Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach

Background: The Special Supplemental Nutrition Assistance Program for Women, Infants, and Children (WIC) is a federal nutrition program that provides nutritious food, education, and health care referrals to low-income women, infants, and children up to the age of 5 years. Although WIC is associated with positive health outcomes for each participant category, modernization and efficiency are needed at the clinic and shopping levels to increase program satisfaction and participation rates. New technologies, such as electronic benefits transfer (EBT), online nutrition education, and mobile apps, can provide opportunities to improve the WIC experience for participants. Objective: This formative study applies user-centered design principles to inform the layout and prioritization of features in mobile apps for low-income families participating in the WIC program. Methods: To identify and prioritize desirable app features, caregivers (N=22) of the children enrolled in WIC participated in individual semistructured interviews with a card sorting activity. Interviews were transcribed verbatim and analyzed using constant comparative analysis for themes. App features were ranked and placed into natural groupings by each participant. The sum and average of the rankings were calculated to understand which features were prioritized by the users. Natural groupings of features were labeled according to participant descriptions. Results: Natural groupings focused on the following categories: clinics/appointments, shopping/stores, education/assessments, location, and recipes/food. Themes from the interviews triangulated the results from the ranking activity. The priority app features were balance checking, an item scanner, and appointment scheduling. Other app features discussed and ranked included appointment reminders, nutrition training and quizzes, shopping lists, clinic and store locators, recipe gallery, produce calculator, and dietary preferences/allergies. Conclusions: This study demonstrates how a user-centered design process can aid the development of an app for low-income families participating in WIC to inform the effective design of the app features and user interface

Behavior problems associated with sleep disordered breathing in school-aged children--the Tucson children's assessment of sleep apnea study

Objective The purpose of the current study was to examine prevalence of and relations between a commonly used measure of nighttime breathing problems, the Respiratory Disturbance Index (RDI), and a range of problem behaviors in community children. Methods Participants were 403 unreferred children aged 6-12 years. Recruitment was completed through public elementary schools. Overnight unattended in-home polysomnography was used to assess sleep and breathing. The RDI was used as the indicator of respiratory events during sleep. The Child Behavior Checklist and the Conners' Parent Rating Scales-Revised were used to assess behavior. Results Prevalence rates for Attention, Cognitive Problems, Aggression, Oppositional behavior, and Social Problems were greatest for subjects with high RDIs. Prevalence for Internalizing behaviors was not greater for those subjects with high RDIs. Hyperactivity was not strongly related to higher RDIs. Conclusions Behavioral problems may exist in the presence of nocturnal breathing events in unreferred children. Specific patterns of behavioral morbidity have still not been established. Some behaviors, such as hyperactivity, may show differing sensitivity and specificity in relation to the RDI