Background and Purpose: E-health interventions can provide Canadian adolescents (13-17 years old) with personalized support to help them modify their obesogenic behaviors. However, use of e-health interventions among adolescents has not been extensively examined. This study examined user characteristics and parenting practices associated with adolescents' initial use of the Aim2Be app; a health behavior modification intervention delivered through a smartphone app. Methods: A total of 371 adolescent-parent dyads completed a baseline assessment and were invited to use the Aim2Be app. Mean adolescent age was 14.9 years and 50.1% were male (n = 186). Mean adult age was 44.1 years and 34.7% were male (n = 129). Using Mplus (v.8), path analyses were completed to identify adolescent characteristics and parenting practices that were significantly associated with initial use of the app. Analyses were then stratified to explore whether these associations were confounded by parents' gender. Results: 79.2% of adolescents (n = 294) initially used the Aim2Be app. Adolescent engagement in healthy behaviors was directly associated with increased odds of using the app (odds ratio [OR] = 1.08; 95% confidence interval [CI] = 1.01-1.14), whereas autonomous motivation was indirectly associated (OR = 1.02; 95% CI = 1.00-1.04). Structure parenting practices were indirectly associated with increased odds of using the app (OR = 1.02; 95% CI = 1.00-1.04). When analyses were stratified by parent's gender, differences in the associations emerged. Conclusions: Both user characteristics and parenting practices were significantly associated with adolescents' initial use of Aim2Be. These findings will help inform future e-health interventions increase user engagement by identifying the characteristics of individuals who are not accessing the intervention, as well as identifying factors of the household environment that support use.
Keywords: adolescent obesity; e-health; initial intervention use.