ORCID

Abstract

Childhood obesity is a growing global health concern. Although mobile health apps have the potential to deliver behavioural interventions, their impact is commonly limited by a lack of sufficient engagement. The purpose of this study was to explore barriers and facilitators to engagement with a family-focused app and its perceived impact on motivation, self-efficacy, and behaviour. Parents with at least one child under 18 and healthcare professionals working with children were recruited; all participants were allocated to use the NoObesity app over a 6-month period. The mixed-methods design was based on the Non-adoption, Abandonment, Scale-Up, Spread, and Sustainability and Reach, Effectiveness, Adoption, Implementation, and Maintenance frameworks. Qualitative and quantitative data were gathered through semi-structured interviews, questionnaires, and app use data (logins and in-app self-reported data). 35 parents were included in the final analysis; quantitative results were analysed descriptively and thematic analysis was conducted on the qualitative data. Key barriers to engagement were boredom, forgetting, and usability issues and key barriers to potential impact on behaviours were accessibility, lack of motivation, and family characteristics. Novelty, gamification features, reminders, goal setting, progress monitoring and feedback, and suggestions for healthy foods and activities were key facilitators to engagement with the app and behaviours. A key observation was that intervention strategies could help address many motivation and capability barriers, but there was a gap in strategies addressing opportunity barriers. Without incorporating strategies that successfully mitigate barriers in all three determinants of behaviour, an intervention is unlikely to be successful. We highlight key recommendations for developers to consider when designing the features and implementation of digital health interventions. Trial Registration: ClinicalTrials.gov (NCT05261555).

Publication Date

2024-03-27

Publication Title

PLOS Digital Health

Volume

3

Issue

3

Acceptance Date

2024-02-28

Deposit Date

2024-09-27

Funding

MMI and EM received research grant funding for this study from the former Health Education England, which is now the South East School of Public Health, Workforce Training and Education Directorate, NHS England (grant reference number: AM1000393). EM and MMI are supported by the NIHR Newcastle Biomedical Research Council (BRC). The views expressed in the paper belong to the authors and not necessarily those of the South East School of Public Health, NHS England, the University of Plymouth, the University of Liverpool, the University of Southampton, the University of Oxford, Newcastle University, the NIHR Newcastle BRC, or Imperial College London. The funding body had no editorial control and was not involved in the decision to submit the article for publication. Funding:MMIandEMreceivedresearchgrant fundingforthisstudyfromtheformerHealth EducationEngland,whichisnowtheSouthEast SchoolofPublicHealth,WorkforceTrainingand EducationDirectorate,NHSEngland(grant referencenumber:AM1000393).EMandMMIare supportedbytheNIHRNewcastleBiomedical ResearchCouncil(BRC).Theviewsexpressedin thepaperbelongtotheauthorsandnotnecessarily thoseoftheSouthEastSchoolofPublicHealth, NHSEngland,theUniversityofPlymouth,the UniversityofLiverpool,theUniversityof Southampton,theUniversityofOxford,Newcastle University,theNIHRNewcastleBRC,orImperial CollegeLondon.Thefundingbodyhadnoeditorial controlandwasnotinvolvedinthedecisionto submitthearticleforpublication.

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