Parents’ Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A Crowdsourced Social Validity Study

Abstract

BackgroundMost pediatric studies do not include parent stakeholders in the design of the intervention itself and many pediatric mobile health (mHealth) interventions are not meaningfully disseminated after the trial period ends. Consequently, the consumer desire for mobile apps targeting pediatric health behavior is likely to be met by commercial products that are not based in theory or evidence and may not take stakeholder preferences into account.ObjectiveThe aim was to assess parent preference for mobile app features that map onto specific Theoretical Domains Framework (TDF) elements.MethodsThis study was a crowdsourced social validity study of 183 parents who were asked to rate their preferences for mobile app features that correspond to elements of the TDF. The TDF organizes a large number of theoretical models and constructs into three components: (1) capability, (2) motivation, and (3) opportunity. Parents of children were recruited through Amazon Mechanical Turk.ResultsThe majority of participants were Caucasian and mean age was 36.9 (SD 8.0) years. Results revealed broad acceptability of communication, motivation, and opportunity domains. However, the degree to which each domain was valued varied within behavioral category. Parents demonstrated a preference for increasing procedural knowledge for physical activity and diet behaviors over sleep (F2,545=5.18, P=.006). Similarly, parents valued self-monitoring as more important for physical activity than sleep (F2,546=4.04, P=.02). When asked about the value of features to help children develop skills, parents preferred those features for dietary behavior over sleep (F2,546=3.57, P=.03). Parents perceived that goal-setting features would be most useful for physical activity over sleep and diet (F2,545=5.30, P=.005). Incentive features within the app were seen as most useful for physical activity over sleep (F2,546=4.34, P=.01).ConclusionsThis study presents a low-cost strategy for involving a large number of stakeholders in the discussion of how health behavior theory should be applied in a mHealth intervention. Our approach is innovative in that it took a scientific framework (ie, TDF) and made it digestible to parents so that they could then provide their opinions about features that might appear in a future app. Our survey items discriminated between various health behaviors allowing stakeholders to communicate the different health behaviors that they would like a TDF feature to change. Moreover, we were able to develop a set of consumer opinions about features that were directly linked to elements of the TDF.

Designing for the Co-Use of Consumer Health Technology in Self-Management of Adolescent Overweight and Obesity: Mixed Methods Qualitative Study (Preprint)

“…By explicitly looking for role congruence regarding social influence from parents and health care providers, we found that as co-users, both parents and health care providers are willing to engage in the process and fulfill their role to empower the primary user consistent with the OCM. These findings correspond to the existing studies that highlight the needs of including parents and physicians in the process of mobile health (mHealth) app design and implementation to promote the use of mHealth technologies [52][53][54][55][56][57].…”

“…Second, we propose the role of CHT co-use for overweight to be tailored to the OCM framework that extends the intention to use construct to recognize CHT co-use (intended behaviors for use) by family members (particularly parents) and health care providers as secondary users that simultaneously influence the adoption of CHT for managing overweight in adolescents. Acknowledging the importance of designing a user interface that is appealing to the users and responds to their needs is central in developing user-centered CHT systems [51][52][53][54][55][56][57]. This study's approach to the design of CHT allows for simultaneous use in the management of adolescent obesity across 3 system users.…”

Fathers of Children With Congenital Heart Disease: Sources of Stress and Opportunities for Intervention

“…Although crowdsourcing has been used extensively in business, information technology, and more recently public health (11)(12)(13), the application of crowdsourcing to qualitative research related to pediatric health is innovative. Three prior published papers of which we are aware have described the use of online crowdsourcing methodology to conduct qualitative research aimed at understanding the lived experiences of families impacted by pediatric illness (14)(15)(16).…”

A Psychosocial Care Model for Families Affected by Congenital Heart Disease*

“…used in health research to engage stakeholders in identifying unmet needs, barriers to care, and potential solutions (16)(17)(18)(19)(20)(21). A stakeholder advisory council (SAC) consisting of multidisciplinary providers across four hospitals and parents of children with CHD also convened twice-monthly to provide guidance on study methodology and interpretation of results.…”