A smartphone app to reduce sugar-sweetened beverage consumption among young adults in Australian remote indigenous communities: Design, formative evaluation and user-testing

Tonkin, Emma, Jeffs, Lauren, Wycherley, Thomas Philip, Maher, Carol, Smith, Ross, Hart, Jonathon, Cubillo, Beau, Hum Nut, B., and Brimblecombe, Julie (2017) A smartphone app to reduce sugar-sweetened beverage consumption among young adults in Australian remote indigenous communities: Design, formative evaluation and user-testing. JMIR mHealth and uHealth, 5 (12). e192.

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Background: The disproportionate burden of noncommunicable disease among Indigenous Australians living in remote Indigenous communities (RICs) is a complex and persistent problem. Smartphones are increasingly being used by young Indigenous adults and therefore represent a promising method to engage them in programs seeking to improve nutritional intake.

Objective: This study aimed to consult RIC members to inform the content of a smartphone app that can be used to monitor and reduce sugar-sweetened beverage intake in RICs.

Methods: The study was conducted in two phases. The formative phase involved a simulated grocery selection activity with think aloud (“think aloud shop”), a semistructured interview, a questionnaire outlining current smartphone and app use, and a paper prototyping activity. A preliminary end-user testing phase involved a think aloud prototype test and a semistructured interview regarding user satisfaction. Convenience sampling was used to recruit 20 18-to 35-year-old smartphone users for each phase from two RICs in the Northern Territory, Australia. Thematic analysis of transcribed audio recordings was used to identify determinants of food choice from the think aloud shop; themes related to the Theory of Planned Behavior (TPB) from the eating behaviors interview; and usability, comprehension, and satisfaction with the app from the preliminary end-user testing.

Results: Smartphone use in RICs is currently different to that found in urban environments; in particular, extremely low use of Facebook, restricted variety of phone types, and limited Internet access. Findings regarding promoting app engagement indicate that utilizing an opt-in approach to social features such as leader boards and team challenges is essential. The inclusion of games was also shown to be important for satisfaction, as were the use of audio features, contextually embedded dissemination, and streamlined app design for comprehension in this target group.

Conclusions: This research provides critical insights and concrete recommendations for the development of lifestyle improvement apps targeted toward disadvantaged young adults in nonurban settings, specifically RICs. It serves as a framework for future app development projects using a consultative user-centered design approach, supporting calls for the increased use of this strategy in app development.

Item ID: 75336
Item Type: Article (Research - C1)
ISSN: 2291-5222
Keywords: Behavior, Diet, Health promotion, Indigenous, Mobile applications, Public health, Telemedicine
Copyright Information: This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR mhealth and uhealth, is properly cited. The complete bibliographic information, a link to the original publication on http://mhealth.jmir.org/, as well as this copyright and license information must be included.
Date Deposited: 08 Aug 2022 00:57
FoR Codes: 42 HEALTH SCIENCES > 4206 Public health > 420605 Preventative health care @ 50%
42 HEALTH SCIENCES > 4206 Public health > 420603 Health promotion @ 50%
SEO Codes: 20 HEALTH > 2004 Public health (excl. specific population health) > 200410 Nutrition @ 100%
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