Usability and Engagement Evaluation of an Unguided Online Program for Promoting a Healthy Lifestyle and Reducing the Risk for Eating Disorders and Obesity in the School Setting

Abstract

Implementing integrated online prevention to reduce the risk of both obesity and eating disorders, in the school setting, is a promising approach. The challenge is to develop highly user-friendly and motivating programs, to foster adherence and effectiveness. The purpose of this study was to evaluate the usability of such a universal prevention program for students aged 14–19 years, and to address engagement issues. A mixed-methods approach was chosen, consisting of a think-aloud task, a semi-structured interview, and a questionnaire including items on sociodemographic characteristics and the System Usability Scale (SUS). Usability tests were conducted in two rounds, with five adolescents participating per round. Mean score in the SUS was 92.5 of 100 points (range 85–100), in the second round, after some adaptations from the participants’ feedback. In the course of the think-aloud tasks and interviews, five major themes emerged—visual design, navigation, mode of transfer, content, and engagement conditions. Interesting headlines, gamification, and monitoring tools are crucial for engagement. Apart from the importance of using the program during school hours, the study showed that problems currently perceived as important by the target group, need to be considered and addressed, prior to offering them prevention programs, which highlights the importance of a user-centered design.

Usability Testing of an Interactive Dashboard for Surgical Quality Improvement in a Large Congenital Heart Center

“…This study design has been used by multiple usability studies in the areas of clinical and health informatics. [29][30][31] The SUS has also been used to evaluate interactive visualizations. 32,33 Since the study focused on user feedback rather than expert feedback on the dashboards, heuristic evaluation 34 was not considered.…”

Eating Disorders and Obesity: The Challenge for Our Times

“…On the other hand, an effective treatment for bulimia nervosa or BED, such as cognitive behavior therapy, did little to improve metabolic physical health status in a randomized controlled trial by Mathisen et al [15]. Nitsch et al [16] concluded the Special Issue with a report on how to improve engagement in a new, online, integrated prevention program that addresses eating, weight, and mental health of adolescents called “Healthy Teens @ School”.…”

Engagement with a Web-Based Health Promotion Intervention among Vocational School Students: A Secondary User and Usage Analysis

“…Blending online and offline learning content within a curriculum is considered more valuable than online learning alone [71]. Studies show that in educational institutions the possibility of using a web-based health program during teaching time and not only during leisure time is a crucial factor for regular usage [72,73]. The integration of web-based measures into everyday school life can reduce barriers to use, e.g., low motivation [74].…”

“…Against the background of the known high drop-out rates, in-depth analyses of the perception and usability of web-based measures for potential users are necessary. The Technology Acceptance Model [97] or the System Usability Scale [73] offer possible approaches. Also, no intended engagement use was predefined [98,99], as the intervention was not designed with a strict modular structure, e.g., in the sense of a teaching series.…”