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Parents’ mHealth App for Promoting Healthy Eating Behaviors in Children: Feasibility, Acceptability, and Pilot Study

  • Mobile & Wireless Health
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Abstract

The use of mobile health apps to improve diet and nutrition behaviors has increased in recent years. Several studies have described the benefits and advantages of this technology as a complement to interventions for improving nutrition behaviors and nutrition‐related health outcomes, including obesity indices and clinical parameters. Few of these works have developed clinical mobile health apps for children, and although parents play a critical role in children’s nutrition behaviors, work targeting parents is scarce. The work presented in this paper describes the development of the PersuHabit app, a stand-alone mobile health app targeting parents to promote the intake of fruits and vegetables (FVs) and reduce the intake of ultra-processed foods (UPF) in children aged 6 to 10 years. The paper also presents the execution of an exploratory pilot study to assess the feasibility, acceptability, and preliminary effects of the PersuHabit app. The results are presented and discussed, and actions for further improvement of the PersuHabit app are identified.

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Acknowledgements

We thank the National Technology of Mexico/Guzman City Campus for granting the first author permission to carry out postgraduate studies (M00/1339/2018). We also thank the Mexican National Research Council (CONACYT) for financial support (grant number PDCPN-2015-824) of the program “Convocatoria de Problemas Nacionales 2015 CONACyT”. We thank all the teachers, parents, and children who participated in this study. We thank the software developers Miguel Ángel Jacobo and Marco Antonio Aguilar Anguiano for participating in the development of the PersuHabit app. Finally, we thank nutritionist Aida Gabriela Anaya Flores for her advice and support in designing the nutrition content and nutrition design elements of the PersuHabit app.

Funding

Partial financial support was received from the Mexican National Research Council (CONACyT) grant number PDCPN-2015–824).

Author information

Authors and Affiliations

  1. Departamento de Sistemas y Computación, TecNM - Instituto Tecnológico de Ciudad Guzmán, Ciudad Guzmán, Jalisco, México

    Ada Mabel Vázquez-Paz & Rosa María Michel-Nava

  2. Centro de Estudios e Investigaciones en Comportamiento, Universidad de Guadalajara, Guadalajara, Jalisco, México

    Edwin Emeth Delgado-Pérez

  3. Instituto de Investigaciones en Comportamiento Alimentario y Nutrición (IICAN), Centro Universitario del Sur, Universidad de Guadalajara, Ciudad Guzmán, Jalisco, México

    Mariana Lares-Michel

  4. Centro de Investigación Científica y de Educación Superior de Ensenada, Unidad de Transferencia Tecnológica Tepic, Tepic, Nayarit, México

    Ismael Edrein Espinosa-Curiel

Authors
  1. Ada Mabel Vázquez-Paz
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  2. Rosa María Michel-Nava
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  3. Edwin Emeth Delgado-Pérez
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  4. Mariana Lares-Michel
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  5. Ismael Edrein Espinosa-Curiel
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Corresponding author

Correspondence to Ismael Edrein Espinosa-Curiel.

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Ethical Approval

The Bioethics Committee of the Centro de Investigacion Cientifica y de Educacion Superior de Ensenada (Ensenada, Baja California, Mexico) approved this study (No. HUM_2020_03). All procedures performed were approved for studies involving human participants according to the ethical standards of the institutional and/or national research committee and the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Appendices

Appendix 1

Questionnaire for acceptability assessment

Number

Question

Scale

Q1

I am satisfied with the app

1) Strongly disagree

Q2

I like to use the app frequently

2) Disagree

Q3

I would like to continue using the app

3) Undecided

Q4

The app is lovely

4) Agree

Q5

I find the app attractive

5) Strongly agree

Q6

The app has all the features and functions you could want

 

Q7

The functionalities of the app meet my requirements

 

Q8

The design of the app makes it easy to find the information I’m looking for

 

Q9

The app is easy to use

 

Q10

It is easy to navigate within the app

 

Q11

I felt that I had control in the app

 

Q12

I found it easy to learn how to use the app

 

Q13

All the information in the app was clear and understandable

 

Q14

The messages sent by the app were clear and understandable

 

Q15

I felt tired or bored when using the app (reversed)

 

Q16

The app helped me improve my child’s eating habits

 

Q17

The app educated me on nutrition issues

 

Q18

The app educated me on how to achieve a healthy diet for my child

 

Q19

The app helped me to have better control of my child’s food intake

 

Q20

The app helped me to be more aware of my child's eating habits

 

Q21

The app allowed me to realize how healthy my child’s diet is

 

Q22

The app persuaded me to improve my child’s eating habits

 

Q23

The app motivated me to improve my child’s eating habits

 

Items Q1-Q3 relate to engagement, items Q4-Q15 relate to user experience/usability, and items Q16-Q23 relate to perceived effectiveness. These sections are based on the questionnaires of Martinez-Miranda et al. [79], Sauro and Zaloria [80], and Stoyanov et al. [81], respectively.

Appendix 2

Questionnaire for parents’ knowledge about the recommended intake of FVs assessment.

Number

Question

Scale

Q1

How many vegetables should adults eat, according to doctors and dietitians?

1) 1–2 pieces per week

2) 3–4 pieces per week

3) 1 per day

4) 2–3 pieces per day

5) I do not know

Q2

How many fruits should adults eat, according to doctors and dietitians?

1) 1 serving per day

2) 2 servings per day

3) 3 servings per day

4) 4 or more servings per day

5) I do not know

Q3

How many vegetables should children eat, according to doctors and dietitians?

1) 1–2 pieces per week

2) 3–4 pieces per week

3) 1 per day

4) 2–3 pieces per day

5) I do not know

Q4

How many fruits should children eat, according to doctors and dietitians?

1) 1 serving per day

2) 2 servings per day

3) 3 servings per day

4) 4 or more servings per day

5) I do not know

This questionnaire is based on the questionnaire developed by Vereecken et al. [82].

Appendix 3

Questionnaire for parents’ intake of FVs and UPF assessment.

Number

Question

Scale

Q1

How many days a week do you eat vegetables

(at least 100 g – example, a cucumber or half a chayote)?

1) 0 to 2

2) 3 to 4

3) 5 to 6

4) daily

Q2

On days you eat vegetables, how many servings do you consume

(Approximately 100 g, example, a cucumber or half chayote)?

1) 1 serving

2) 2 servings

3) 3 servings

4) 4 servings or more

Q3

How many days a week do you eat vegetables

(at least 100 g—example: a cucumber or half a chayote)?

1) 0 to 2

2) 3 to 4

3) 5 to 6

4) daily

Q4

On days you eat vegetables, how many servings do you consume

(Approximately 100 g, example: a cucumber or half chayote)?

1) 1 serving

2) 2 servings

3) 3 servings

4) 4 servings or more

Q5

How many days a week do you eat ham, sausage, salami, or chorizo?

1) None

2) 1 to 2

3) 3 to 4

4) 5 or more

Q6

How many days a week do you eat fast food (hamburgers, pizzas)?

Q7

How many days a week do you eat sweets or chocolates?

Q8

How many days a week do you eat sweet bread, cookies, or cakes?

Q9

How many days a week do you eat French fries, chips, nachos, or similar snacks?

Q10

How many days a week do you drink soda, bottled juices, or fresh water?

Items Q1 and Q2 relate to the intake of fruits, items Q3 and Q4 relate to the intake of vegetables, and items Q5-Q10 relate to the intake of UPFs. This questionnaire is based on the Sects. 1 and 2 of the questionnaire developed by Flores and Macedo [83].

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Vázquez-Paz, A.M., Michel-Nava, R.M., Delgado-Pérez, E.E. et al. Parents’ mHealth App for Promoting Healthy Eating Behaviors in Children: Feasibility, Acceptability, and Pilot Study. J Med Syst 46, 70 (2022). https://doi.org/10.1007/s10916-022-01860-w

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