A Multiple Health Behavior Change, Self-Monitoring Mobile App for Adolescents: Development and Usability Study of the Health4Life App

Louise Thornton; Lauren Anne Gardner; Bridie Osman; Olivia Green; Katrina Elizabeth Champion; Zachary Bryant; Maree Teesson; Frances Kay-Lambkin; Cath Chapman; Health4Life Team

doi:10.2196/25513

A Multiple Health Behavior Change, Self-Monitoring Mobile App for Adolescents: Development and Usability Study of the Health4Life App

JMIR Form Res. 2021 Apr 12;5(4):e25513. doi: 10.2196/25513.

Authors

Louise Thornton^{1

2

3}, Lauren Anne Gardner¹, Bridie Osman¹, Olivia Green¹, Katrina Elizabeth Champion¹, Zachary Bryant¹, Maree Teesson¹, Frances Kay-Lambkin², Cath Chapman¹; Health4Life Team^{1

2

4

5

6

7}

Collaborators

Health4Life Team:
Nicola C Newton, Tim Slade, Katherine Mills, Matthew Sunderland, Belinda Parmenter, Bonnie Spring, David Lubans, Steve Allsop, Leanne Hides, Nyanda McBride, Lexine Stapinski, Louise Birrell

Affiliations

¹ The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, Australia.
² Priority Research Centre for Brain and Mental Health, The University of Newcastle, Newcastle, Australia.
³ School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
⁴ Department of Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, Sydney, Australia.
⁵ Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
⁶ National Drug Research Institute, Curtin University, Perth, Australia.
⁷ School of Psychology, Centre for Youth Substance Abuse Research, The University of Queensland, Brisbane, Australia.

PMID: 33843590
PMCID: PMC8076990
DOI: 10.2196/25513

Abstract

Background: The link between chronic diseases and the Big 6 lifestyle risk behaviors (ie, poor diet, physical inactivity, smoking, alcohol use, sedentary recreational screen time, and poor sleep) is well established. It is critical to target these lifestyle risk behaviors, as they often co-occur and emerge in adolescence. Smartphones have become an integral part of everyday life, and many adolescents already use mobile apps to monitor their lifestyle behaviors and improve their health. Smartphones may be a valuable platform for engaging adolescents with interventions to prevent key chronic disease risk behaviors.

Objective: The aim of this paper is to describe the development, usability, and acceptability of the Health4Life app, a self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors.

Methods: The development of the Health4Life app was an iterative process conducted in collaboration with adolescents and experts. The development process consisted of three stages: scoping the literature; end user consultations, which included a web-based survey (N=815; mean age 13.89, SD 0.89 years) and a focus group (N=12) among adolescents; and app development and beta testing. Following this development work, 232 adolescents were asked to rate the usability and acceptability of the app.

Results: The process resulted in a self-monitoring smartphone app that allows adolescent users to track and set goals for the Big 6 health behaviors, using in-app rewards and notifications to enhance engagement. The overall adolescent feedback was positive in terms of user-friendly design, content, relevance, and helpfulness. Commonly identified areas for improvement were to increase interactive features and display recorded health behaviors differently to improve interpretability.

Conclusions: The Health4Life app is a co-designed, self-monitoring smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. Adolescents rated the app as highly acceptable and usable. The app has the potential to efficiently and effectively modify important risk factors for chronic disease among young people and is currently being evaluated in a world-first trial of 6640 secondary school students in 71 schools across Australia.

Keywords: adolescents; chronic disease; health promotion; mHealth; mobile phone.

©Louise Thornton, Lauren Anne Gardner, Bridie Osman, Olivia Green, Katrina Elizabeth Champion, Zachary Bryant, Maree Teesson, Frances Kay-Lambkin, Cath Chapman, The Health4Life Team. Originally published in JMIR Formative Research (http://formative.jmir.org), 12.04.2021.