifications, lack of access to usage data, and the challenges of maintaining participants’ interest in using the app.Conclusion: Although participants reported high levels of satisfaction with the ATLAS program in general, the smartphone app was not used extensively. Additional strategies and features may be needed to enhance engagement in adolescent boys.

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review

“…Of the 4818 titles identified from the database search, 64 articles were included: 9 reporting dietary self-monitoring trials (38)(39)(40)(41)(42)(43)(44)(45)(46), 18 reporting nutritionimprovement trials (36,(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62)(63), 30 reporting applicationdevelopment projects (37,, and 7 reporting qualitative studies with consumers (93)(94)(95)(96)(97)(98)(99). Five reports were published in 2016, 16 each in 2015 and 2014, 11 in 2013, and 16 between 2008 and 2012.…”

“…Tailoring and personalization of the application and its features were considered important or desirable across all population groups. Although push notifications were valued, consideration of their timing was important, with user customization ideal (56,65,74) particularly in adolescents (57). Personalized settings and the ability to turn off features were considered important across population groups (74,90,93).…”

“…Regarding tailored feedback, both positive and negative reinforcement were considered motivating by overweight (90) and young-adult populations (99), although young adults were clear this should not feel like "telling off " (93). A user-friendly and age-appropriate presentation of content was important for adolescent and young-adult populations (57,76), with star representations of healthiness reportedly appealing to adults and traffic-lights appealing to adolescents (77). Images of portion sizing and rating the relative healthiness of meal options helped with nutrition knowledge development for young adults (76) and low-SES populations (79).…”

“…Multiple strategies were used in one self-monitoring trial (42), 5 nutrition-improvement trials (48,(50)(51)(52)57), and 6 development projects (65,74,77,86,88,89).…”

“…The most commonly used models were used across both nutrition-improvement trials and applicationdescription articles. These were Social Cognitive Theory, which informed the development of 7 applications (50-52, 57, 74, 77, 89); the Transtheoretical model (36,52,79) and Self-determination theory (57,74,89), both informing 3 applications; and Transportation theory (50,77) and the Health Action Process Approach (56,60), both informing the development of 2 applications. Additional models reported in nutrition-improvement trials and application-development projects were Control Systems Theory (44), Fogg's behavioral model (51,62), the Behavior Change Wheel (72,86), the Health Belief Model (74,77), the Theory of Planned Behavior (48), the Elaboration Likelihood Model (77), and the Precaution Adoption Process Model (77).…”