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A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study

Martin, Anne; Caon, Maurizio; Adorni, Fulvio; Andreoni, Giuseppe; Ascolese, Antonio; Atkinson, Sarah; Bul, Kim; Carrion, Carme; Castell, Conxa; Ciociola, Valentina; Condon, Laura; Espallargues, Mireia; Hanley, Janet; Jesuthasan, Nithiya; Lafortuna, Claudio L; Lang, Alexandra; Prinelli, Federica; Puidomenech Puig, Elisa; Tabozzi, Sarah A.; McKinstry, Brian; PEGASO Fit for Future Consortium

A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study Thumbnail


Authors

Anne Martin

Maurizio Caon

Fulvio Adorni

Giuseppe Andreoni

Antonio Ascolese

Sarah Atkinson

Kim Bul

Carme Carrion

Conxa Castell

Valentina Ciociola

Laura Condon

Mireia Espallargues

Janet Hanley

Nithiya Jesuthasan

Claudio L Lafortuna

Federica Prinelli

Elisa Puidomenech Puig

Sarah A. Tabozzi

Brian McKinstry

PEGASO Fit for Future Consortium



Abstract

Background: Promotion of physical activity, healthy eating, adequate sleep and reduced sedentary behavior in adolescents is a major priority globally given the current increase in population health challenges of non-communicable diseases and risk factors such as obesity. Adolescents are highly engaged with mobile technology, but the challenge is to engage them with mHealth technology. Recent innovations in mobile technology provide opportunities to promote a healthy lifestyle in adolescents. An increasingly utilized approach to facilitate increased engagement with mHealth technology is to involve potential users in the creation of the technology.

Objective: To describe the process of and findings from co-designing and prototyping components of the PEGASO Fit for Future mHealth intervention for adolescents from different cultural backgrounds.

Methods: Seventy-four adolescents aged 13-16 years from Spain, Italy and the United Kingdom participated in the co-design of the PEGASO Fit for Future technology. In three iterative cycles over 12 months, participants were involved in the co-design, refinement and feasibility testing of a system consisting of diverse mobile applications with a variety of functions and facilities to encourage healthy weight promoting behaviors. In the first iteration, participants attended a single workshop session and were presented with mock-ups or early-version prototypes of different apps for user requirements assessment and review. During the second iteration, prototypes of all apps were tested by participants for one week at home or school. In the third iteration, further developed prototypes were tested for two weeks. Participants’ use experience feedback and development ideas were collected from focus groups and completion of questionnaires.

Results: For the PEGASO Fit for Future technology to be motivating and engaging, participants suggested that it should (i) allow personalization of the interface, (ii) have age-appropriate and easy to understand language (of icons, labels, instructions, notifications), (iii) provide easily accessible tutorials on how to use the app or navigate through a game, (iv) present a clear purpose and end goal, (v) have an appealing and self-explanatory reward systems, (vi) offer variation in gamified activities within apps and the serious game, and (vii) allow to seek peer-support and connect with peers for competitive activities within the technology.

Conclusions: Incorporating adolescents’ preferences, the PEGASO Fit for Future technology combines the functions of a self-monitoring, entertainment, advisory, and social support tool. This was the first study demonstrating that it is possible to develop a complex smartphone-based technological system applying the principles of co-design to mHealth technology with adolescents across three countries. Findings of this study informed the development of an mHealth system for healthy weight promotion to be tested in a controlled multi-national pilot trial.

Citation

Martin, A., Caon, M., Adorni, F., Andreoni, G., Ascolese, A., Atkinson, S., …PEGASO Fit for Future Consortium. (2020). A Mobile Phone Intervention to Improve Obesity-Related Health Behaviors of Adolescents Across Europe: Iterative Co-Design and Feasibility Study. JMIR mHealth and uHealth, 8(3), Article e14118. https://doi.org/10.2196/14118

Journal Article Type Article
Acceptance Date Dec 16, 2019
Online Publication Date Mar 2, 2020
Publication Date 2020-03
Deposit Date Jan 7, 2020
Publicly Available Date Mar 29, 2024
Journal JMIR mHealth and uHealth
Electronic ISSN 2291-5222
Publisher JMIR Publications
Peer Reviewed Peer Reviewed
Volume 8
Issue 3
Article Number e14118
DOI https://doi.org/10.2196/14118
Keywords Health behavior, Obesity prevention, Co-design, mHealth, Mobile app, Smartphone, Adolescents, Youth, Focus groups, Mixed-methods research
Public URL https://nottingham-repository.worktribe.com/output/3611593
Publisher URL https://mhealth.jmir.org/2020/3/e14118/

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