JMIR Publications

ABSTRACT

Background:

Overweight and obesity in adolescents has reached epidemic proportions in the United States. Consumer Health Technology (CHT) can serve as a behavioral and social support tool for adolescents’ overweight management. Recognizing CHT as a social support tool during design enables multiple stakeholders in the care support network to engage in shared co-use to reinforce and empower adolescents in their self-management efforts.

Objective:

The aim of this research was to explore design requirements and enabling factors for use of CHT as a social support tool for the patient (as primary user) and parents and providers (as co-users). Our conceptual model incorporates key components of the Unified Theory of Acceptance and Use of Technology (UTAUT) within the framework of the Obesity Care Model (OCM) by recognizing patient self-management as the central process with the influence of environmental and medical systems on CHT use and outcomes.

Methods:

This study was part of a larger two-staged usability study combining focus group, semi-structured interviews and usability walk through of CHT mock-ups from adolescents, parents and physicians. In phase 1, 48 adolescents between the ages of 12 and 17, 10 of their parents and 6 providers participated in identifying design requirements and enabling factors for use of a potential CHT. In phase 2, 70 adolescents and 10 health providers evaluated the CHT mock-ups and indicated enabling factors as well as willingness to use the proposed CHT.

Results:

Our qualitative analysis identified adolescents’ intention for primary use of CHT identified features impacting UTAUT elements of performance expectancy, effort expectancy and facilitating conditions. Our reconceptualization of social influence in alignment with the OCM identified the expectations and envisioned roles of parents and providers as co-users as well as multiple influencing factors on the co-use of CHT in managing adolescents’ obesity among the three stakeholders. Parents were expected to monitor, provide guidance and motivation and to suggest modifications in daily habits, e.g., recipes and meals, while providers were expected to encourage and monitor progress in a clinical setting. These expected roles and co-use patterns were congruent among all three stakeholders; co-use of CHT was desired to be minimally invasive for parents and providers and controlled by the adolescents.

Conclusions:

Our study integrates and extends the perspectives of two seminal models to explore design features and social influence roles for successful user-centered design of CHT for adolescents’ weight self-management in the context of the OCM. While the co-users (adolescents, parents and providers) suggested differing features consistent to their roles, role definitions were congruent. All users recognized the adolescent as central and primary user and differential, supportive social influence from parents and providers. This multi-stakeholder approach can guide successful CHT design that reinforces a collective perspective of self-management.