Development of a Smartphone Application Prototype for Child Obesity Prevention: Rationale and Study Design of Acceptability and Feasibility Tests

Hyerang Kim; Jae‐Heon Kang; Hyn Ah Park; Soo Hyun Cho; Sohye Jeon; Ji‐hye Jung; Eunju Sung

doi:10.15384/kjhp.2015.15.4.194

Korean J Health Promot > Volume 15(4); 2015 > Article

Kim, Kang, Park, Cho, Jeon, Jung, and Sung: Development of a Smartphone Application Prototype for Child Obesity Prevention: Rationale and Study Design of Acceptability and Feasibility Tests

Original Article

Korean Journal of Health Promotion 2015;15(4):194-201.

Published online: December 19, 2015

DOI: https://doi.org/10.15384/kjhp.2015.15.4.194

Development of a Smartphone Application Prototype for Child Obesity Prevention: Rationale and Study Design of Acceptability and Feasibility Tests

Hyerang Kim^1,², Jae‐Heon Kang³, Hyn Ah Park³, Soo Hyun Cho⁴, Sohye Jeon⁵, Ji‐hye Jung⁶, Eunju Sung¹

¹Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

²Medical Research Center, Sungkyunkwan University School of Medicine, Seoul, Korea

³Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

⁴Department of Family Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea

⁵Korea Testing Certification, Seoul, Korea

⁶Institute for Clinical Nutrition, Inje University, Seoul, Korea

￭ Corresponding author：Eunju Sung, MD, PhD Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine. 29 Saemunan-ro, Jongno-gu, Seoul 03181, Korea
Tel: +82-2-2001-5138, Fax: +82-2-757-0436 E-mail: eunjusung68@gmail.com

Received October 12, 2015 Accepted December 24, 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Background

There have been many efforts to rectify lifestyles that contribute to obesity using a variety of methodologies in heterogeneous settings, but effective and sustainable interventions that are suitable for children are still needed. We developed a smartphone application called “HAPPY ME” for guiding health behavior decisions, which employs gamification and self-monitoring strategies. The aim of this paper is to outline the rationale and methods for the development and feasibility test of “HAPPY ME”.

Methods

The study consisted of two phases: 1) description of theory-based conceptual framework and rationales for smartphone application development and 2) outline of a pre- and post-test design in 4^th-6^th grade of healthy elementary school students for 4 weeks. The students will be delivered missions or messages on a daily basis, which is to stretch the knowledge and skills for action. They will simultaneously be engaged in self-monitoring their eating and physical activities to clear daily quests. To measure acceptability and feasibility we will monitor usability, compliance, and satisfaction for a 4-week study period and evaluate the intervention effects on self-efficacy, readiness, and intention to engage in healthy behavior.

Conclusions

The results of the feasibility study will show whether the smartphone application “HAPPY ME” for children is acceptable, as well as if it is usable and feasible for self-directed health management. The results will provide preliminary evidence of the effectiveness of smartphone application-supported child behavioral modification for child obesity prevention and management.

Keywords: Behavioral change, Child obesity, Gamification, Smartphone application

REFERENCES

1.. Khang YH, Park MJ. Trends in obesity among Korean children using four different criteria. Int J Pediatr Obes 2011;6(3-4):206-14.

2.. Korean Educational Development Institute. Students health inspection and analysis in 2011. Seoul: Ministry of Education Science and Technology; 2011. [Accessed Jan 05, 2016].. http://www.googlE. Co.kr/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=2&cad=rja&uact=8&ved=0ahUKEwiE6fmjxpHKAhUBjZQKHeb8B70QFggnMAE&url=http%3A%2F%2Fwww.schoolhealth.kr%2Fshnhome%2Fglib%2FSHDataFileDownload.php%3FGbnCd%3DSHData%26lstnum1%3D1384%26file_seq%3D1&usg=AFQjCNH2-z88FirIfMMcAdX7Um2qywH2fA&sig2=QV_yFTdSpDGxM2IGs1N95Q.

3.. Roberts CK, Izadpanah A, Angadi SS, Barnard RJ. Effects of an intensive short-term diet and exercise intervention: comparison between normal-weight and obese children. Am J Physiol Regul Integr Comp Physiol 2013;305(5):R552-557.

4.. GSMA/NTT DOCOMO. Children's use of mobile phones - An international comparison 2013. Japan: GSMA/NTT DOCOMO; 2013. [Assessed January 5, 2016].. http://www.gsma.com/publicpolicy/wp-content/uploads/2012/03/GSMA_AND_NTT_DOCOMO_Childrens_Report_WebPages_R1.pdf.

5.. Ministry of Gender Equality and Family. 2013 Investigation for media use in adolescence. Seoul: Ministry of Gender Equality and Family; 2013. [Assessed January 5, 2016].. http://www.googlE. Co.kr/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwj0v7LHyZHKAhXCjJQKHSUwAYgQFgglMAA&url=http%3A%2F%2Fwww.prism.go.kr%2Fhomepage%2FresearchCommon%2FdownloadResearchAttachFile.do%3Bjsessionid%3DE88D5220DB4A35E83B24ACCF3044F8E9.node02%3Fwork_key%3D001%26file_type%3DCPR%26seq_no%3D001%26pdf_conv_yn%3DN%26research_id%3D1382000-201300011&usg=AFQjCNEhuMOTNBzwP0x4q4PHBRCgZm0WmA&sig2=e26ZrOAjRSMt7HmnSJpv3w.

6.. Coons MJ, DeMott A, Buscemi J, Duncan JM, Pellegrini CA, Steglitz J, et al. Technology interventions to curb obesity: a systematic review of the current literature. Curr Cardiovasc Risk Rep 2012;6(2):120-34.

7.. Spring B, Duncan JM, Janke EA, Kozak AT, McFadden HG, DeMott A, et al. Integrating technology into standard weight loss treatment: a randomized controlled trial. JAMA Int Med 2013;173(2):105-11.

8.. Klohe-Lehman DM, Freeland-Graves J, Clarke KK, Cai G, Voruganti VS, Milani TJ, et al. Low-income, overweight and obese mothers as agents of change to improve food choices, fat habits, and physical activity in their 1-to-3-year-old children. J Am Coll Nutr 2007;26(3):196-208.

9.. Boushey CJ, Kerr DA, Wright J, Lutes KD, Ebert DS, Delp EJ. Use of technology in children's dietary assessment. Eur J Clin Nutr 2009;63(Suppl 1):S50-7.

10.. Nakamura J, Csikszentmihalyi M. Handbook of positive psychology. New York: Oxford University Press; 2002. p. 89-105.

11.. Keller J, Suzuki K. Learner motivation and E-learning design: a multinationally validated process. J Educ Media 2004;29(3):229-39.

12.. Zichermann G, Cunningham C. Gamification by design: Implementing game mechanics in web and mobile apps. 1st ed. Sebastopol: O'Reilly Media; 2011.

13.. Bunchball Inc. Gamification 101: an introduction to the use of game dynamics to influence behavior. California: Bunchball Inc; 2011. [Assessed January 5, 2016].. http://www.bunchball.com/sites/default/files/downloads/gamification101.pdf.

14.. Free C, Whittaker R, Knight R, Abramsky T, Rodgers A, Roberts IG. Txt2stop: a pilot randomised controlled trial of mobile phone-based smoking cessation support. Tob Control 2009;18(2):88-91.

15.. Lester RT, Ritvo P, Mills EJ, Kariri A, Karanja S, Chung MH, et al. Effects of a mobile phone short message service on anti-retroviral treatment adherence in Kenya (WelTel Kenya1): a randomised trial. Lancet 2010;376(9755):1838-45.

16.. Miller AS, Cafazzo JA, Seto E. A game plan: gamification design principles in mHealth applications for chronic disease management. Health Informatics J. 2014 Jul 1;[Epub ahead of print]..

17.. Thorsteinsen K, Vittersø J, Svendsen GB. Increasing physical activity efficiently: an experimental pilot study of a website and mobile phone intervention. Int J Telemed Appl 2014;2014:746232.

18.. Jones BA, Madden GJ, Wengreen HJ, Aguilar SS, Desjardins EA. Gamification of dietary decision-making in an elementary-school cafeteria. PLoS One 2014;9(4):e93872.

19.. Gabarron E, Schopf T, Serrano JA, Fernandez-Luque L, Dorronzoro E. Gamification strategy on prevention of STDs for youth. Stud Health Technol Inform 2013;192:1066.

20.. Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice-Hall; 1986.

21.. Díaz RG, Esparza-Romero J, Moya-Camarena SY, Robles-Sardín AE, Valencia ME. Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth. J Am Diet Assoc 2010;110(2):285-90.

22.. Ministry of Health and Welfare. Dietary guidelines for obesity prevention. Seoul: Ministry of Health and Welfare; 2010. [Assessed January 5, 2016].. http://www.googlE. Co.kr/url?sa=t&rct=j&q=&esrc=s&frm=1&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjh_YaxzJHKAhXBn5QKHX5ODIsQFgggMAA&url=http%3A%2F%2Fdownload.mw.go.kr%2Ffront_new%2Fmodules%2Fdownload.jsp%3FBOARD_ID%3D320%26CONT_SEQ%3D318426%26FILE_SEQ%3D162450&usg=AFQjCNEnICnOcvzuC5e_-2vPPtiCFT8HEA&sig2=32BCnNjqi9iUc2dgIlFRrg.

23.. The Korean Dietetic Association. Guidelines for Health Eating for Child Obesity Prevention and Management. Seoul: Ministry of Health and Welfare & The Korean Dietetic Association; 2010. [Assessed January 5, 2016].. http://www.schoolhealth.kr/shnhome/bbs/bbs01002v.php?LstNum1=1219&purl=bbs01001l&GbnCode=0203.

24.. Ministry of Health and Welfare. The physical activity guide for Koreans. Seoul: Ministry of Health and Welfare; 2013. [Assessed January 5, 2016].. http://www.mw.go.kr.

25.. de Jongh T, Gurol-Urganci I, Vodopivec-Jamsek V, Car J, Atun R. Mobile phone messaging for facilitating self-management of long-term illnesses. Cochrane Database Syst Rev 2012;12:CD007459.

26.. Schoffman DE, Turner-McGrievy G, Jones SJ, Wilcox S. Mobile apps for pediatric obesity prevention and treatment, healthy eating, and physical activity promotion: just fun and games? Transl Behav Med 2013;3(3):320-5.

27.. Deterding S, Dixon D, Khaled R, Nacke L. From game design elements to gamefulness: defining gamification. The 15th International Academic MindTrek Conference Envisioning Future Media Environments. 2011;September 28-30; Tampere. Finland: ACM Press; 2011..

28.. Sarwar M, Soomro TR. Impact of smartphone's on society. Europ J Scien Res 2013;98:216-26.

29.. Marshall SJ, Biddle SJ, Gorely T, Cameron N, Murdey I. Relationships between media use, body fatness and physical activity in children and youth: a meta-analysis. Int J Obes Relat Metab Disord 2004;28(10):1238-46.

30.. Ness AR, Leary SD, Mattocks C, Blair SN, Reilly JJ, Wells J, et al. Objectively measured physical activity and fat mass in a large cohort of children. PLoS Med 2007;4(3):e97.