Mobile app increases vegetable-based preparations by low-income household cooks: a randomized controlled trial

Abstract

ObjectiveWe built an app to help clients of food pantries. The app offers vegetable-based recipes, food tips and no-cost strategies for making mealtimes healthier and for bargain-conscious grocery shopping, among other themes. Users customize materials to meet their own preferences. The app, available in English and Spanish, has been tested in a randomized field trial.DesignA randomized controlled trial with repeated measures across 10 weeks.SettingClients of fifteen community food pantry distributions in Los Angeles County, USA.ParticipantsDistributions were randomized to control and experimental conditions, and 289 household cooks and one of their 9–14-year-old children were enrolled as participants. Experimental dyads were given a smartphone with our app and a phone use-plan, then trained to use the app. ‘Test vegetables’ were added to the foods that both control and experimental participants received at their pantries.ResultsAfter 3–4 weeks of additional ‘test vegetables’, cooks at experimental pantries had made 38 % more preparations with these items than control cooks (P = 0·03). Ten weeks following baseline, experimental pantries also scored greater gains in using a wider assortment of vegetables than control pantries (P = 0·003). Use of the app increased between mid-experiment and final measurement (P = 0·0001).ConclusionsThe app appears to encourage household cooks to try new preparation methods and widen their incorporation of vegetables into family diets. Further research is needed to identify specific app features that contributed most to outcomes and to test ways in which to disseminate the app widely.

Cooking Matters Mobile Application: a meal planning and preparation tool for low-income parents

“…Since over 77 % of Americans own a smartphone and 64 % of smartphone users live in households earning less than $US 30 000 per year, there is potential for broad reach of mobile health (mHealth) technology, which includes using mobile and wireless devices to improve health outcomes among lower-income populations (19) . Emerging research has suggested that mobile apps may be an effective approach to supporting healthier food purchasing behaviours (20) , healthier food preparation methods (21) , and healthier recipe management and meal planning behaviours (22) , but that there is a need to engage mobile app users and nutrition professionals in the design.…”

A Consumer Health App Works Well. . . But, Diffusion Is Not So Easy

“…Perhaps the advantage from printed output was due to the reasons that led us at the outset to build the app to provide tangible VeggieBooks and SecretsBooks. Many household cooks, one-third in our RCT experiment testing app effectiveness (Clarke et al 2019), preferred using printed recipes compared with the recipes on the phone, a device that can get wet and greasy in the kitchen. Also, in households with just one smartphone, many cooks cannot commandeer the device during times of value to them, such as visiting food pantries, preparing meals, or shopping.…”

“…We tested the app's effectiveness in a randomized controlled trial with nearly 300 households. Briefly, app-enabled household cooks began preparing 38% more vegetable-based servings than the control group, and showed other and sustained signs of healthier food use across a 10-week study period (Clarke et al 2019).…”

“…In addition, we had deep know-how with deploying VeggieBook from our randomized field trial, and also with studying impacts of our earlier tablet-based tool (Clarke et al 2011(Clarke et al , 2019. Altogether, this background allowed us to advise our collaborating organizations about human touches that seemed likely to affect rates of downloading our app and persistence in using it.…”

“…This paper identifies such barriers in the case of a nutrition app that was built with the help of abundant formative studies among users (Evans and Clarke 2019). The app also demonstrated its effectiveness in a rigorous randomized controlled trial (RCT), the gold standard for evaluating interventions in health care delivery (Clarke et al 2019). We have uncovered a number of "human touches" that improve the use and effectiveness of the app.…”