Accepted for/Published in: JMIR Formative Research
Date Submitted: Apr 30, 2024
Date Accepted: Sep 18, 2024
An investigation of the feasibility and acceptability of using a commercial DASH diet app in Saudi Arabia in people with high blood pressure: a mixed methods study
ABSTRACT
Background:
The use of smartphone apps for dietary self-management among patients with high blood pressure is becoming increasingly common. Few commercially available Dietary Approaches to Stop Hypertension (DASH) diet apps have the potential to be effective, and only a few of these have adequate security and privacy measures. In previous studies, we identified two high-quality apps that are likely to be effective and safe. One of these, the Noom app, was selected as the most suitable app for use in the Saudi Arabian context based on healthcare professionals' and patients' preferences.
Objective:
This study aimed to determine the feasibility and acceptability of using the Noom app to support DASH diet self-management among people with high blood pressure in Saudi Arabia.
Methods:
This study used mixed methods to evaluate the feasibility and acceptability of using the Noom app for people with high blood pressure in Riyadh, Saudi Arabia. Fourteen participants with high blood pressure were recruited and asked to use the app for eight weeks. The quantitative outcome measures were DASH diet adherence and self-efficacy. Feasibility and acceptability were assessed during and after the intervention via a user engagement with the Noom diet-tracking questionnaire, the system usability scale, and semi-structured interviews.
Results:
Self-efficacy and adherence to the DASH diet were generally improved by the end of the study. Most participants logged their meals for three to five days a week; snacks were the most commonly forgotten eating occasion to be recorded. The interviews revealed four main themes: (1) acceptance, (2) app usability, (3) technical issues, and (4) suggestions for improvement. Most participants found the Noom acceptable and most had no difficulties integrating it into their daily routines. The results of this feasibility study provided insights into the app's educational content, some of which was deemed unsuitable for Saudi Arabian users. App usability was identified as a critical theme: the app and its database were easy to use, convenient, and valuable to most participants. Despite this, some participants reported difficulties in identifying some foods because of a lack of local options. Technical issues included the app freezing or responding slowly. Most participants also suggested translating the app into Arabic to simplify the method of logging food in the app.
Conclusions:
The use of the app was feasible and acceptable among the participants who completed the study. Further studies are needed to examine the potential for smartphone apps to improve adherence to the DASH diet among people with high blood pressure in Saudi Arabia and to evaluate their effects on the blood pressure levels of individuals with hypertension.
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