Dataset Information

Gamifying Breastfeeding for Fathers: Process Evaluation of the Milk Man Mobile App.

ABSTRACT:

Background

Mobile technology offers unique opportunities to reach people with health promotion interventions. Breastfeeding is an important public health issue, and fathers are a key support. Milk Man is a father-focused breastfeeding app that sought to engage fathers with information and conversation about breastfeeding, with the goal to impact positively on breastfeeding duration.

Objective

The study aimed to describe the process evaluation of the Milk Man app that was trialed in the Parent Infant Feeding Initiative randomized controlled trial.

Methods

The app used an information library, gamification, push notifications, and social connectivity via a Web-based conversation forum, which included polls and conversation starters, to engage fathers with breastfeeding information. Fathers had access to the app from approximately 32 weeks of gestation to 6 months postpartum. Process evaluation data were collected from a self-completed questionnaire administered via a Web-based link sent to participants at 6 weeks postpartum, and app analytics data were collected directly from the app. Quantitative data from both sources and qualitative responses to open-ended questions were used to triangulate findings to investigate patterns of usage and the effectiveness of each app engagement strategy to motivate and engage users.

Results

A total of 80.3% (586/730) of participants, who were randomized to receive the app, downloaded Milk Man. Push notifications and interest in what other fathers had posted in the forum were the 2 main motivators to app use. Fathers used the app most while their partners were still pregnant and in the weeks immediately after the birth of their baby. Perspectives on the gamification strategy were varied. However, at 6 weeks postpartum, approximately one-third of fathers still using the app said that the gamification elements were encouraging the app use. The ease of use of the app and the design were important elements that were rated positively. The conversation forum emerged as the hub of app activity; all but 1 of the most accessed library articles and external organization links had been prompted as part of a conversation starter. Fathers posted comments in the conversation forum 1126 times (average of 2.21 per user) and voted in polls 3096 times (average of 6 per user).

Conclusions

These results demonstrate that the Milk Man app was an acceptable source of breastfeeding information and support that fathers and fathers-to-be are prepared to use throughout the perinatal period. The app showed encouraging results with facilitating conversation between partners. The conversation forum was clearly central to the success of the app, and fathers provided suggestions for improvement. Gamification results were varied, yet it was a key motivator for some users. These results provide valuable insight into the acceptability of the engagement strategies, including motivations for use and user perspectives on the app.

Trial registration

Australian New Zealand Clinical Trials Registry ACTRN12614000605695; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?ACTRN=12614000605695.

SUBMITTER: White B

PROVIDER: S-EPMC6716479 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Gamifying Breastfeeding for Fathers: Process Evaluation of the Milk Man Mobile App.

White Becky B Giglia Roslyn C RC White James A JA Dhaliwal Satvinder S Burns Sharyn K SK Scott Jane A JA

JMIR pediatrics and parenting 20190620 1

<h4>Background</h4>Mobile technology offers unique opportunities to reach people with health promotion interventions. Breastfeeding is an important public health issue, and fathers are a key support. Milk Man is a father-focused breastfeeding app that sought to engage fathers with information and conversation about breastfeeding, with the goal to impact positively on breastfeeding duration.<h4>Objective</h4>The study aimed to describe the process evaluation of the Milk Man app that was trialed i ...[more]

PMID: 31518324

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Project description:BackgroundDespite the recognized health and economic benefits of exclusive breastfeeding, few Australian infants are exclusively breastfed beyond 5 months of age. Social support for breastfeeding, in particular the support of an infant's father, has been identified as a crucial element for successful breastfeeding.ObjectiveThe objective of this study was to determine the effectiveness of various father-focused breastfeeding interventions in terms of key infant feeding outcomes.MethodsThe study was a 4-arm, factorial, randomized controlled trial conducted in Perth, Australia. The trial arms included a control group and 3 interventions, consisting of a face-to-face father-focused antenatal breastfeeding class facilitated by a male peer facilitator; Milk Man, a breastfeeding smartphone app designed specifically for fathers; and a combination of both interventions. Expecting couples were recruited from hospital-based antenatal classes and block randomized to 1 of the 4 arms. Each partner completed surveys at recruitment and at 6 weeks and 26 weeks postpartum. Primary outcomes were duration of exclusive and any breastfeeding. Secondary outcomes included age of introduction of formula and complementary foods, maternal breastfeeding self-efficacy, and partner postpartum support.ResultsA total of 1426 couples were recruited from public (443/1426, 31.1%) and private (983/1426, 68.9%) hospitals. Of these, 76.6% (1092/1426) of fathers completed the baseline questionnaire, 58.6% (836/1426) completed the 6-week follow-up questionnaire, and 49.2% (702/1426) completed the 26-week follow-up questionnaire. The average age of fathers who completed the baseline questionnaire was 33.6 (SD 5.2) years; the majority were born in Australia (76.4%) and had attended university (61.8%). There were no significant differences between the control and any of the intervention groups in any of the infant feeding outcomes or level of breastfeeding self-efficacy and postpartum partner support reported by mothers.ConclusionsThis study did not demonstrate that any intervention was superior to another or that any intervention was inferior to the standard care delivered in routine antenatal classes. Further studies are needed to test the effectiveness of these interventions in more socioeconomically diverse populations that are likely to benefit most from additional partner supports.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12614000605695; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614000605695.International registered report identifier (irrid)RR2-10.1186/s12884-015-0601-5.

Project description:BackgroundProcess evaluation measures the context in which an outcome was or was not achieved through the ongoing monitoring of operations. Mobile apps are a potentially less burdensome tool for collecting these metrics in real time from participants. Research-driven apps are not always developed while paying attention to their usability for target users. Usability testing uncovers gaps in researchers', developers', and users' mental models of what an efficient, effective, and satisfying product looks like and facilitates design improvement. Models may vary by user demographics.ObjectiveThis study describes the development of a mobile app for collecting process evaluation metrics in an intervention study with health care workers that uses feedback at multiple stages to refine the app design, quantify usage based on workers' overall adoption of the app and the app's specific function, and compare the demographic and job characteristics of end users.MethodsAn app was developed to evaluate the Center for Promotion of Health in the New England Workplace Healthy Workplace Participatory Program, which trains teams to develop solutions for workforce health obstacles. Labor-management health and safety committee members, program champions, and managers were invited to use the app. An accompanying website was available for team facilitators. The app's 4 functions were meeting creation, postmeeting surveys, project time logs, and chat messages. Google Analytics recorded screen time. Two stages of pilot tests assessed functionality and usability across different device software, hardware, and platforms. In stage 1, student testers assessed the first functional prototype by performing task scenarios expected from end users. Feedback was used to fix issues and inform further development. In stage 2, the app was offered to all study participants; volunteers completed task scenarios and provided feedback at deployment. End user data for 18 months after deployment were summarized and compared by user characteristics.ResultsIn stage 1, functionality problems were documented and fixed. The System Usability Scale scores from 7 student testers corresponded to good usability (mobile app=72.9; website=72.5), whereas 15 end users rated usability as ok (mobile app=64.7; website=62.5). Predominant usability themes from student testers were flexibility and efficiency and visibility of system status; end users prioritized flexibility andefficiency and recognition rather than recall. Both student testers and end users suggested useful features that would have resulted in the large-scale restructuring of the back end; these were considered for their benefits versus cost. In stage 2, the median total use time over 18 months was 10.9 minutes (IQR 23.8) and 14.5 visits (IQR 12.5). There were no observable patterns in use by demographic characteristics.ConclusionsOccupational health researchers developing a mobile app should budget for early and iterative testing to find and fix problems or usability issues, which can increase eventual product use and prevent potential gaps in data.

Project description:Behavioral economics has stimulated renewed interest in financial health incentives worldwide. The Carrot Rewards app was developed as part of a public-private partnership to reward Canadians with loyalty points (eg, movies and groceries) for downloading the app, referring friends, and completing an average of 1 to 2 educational health quizzes per week ("micro-learning"), with long-term objectives of increasing health knowledge and encouraging healthy behaviors.The main objective of this study was to evaluate uptake of a loyalty points-based mHealth app during the exclusive 3-month launch period in British Columbia (BC), Canada. The secondary aims were to describe the health and sociodemographic characteristics of users, as well as participation levels (eg, proportion of quizzes completed and friends referred).The app was promoted via loyalty program email campaigns (1.64 million emails). Number of downloads and registrations (users enter age, gender, and valid BC postal code to register) were collected. Additional sociodemographics were inferred by linking postal codes with census data at the local health area (LHA) level. Health risk assessments were also deployed. Participation levels were collected over 3 months and descriptive data were presented.In 3 months, 67,464 individuals downloaded the app; in its first week, Carrot Rewards was the most downloaded health app in Canada. Among valid users (n=57,885; at least one quiz completed), the majority were female (62.96%; 36,446/57,885) and aged 18 to 34 years (54.34%; 31,459/57,885). More than half of the users (52.40%; 30,332/57,885) resided in LHAs where the median personal income was below the provincial average (Can $28,765). Furthermore, 64.42% (37,291/57,885) of users lived in metropolitan (ie, urban) LHAs, compared with 56.17% of the general BC population. The most prevalent risk factors were "not" meeting physical activity guidelines (72.70%; 31,765/43,692) and "not" getting the flu shot last year (67.69%; 30,286/44,739). Regarding participation, 60.05% (34,761/57,885) of users were classified as "very high" engagers (>75% quiz completion rate).Early results suggest that loyalty points may promote mHealth app uptake. The app was downloaded by younger females especially, and BC residents from higher and lower income regions were equally represented. Loyalty points appear to have driven participation throughout the inaugural 3-month period (ie, quiz completion).

Project description:BACKGROUND:Three recent reviews evaluated 19 studies testing the hemoglobin A1c (HbA1c) benefit of 16 diabetes apps, including 5 publicly available apps. Most studies relied on small samples and did not link app engagement with outcomes. OBJECTIVE:This study assessed both HbA1c change in a large sample of people using the One Drop | Mobile app and associations between app engagement and changes in HbA1c. METHODS:The One Drop | Mobile app for iOS and Android is designed to manually and passively (via Apple HealthKit, Google Fit, and the One Drop | Chrome blood glucose meter) store, track, and share data. Users can schedule medication reminders, view statistics, set goals, track health outcomes, and get data-driven insights. In June 2017, we queried data on people with diabetes using the app who had entered at least 2 HbA1c values in the app >60 and ≤365 days apart. Multiple imputation corrected for missing data. Unadjusted and adjusted mixed effects repeated measures models tested mean HbA1c change by time, diabetes type, and their interaction. Multiple regression models assessed relationships between using the app to track food, activity, blood glucose, and medications and HbA1c change. RESULTS:The sample (N=1288) included people with type 1 diabetes (T1D) (n=367) or type 2 diabetes (T2D) (n=921) who were 35% female, diagnosed with diabetes for a mean 9.4 (SD 9.9) years, and tracked an average 1646.1 (SD 3621.9) self-care activities in One Drop | Mobile between their first (mean 8.14% [SD 2.06%]) and second HbA1c entry (mean 6.98% [SD 1.1%]). HbA1c values were significantly associated with user-entered average blood glucose 90 days before the second HbA1c entry (rho=.73 to .75, P<.001). HbA1c decreased by an absolute 1.07% (unadjusted and adjusted F=292.03, P<.001) from first to second HbA1c entry. There was a significant interaction between diabetes type and HbA1c. Both groups significantly improved, but users with T2D had a greater HbA1c decrease over time than users with T1D (F=10.54, P<.001). For users with T2D (n=921), HbA1c decreased by an absolute 1.27% (F=364.50, P<.001) from first to second HbA1c entry. Finally, using One Drop | Mobile to record food was associated with greater HbA1c reductions even after adjusting for covariates and after also adjusting for insulin use for users with T2D (all P<.05). CONCLUSIONS:People with T1D and T2D reported a 1.07% to 1.27% absolute reduction in HbA1c during a median 4 months of using the One Drop | Mobile app. Using the app to track self-care was associated with improved HbA1c. More research is needed on the health benefits of publicly available diabetes apps, particularly studies associating app engagement with short- and long-term effects.

Project description:BACKGROUND:Gait disorders are common among older adults. With an increase in the use of technology among older adults, a mobile phone app provides a solution for older adults to self-monitor their gait quality in daily life. OBJECTIVE:This study aimed to develop a gait-monitoring mobile phone app (Pocket Gait) and evaluate its acceptability and usability among potential older users. METHODS:The app was developed to allow older adults to track their gait quality, including step frequency, acceleration root mean square (RMS), step regularity, step symmetry, and step variability. We recruited a total of 148 community-dwelling older adults aged 60 years and older from two cities in China: Beijing and Chongqing. They walked in three ways (single task, dual task, and fast walking) using a smartphone with the gait-monitoring app installed and completed an acceptability and usability survey after the walk test. User acceptability was measured by a questionnaire including four quantitative measures: perceived ease of use, perceived usefulness, ease of learning, and intention to use. Usability was measured using the System Usability Scale (SUS). Interviews were conducted with participants to collect open-ended feedback questions. RESULTS:Task type had a significant effect on all gait parameters, namely, step frequency, RMS, step variability, step regularity, and step symmetry (all P values <.001). Age had a significant effect on step frequency (P=.01), and region had a significant effect on step regularity (P=.04). The acceptability of the gait-monitoring app was positive among older adults. Participants identified the usability of the system with an overall score of 59.7 (SD 10.7) out of 100. Older adults from Beijing scored significantly higher SUS compared with older adults from Chongqing (P<.001). The age of older adults was significantly associated with their SUS score (P=.048). Older adults identified improvements such as a larger font size, inclusion of reference values for gait parameters, and inclusion of heart rate and blood pressure monitoring. CONCLUSIONS:This mobile phone app is a health management tool for older adults to self-manage their gait quality and prevent adverse outcomes. In the future, it will be important to take factors such as age and region into consideration while designing a mobile phone-based gait assessment app. The feedback of the participants would help to design more elderly-friendly products. TRIAL REGISTRATION:

Dataset Information

Gamifying Breastfeeding for Fathers: Process Evaluation of the Milk Man Mobile App.

Background

Objective

Methods

Results

Conclusions

Trial registration

Publications

Gamifying Breastfeeding for Fathers: Process Evaluation of the Milk Man Mobile App.

Similar Datasets

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