Accepted for/Published in: JMIR Pediatrics and Parenting
Date Submitted: Oct 19, 2025
Date Accepted: Apr 13, 2026
Usability and Acceptability of a Digital health Application to Support Infant Feeding and Lifestyle Behaviours: A Mixed-Methods Pilot Study
ABSTRACT
Background:
Childhood obesity is a global health concern with long-term cardiometabolic and psychosocial consequences. Establishing healthy feeding and lifestyle behaviours from infancy is critical to population health efforts with a life course perspective. Recently, mobile health applications have gained traction in reaching out to parents and promoting healthy feeding behaviours.
Objective:
The aim of this study was to evaluate the usability and acceptability of the Feeding, Lifestyle, Activity Goals (FLAGs) application in providing parents with evidence-based guidance to promote healthier eating behaviors and lifestyle habits among infants.
Methods:
We conducted a mixed-methods pilot study among parents of infants aged 0–24 months recruited from a tertiary maternity and children’s hospital in Singapore. Participants used the mobile health application for seven days. Usability was assessed using the validated System Usability Scale (SUS; score range 0–100, with ≥70 indicating acceptable usability). Acceptability was explored via open-ended questionnaires on satisfaction, relevance, and user experience, with qualitative data analyzed thematically by two independent coders to ensure rigor.
Results:
Twenty-six parents completed the study. The application demonstrated good usability with a mean SUS score of 71.3 ±11.0. Parents valued its role in organizing infant care, promoting self-reflection on parenting practices, and providing personalized, evidence-based recommendations. These benefits were particularly appreciated by first-time parents and those with multiple caregiving responsibilities. Challenges included an unintuitive user interface, high manual data entry burden, and advisory content that was occasionally overly general or text-heavy. These insights highlight clear priorities for onward efforts in optimization.
Conclusions:
Results of our mixed methods evaluation indicate that our mobile health application demonstrated good usability and acceptability among parents of infants. Targeted refinements to the interface, data entry processes, and content delivery are warranted before large-scale evaluation to determine its impact on early-life health behaviours and obesity prevention.
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