Acceptability and Feasibility of a Smartphone Application for 5th, 6th Grade Elementary Students to Prevent Childhood Obesity; a Qualitative Study

Ji-Hye Jung; Young-Gyu Cho; Da-Ye Ji; Jae-Heon Kang

doi:10.15384/kjhp.2016.16.4.251

Korean J Health Promot > Volume 16(4); 2016 > Article

Jung, Cho, Ji, and Kang: Acceptability and Feasibility of a Smartphone Application for 5th, 6th Grade Elementary Students to Prevent Childhood Obesity; a Qualitative Study

Original Article

Korean Journal of Health Promotion 2016;16(4):251-259.

Published online: January 20, 2016

DOI: https://doi.org/10.15384/kjhp.2016.16.4.251

Acceptability and Feasibility of a Smartphone Application for 5th, 6th Grade Elementary Students to Prevent Childhood Obesity; a Qualitative Study

¹Institute for Clinical Nutrition, Inje University, Seoul, Korea

²Department of Family Medicine, Seoul Paik Hospital, College of Medicine, Inje University, Seoul, Korea

Ji-Hye Jung¹, Young-Gyu Cho^1,², Da-Ye Ji¹, Jae-Heon Kang^1,^2,

Corresponding author: Jae-Heon Kang, MD, PhD Institute for Clinical Nutrition, Inje University, 18 Mareunnae-ro, Jung-gu, Seoul 04552, Korea
Tel: +82-2-2272-0908, Fax: +82-2-2268-0971 E-mail: fmleader@nuri.net

Received July 15, 2016 Accepted December 28, 2016

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.

요약

Background

This study aimed to describe the acceptability and feasibility of the “HAPPY ME”, a smartphone application (app) for guiding healthy eating habits and physical activities to prevent childhood obesity, through in-depth interviews of 5th and 6th grade students of an elementary school.

Methods

A total of 25 students were recruited from grades 5 and 6 of an elementary school in Gimpo. They were asked to participate in in-depth interviews about expectations regarding the “HAPPY ME”, smartphone usage behaviors, perceptions and attitudes towards health, and satisfaction with the “HAPPY ME”, before and after the 4-week trial of the “HAPPY ME”.

Results

Study participants reported a high level of satisfaction regarding gamification elements such as awarding points as rewards for completing missions and using closed social networking services with friends. They also reported that their eating habits had improved after the 4-week trial. However, some students felt that the app was complicated to use and recommended that it should have prompts as notifications.

Conclusions

This study showed that the “HAPPY ME” is acceptable and feasible for use with children. However, the app needs to be modified based on the results of this study.

Keywords: Obesity, Mobile applications, Child, Child nutrition sciences, Exercise

Figure 1.

Screenshots of the “HAPPY ME” application.

Table 1.

Contents of pre-intervention interview questions

Theme	Sub-theme
Expectations	Expectations from participating in the study
regarding the “HAPPY ME”	Interesting features of the “HAPPY ME”
regarding the “HAPPY ME”	Features that the “HAPPY ME” should include
	Form (quiz, video, game, etc.)
Smartphone	Benefits of a smartphone
usage behaviors	Commonly used applications Total time spent on smartphone use per day
Perceptions	Perceptions regarding health
and attitudes towards health	Self-evaluation of your health Definition of healthy eating habits Usual eating habits
	Perceptions towards exercise
	Relationship between exercise and health Usual exercise pattern (duration, frequency, intensity, etc.)

Table 2.

Contents of post-intervention interview questions

Theme	Sub-theme
Expectation regarding the	Features that the “HAPPY ME” should include
“HAPPY ME”	Form (quiz, video, game, etc.)
Satisfaction with	Your favorite features of the “HAPPY ME”
the “HAPPY ME”	Functions that the “HAPPY ME” should
the “HAPPY ME”	have for sustained use
	Evaluation of the gamification elements
	Function used most frequently
	Inconvenient elements
Perceptions and	Perceptions regarding health
attitudes towards health	Self-evaluation of health Definition of healthy eating habits
	Effect of the “HAPPY ME” on eating habits
	Reasons for changes in eating habits
	Perceptions towards exercise
	Relationship between exercise and health
	Effect of the “HAPPY ME” on the exercise pattern
	Reasons for changes in the exercise pattern

Table 3.

General characteristics of the study participants

Question	Number (%)
Gender
Boys	14 (56)
Girls	11 (44)
Age (years)
10	2 (8)
11	12 (48)
12	11 (44)
Year in elementary school
Fifth year	9 (36)
Sixth year	16 (64)
Type of mobile OS
Android	25 (100)
iOS	0 (0)
Time of smartphone use (hours/day)
<1	4 (16)
1–2	12 (48)
≥2	9 (36)

References

1. Kim CS, Ko SH, Kwon HS, Kim NH, Kim JH, Lim S, et al. Prevalence, awareness, and management of obesity in Korea: data from the Korea national health and nutrition examination survey (1998–2011). Diabetes Metab J 2014;38(1):35-43.

2. Namgung YS. Sample analysis of result on physical development, and health screenings of elementary, middle and high school students [Internet]. Sejong: The Ministry of Education; 2016. [Accessed April 16, 2016]. Available from:. http://www.korea.kr/policy/pressReleaseView.do?newsId=156036809.

3. Goossens L, Braet C, Van Vlierberghe L, Mels S. Loss of control over eating in overweight youngsters: the role of anxiety, depression and emotional eating. Eur Eat Disord Rev 2009;17(1):68-78.

4. Haut C. Child behavioral health: are we there yet? J Pediatr Health Care 2016;30(1):3-4.

5. Cho YG, Song HR, Kim KA, Kang JH, Kang JH, Song YH, et al. Effect of a school-based intervention for overweight children “fitness class” performed on elementary schools located in Seoul. Korean J Obes 2009;18(4):146-57.

6. Tate EB, Spruijt-Metz D, O'Reilly G, Jordan-Marsh M, Gotsis M, Pentz MA, et al. mHealth approaches to child obesity prevention: success, unique challenges, and next directions. Transl Behav Med 2013;3(4):406-15.

7. Hong YJ. The present possession of smartphone of elementary, middle and high school students [Internet]. Sejong: The Ministry of Education; 2013. [Accessed March 09, 2016] Available from:. http://www.korea.kr/policy/pressReleaseView.do?newsId=15. 5909244..

8. Case MA, Burwick HA, Volpp KG, Patel MS. Accuracy of smartphone applications and wearable devices for tracking physical activity data. JAMA 2015;313(6):625-6.

9. Moustafa K. A smart application for smartphone: a proposal to reduce noise pollution for people having regular tasks. Front Public Health 2014;2:122.

10. Abaidoo B, Larweh BT. Consumer health informatics: the application of ICT in improving patient-provider partnership for a better health care. Online J Public Health Inform 2014;6(2):): e188..

11. Husain I, Spence D. Can healthy people benefit from health apps? BMJ 2015;350:h1887.

12. Kim YJ, Rhee SY, Byun JK, Park SY, Hong SM, Chin SO, et al. A smartphone application significantly improved diabetes self-care activities with high user satisfaction. Diabetes Metab J 2015;39(3):207-17.

13. Hoey H. Management of obesity in children differs from that of adults. Proc Nutr Soc 2014;73(4):519-25.

14. Jung JH, Jeon SH, Bae HJ, Cho YG, Hur YI, Sung EJ, et al. Development of a smartphone application for 4th–6th grade elementary students to prevent childhood obesity and satisfaction study. Korean J Obes 2016;25(2):99-104.

15. Kim H, Kang JH, Park HA, Cho SH, Jeon S, Jung JH, et al. Development of a smartphone application prototype for child obesity prevention: rationale and study design of acceptability and feasibility test. Korean J Health Promot 2015;15(4):194-201.

16. Gowin M, Cheney M, Gwin S, Franklin Wann T. Health and fitness app use in college students: a qualitative study. Am J Health Educ 2015;46(4):);. 223-30.

17. Salmivalli C, Sainio M, Hodges EV. Electronic victimization: correlates, antecedents, and consequences among elementary and middle school students. J Clin Child Adolesc Psychol 2013;42(4):442-53.

18. Barnett B, Corkum P, Elik N. A web-based intervention for elementary school teachers of students with attention-deficit/hyper-activity disorder (ADHD). Psychol Serv 2012;9(2):227-30.

19. Kinnafick FE, Th⊘gersen-Ntoumani C, Duda J. The effect of need supportive text messages on motivation and physical activity behaviour. J Behav Med 2016;39(4):574-86.

20. Sidhu MS, Daley A, Jolly K. Evaluation of a text supported weight maintenance programme ‘lighten up plus' following a weight reduction programme: randomised controlled trial. Int J Behav Nutr Phys Act 2016;13:19.

21. Kim DG, Kim CW. Analysis of the educational utilization of smartphones on elementary students. J Korean Assoc Inform Educ 2013;17(3):367-73.

22. Wu TY, Robbins LB, Hsieh HF. Instrument development and validation of Perceived Physical Activity Self-Efficacy Scale for adolescents. Res Theory Nurs Pract 2011;25(1):39-54.

23. Pellegrini CA, Pfammatter AF, Conroy DE, Spring B. Smart-phone applications to support weight loss: current perspectives. Adv Health Care Technol 2015;1:13-22.

24. Dennison l. Morrison L, Conway W, Yardley L. Opportunities and challenges for smartphone applications in supporting health behavior change: qualitative study. J Med Intern Res 2013;15(4):): e86..

25. Slater A, Tiggemann M. Gender differences in adolescent sport participation, teasing, self-objectification and body image concerns. J Adolesc 2011;34(3):455-63.

26. Park KM, Jung HS, Lee JE, Kim SE. The effects of school health education on health knowledge, health attitude and health behavior among middle school students. J Korean Soc School Health 2012;25(1):68-76.

27. Park N, Sohn S. The effects of food safety education on children's food safety knowledge, belief, attitude, and behavior. Consum Policy Educ Rev 2010;6(1):47-66.

28. Park JG, Kim KW. Physical activity level according to gender, grades, body mass index, and personality traits in adolescents. KINESIOLOGY 2012;14(2):37-47.

29. Suh JK, Kim HK. A study on the difference of students' recognition, attitude, and knowledge level of health activity by the health education. Korean J Health Serv Management 2012;6(2):121-31.

30. Noh HJ, Choi CH, Sohn WS. The relationship between oral health behavior and frequency of oral health education in adolescent. J Korean Acad Oral Health 2008;32(2):203-13.