JMIR Publications

ABSTRACT

Background:

Changing dietary behaviour is difficult and although it is often clear what needs to change, how to action change is more difficult. Mobile phones have characteristics which may support the complexity of changing dietary behaviour.

Objective:

This paper describes the iterative development process to build and test a mobile app called VegEze that aims to increase vegetable consumption.

Methods:

In order to upscale, reach target users and create a user-friendly end product, a collaborative research-industry partnership was formed to build the app over a 20-week build phase. The IDEAS framework was used as a scientific basis to guide the development. The Behaviour Change Wheel was also used as a theoretical grounding in combination with other theory-based strategies, such as self-monitoring, social comparison and gamification – which have all been shown to be successful in dietary change or digital health interventions. One consumer survey (n=1068), one usability testing session (n=11), and a pilot efficacy and usability trial (n=283) were conducted to inform the design of the app. The samples for the consumer survey and pilot trial were recruited via email from a database of individuals who had previously expressed an interest in participating in online health-related programs.

Results:

The target behaviour for the app was defined as “having 3 different types of vegetables at dinner”. The perceived achievability of this target behaviour was high; 93% of respondents felt they were ‘likely’ or ‘very likely’ to be able to regularly achieve the behaviour. App features that users reported to want included recipes and meal ideas (82% of users), functionality to track their intake (62%), and information on how to prepare vegetables. Based on the importance of self-monitoring as a behaviour change technique and its rating by users, the vegetable tracker was a core feature of the app, and was designed to be quick and simple to use and highly applicable to a range of users. Daily feedback messages for logging intake and communicating progress were designed to be engaging and fun using friendly and positive language and emoji icons. Daily and weekly feedback on vegetables consumption was designed to be simple and informative and reinforce monitoring. A creative team were engaged to assist in the branding of the app to ensure it had an identity that reflected the fun and simple nature of the underlying behaviour. The app included 16 behaviour change techniques, most of which were from the goals and planning subsection of the taxonomy.

Conclusions:

Combining a theoretical framework with an industry perspective and input resulted in an app that was developed in a timely manner while retaining its’ evidence-base and the process of scientific evaluation. VegEze is currently available in the App store, and the overall impact of the VegEze app will be evaluated using the RE-AIM framework in an uncontrolled, quantitative study. Clinical Trial: ACTRN12618000481279