JMIR Publications

ABSTRACT

Background:

Childhood obesity is on the rise in Singapore with the majority continuing into adulthood and experiencing poor long-term outcomes. Current evidence for childhood obesity interventions shows a clear dose-response effect with increasing number of hours of treatment, with a threshold for effectiveness at >25 hours over a 6-month period [1]. The Kick Start Move Smart programme is the first online community-based programme with multi-disciplinary healthcare involvement to treat paediatric obesity in Singapore, which has demonstrated feasibility and acceptability with 70% participants achieving the recommended >25 hours of intervention. Preliminary data shows significantly lower body mass index and improved quality of life in participants compared to controls. These families who succeeded are positive outlier who developed strategies for health in the context of an obesogenic environment. The positive outlier approach indicates that solutions to problems faced by a community often exist within certain individual community members and these community-specific, successful strategies can be generalised and promoted to improve the health of others in the same community [2]. A mobile health (mHealth) application that targets parents is a critical missing link in the currently available interventions to support parents in self-management of childhood obesity [3]. Using a combination of approaches from behavioural theory and user-centred design is important in designing mHealth applications. One recommended framework is the Integrate, Design, Assess and Share (IDEAS) framework which aims to facilitate the development and dissemination of more effective interventions by engaging perspectives from different stakeholders.

Objective:

This study aims to (1) describe the co-design protocol of an mHealth app using the IDEAS framework as a low-intensity intervention or as adjuncts to a more intensive existing paediatric obesity intervention and (2) assess the usability, acceptability and engagement of the mHealth application by parents.

Methods:

A clinician led co-design approach will be undertaken with a multidisciplinary team using the IDEAS framework. There are four iterative phases for the mHealth app development. Phase 1 involves stakeholder engagement, the formation of both a core committee and a parent advisory board. Phase 2 involves developmement of the app content through focus group and expert panel discussions. Phase 3 involves the development of a prototype app and gathering of feedback. Lastly, Phase 4 involves piloting of the Minimum Viable Product (MVP) by parent users and evaluation using interviews and uMARS questionnaire.

Results:

As of February 2024, we have completed Phase 1 and portions of Phase 2, and formed a parent advisory board. Two focus group discussions with the parent advisory board and two expert panel discussions were conducted.

Conclusions:

A mHealth application that is evidence-based and theory driven, developed utilizing a design framework can bridge the gap in providing multidisciplinary care in the community setting for families with overweight children.