Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Apr 13, 2019
Open Peer Review Period: Apr 17, 2019 - May 24, 2019
Date Accepted: Aug 23, 2019
(closed for review but you can still tweet)
Development and initial randomized controlled test of an interactive mobile phone app for increasing fruit and vegetable knowledge and intakes
ABSTRACT
Background:
Fruit and vegetable (FV) consumption is important for health, but many individuals fail to consume adequate FV for health benefits. While many individuals are aware of current FV consumption recommendations, research suggests that adherence to these recommendations is hampered by low knowledge and confusion surrounding the details of the recommendations.
Objective:
This paper reports the development and details of a pilot randomized controlled trial for a novel interactive mobile phone application (app) for addressing low knowledge of the UK 5 a day FV recommendations.
Methods:
First, the requirements for the app were elicited and defined by researchers and potential end-users, and prioritised using the MoSCoW method. Then a prototype smart phone app was designed and developed using an agile approach. The prototype app was then tested in a randomized controlled pilot trial, for impacts on FV knowledge and FV intake, where users also provided qualitative feedback. In this trial, volunteers were randomized to either receive (N=50) or not receive the app (N=44) for two or four weeks, and FV knowledge, FV intakes, and FV behaviour were assessed at study start and study end. App usage and feedback was also investigated. Lastly, a final version of the app was developed to incorporate the findings from this pilot test.
Results:
Low knowledge of the FV recommendations centred around portion sizes and the need for variety, and an interactive mobile phone app was considered a suitable tool for improving knowledge in a practical manner, that would be available both at time of consumption and outside of these times. The pilot test revealed improved FV behaviour in volunteers who received the app for two weeks compared to baseline, and suggestions of increased FV intakes, but improvements in FV knowledge were found in both groups, and no improvements in FV intake were found in formal measures. App usage was also low and feedback suggested a desire for reminder notifications and a value from increased awareness of low FV intakes. Improvements in the final version of the app include a message to increase awareness of low intakes and an option to add notifications to increase use.
Conclusions:
A novel interactive mobile phone app was successfully developed based on requirements, and when tested in a pilot randomized controlled trial, this app was found to have some impacts on FV outcomes. While benefits from the app were small, app usage was also low, and feedback from those testing the app offered useful insights to improve engagement. A final version of the app has now been developed and requires full testing. Clinical Trial: www.clinicaltrials.gov (ID NCT02779491).
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Copyright
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