Using social media and mobile gaming to improve the vegetable intake of young adults

Australian Dietary Guidelines recommend five servings of vegetables daily for prevention of chronic disease, but only 7% of adults achieve this. The initial stages of this thesis involved secondary analysis of the 2011-12 National Nutrition and Physical Activity Survey data. Results showed young adults aged 18-24 years were the poorest consumers of vegetables, with mean intake of 2.7 serves daily. To inform the design of a targeted intervention using new technology the PhD candidate systematically reviewed the literature and found mobile-phone based interventions have positive effects on vegetable consumption (Cohen’s d 0.15,95% CI 0.04–0.28). Notably, engagement was low among young adults and few studies harnessed novel strategies such as social media or gamification for program delivery. Yet 95% of young adults own a smartphone and 91% use their device for game play or social networking. The final stage of this thesis involved the development of a 4-week social media and mobile-gaming intervention underpinned by behavioural theory, to addresses key barriers to, and psychosocial determinants of, vegetable intake. Behaviour change techniques demonstrated to mediate success, such as goal setting and self-monitoring were integrated. Short mobile-phone delivered cooking videos were developed to address the low level of cooking literacy among this age group, with focus group testing confirming their acceptability among the target audience. A factorial study design was used to determine the feasibility of delivering the program. This was the first study to explore the impact of social support using social media in combination with gaming elements in a nutrition intervention for young adults. The research revealed that it is feasible and practical to deliver behaviour change interventions to young adults using these novel communication mediums. The accessibility of these platforms could allow the dissemination of individual behaviour change interventions at scale

Meta-Analysis For Comparing Effect Between Game-Based Learning Versus Gamification Utilized In Nutrition Education

The prevalence of obesity tripled from 1975 to 2016 and was declared as a global epidemic by the World Health Organization (WHO) in 1997 (Haththotuwa et al., 2020; Controlling the global obesity epidemic, 2022). Nutrition education that involves knowledge and behavioral change is one major component addressing the problem ( Controlling the global obesity epidemic, 2022). Therefore, the effectiveness of each learning session is essential (Sharifirad et al., 2013). Thus, many nutrition educators have used gamified nutrition education to improve teaching effectiveness to increase healthy behavior or knowledge (Chow et al., 2020.; Munguba et al., 2008; Azevedo et al., 2019). Two approaches were often used for gamified learning: gamification and GBL (GBL; Browne et al., 2014; Johnson et al., 2016; Chow et al., 2020). Gamification applies a game mechanism to non-game content, while GBL or serious gaming involves a game that was built to achieve educational goals (De Freitas, 2006; Johnson et al., 2016). Despite many positive outcomes promoted by gamified education as a whole (Chow et al., 2020; Hamari et al., 2014), there is disagreement among researchers and professionals regarding how games affect education. This study aims to identify and analyze research literature on the effects of active game, gamification and GBL applied to nutrition knowledge and behavior. The researcher performed a network meta-analysis with three sub-constructs. First, searching journal articles that addressed nutrition education implied an intervention consolidated educational strategies into food choice knowledge, fruit and vegetable consumption, and physical activity to a non-medical background population. Then, the studies were compared on the average effect of treatment indirectly through the control group. Results indicated there were plenty of studies that investigated the effect of gamification or GBL to nutrition education. Out of three focused outcomes: food choice knowledge, fruit and vegetable consumption, and physical activity, only studies focusing on physical activity were able to produce measurable differences by comparing hours per week spent performing physical activity. Comparison of the treatment result showed that gamification had the greatest improvement in facilitating physical activity, but it was non-significant. This suggests that utilizing gamification across the globe would be the more successful intervention strategy, but would require improved heterogeneity of measurements for food knowledge and fruit and vegetable consumption in order to achieve consistent measurable results for comparison

Characteristics of Smartphone Applications for Nutrition Improvement in Community Settings: A Scoping Review

Reproduced by permission of Oxford University Press https://academic.oup.com Copyright © 2019 American Society for NutritionSmartphone applications are increasingly being used to support nutrition improvement in community settings. However, there is a scarcity of practical literature to support researchers and practitioners in choosing or developing health applications. This work maps the features, key content, theoretical approaches, and methods of consumer testing of applications intended for nutrition improvement in community settings. A systematic, scoping review methodology was used to map published, peer-reviewed literature reporting on applications with a specific nutrition-improvement focus intended for use in the community setting. After screening, articles were grouped into 4 categories: dietary self-monitoring trials, nutrition improvement trials, application description articles, and qualitative application development studies. For mapping, studies were also grouped into categories based on the target population and aim of the application or program. Of the 4818 titles identified from the database search, 64 articles were included. The broad categories of features found to be included in applications generally corresponded to different behavior change support strategies common to many classic behavioral change models. Key content of applications generally focused on food composition, with tailored feedback most commonly used to deliver educational content. Consumer testing before application deployment was reported in just over half of the studies. Collaboration between practitioners and application developers promotes an appropriate balance of evidence-based content and functionality. This work provides a unique resource for program development teams and practitioners seeking to use an application for nutrition improvement in community settings

Development of “LvL UP 1.0”: a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders

BackgroundNon-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, “LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs.Materials and MethodsA multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development.ResultsPreliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily “Life Hacks” (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device.ConclusionsThe development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers

Quantitative and qualitative evaluations of impacts and benefits of nine INHERIT case studies

The INHERIT report Quantitative and Qualitative Evaluations of Impacts and Benefits of Nine INHERIT Case Studies documents the findings relevant to potential impacts and benefits of nine case studies for health, equity and a more sustainable environment. It uses a mixed method approach with quantitative methods augmented in some cases by written responses to survey questions, or by focus group discussions on impacts, as appropriate. Each case study evaluation was led by a different INHERIT partner. In each case, partners formulated the research design appropriate to their case studies and the associated research questions identified within the framework of INHERIT. The coordinating partner, University College London (UCL), developed an evaluation framework to suit the range of case studies examined for impacts and benefits, the case specific logic models developed, and the research questions identified. The nine chapters describe the impact evaluations and findings from the nine case studies using the following format: Background; Overall aims; Context; Research Questions; Methodology; Results; Discussion; Limitations; Learning points for future research; Learning points for potential scale up and transferability

Wearables at work:preferences from an employee’s perspective

This exploratory study aims to obtain a first impression of the wishes and needs of employees on the use of wearables at work for health promotion. 76 employ-ees with a mean age of 40 years old (SD ±11.7) filled in a survey after trying out a wearable. Most employees see the potential of using wearable devices for workplace health promotion. However, according to employees, some negative aspects should be overcome before wearables can effectively contribute to health promotion. The most mentioned negative aspects were poor visualization and un-pleasantness of wearing. Specifically for the workplace, employees were con-cerned about the privacy of data collection

Development of “LvL UP”, a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders

Background: Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, “LvL UP”, a digital lifestyle intervention aimed at preventing NCDs and CMDs.Materials and Methods: A multidisciplinary team led the intervention design process of LvL UP, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding (prototype development), and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development.Results: The first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks” (healthy activity suggestions), breathing exercises, and journaling. Engagement components involve motivational interviewing and storytelling to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a digital device.Conclusions: The development process of LvL UP led to an evidence-based and user-informed digital health intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers