Progress 04/15/20 to 04/14/24
Outputs
Target Audience: Low-income and ethnically-diverse families with 2-4 year-old children that are eligible for WIC and other assistance programs WIC program staff and other community organization staff High school, undergraduate, and graduate students and post-doctoral fellows Changes/Problems:As reported previously, to make up for previous delays that resulted from the PI change of institution, grant transfer, and the pandemic, we expanded our study plans to recruit participants for the app evaluation phase through a variety of methods and settings, instead of limiting it to WIC clinics. Leveraging the ResearchMatch research registry provided us the benefit of being able to have a national reach for recruiting participants into the app evaluation study. What opportunities for training and professional development has the project provided?During Years 1-7: The postdoctoral fellows, students, and staff attended seminars and online webinars related to childhood obesity and research, university-sponsored scientific conferences, and regional and national scientific conferences. The first postdoctoral fellowcompleted two 3-credit hour courses: 1) Measurement and Analysis for Healthcare Improvement in the Spring 2018, and 2) Introduction to Implementation Science in Spring 2019, to enhance her skills in data collection and analysis to evaluate the implementation of community nutrition programs. The first postdoctoral fellow attended theWIC Technology, Program Integrity, and Vendor Management Education & Networking Conference in fall 2017 to understand the current and future trajectory of technology in the WIC program. Both postdoctoral fellows helped to mentor the CHEW students, giving them valuable experience in student mentorship. How have the results been disseminated to communities of interest?During Years 1-7: Publications: We have published 4 peer-reviewed journal articles reporting on research findings, and we have a 5th manuscript under review. We have published these articles in open-access journals so that interested practitioners and people outside of universities can access the articles for free online. One of thearticles was highlighted in the National WIC Association (NWA) newsletter that goes out to WIC stakeholders across the country. Conferences: We gave 5 oral and 10 poster presentations at national and regional scientific conferences and university research conferences. Local presentations: We gave presentations at two staff trainings: one for the Tennessee Department of Health central office and district office staff, and another for staff in the Metro Nashville WIC program. What do you plan to do during the next reporting period to accomplish the goals?
Nothing Reported
Impacts
What was accomplished under these goals?
IMPACT OF PROJECT This study promotes healthy nutrition and lifestyle behaviors to reduce childhood obesity risk, addressing a pressing public health need.Ourteam developed the Children Eating Well (CHEW) mobile app as a behavioral intervention forparents with 2-5 year-old children,with a focus on low-income families enrolled in the WIC program and other assistance programs.The overall purpose of the app is to provide parents easy, practical ways to improve nutrition and wellness among their preschool-aged children. The CHEW app can be disseminated in a variety of settings, such as WIC clinics, Head Start centers, SNAP, EFNEP, and social media. The CHEW app is also disseminating two self-assessment tools created under a previous NIFA-funded grant to University of California (Townsend, PI). OBJECTIVE 1 (Extension: Mobile app development) We carried out iterative phases of formative research to develop the CHEW app using a user-centered design approach. This involved conducting multiple rounds of qualitative interviews (N=70): 1) 22 parents to identify desired app features, 2) 13 parents tocollect usability testing data and guide revisions, 3) 30 parents to refine goal setting/tracking screens, and 4)5 parents for beta testing and debugging. Our team invested extensive work into designing the app and building the educational content and features; e.g., curating a library of 700+ recipes and conducting nutrient analysis for nutrition labels.The two core features are the app are guided goal setting (self-assessment quizzes and personalized goal recommendations) and tracking goal progress. These complementary features promote goal attainment: family member profiles, supportive tools (searchable recipe database, meal plan, shopping list), educational information (resources links and helpful tips through push notifications related to the target behaviors), rewards and incentives (earning badges/coins), and social network sharing (sharing recipes and badges).The featuresincrease parental awareness of the importance of targeted behaviors, give them practical strategies to do them, incentivize through gamification elements, and reinforce through reminders, progress monitoring, and social sharing achievements. OBJECTIVE 2 (Research: App evaluation) We published 4 journal articles and submitted a 5th manuscript (under review) with formative research findings. We enrolled a national sample of 80 parents into the app evaluation study and randomly assigned them to test the CHEW app or an alternative ("attention control") app. Participants take pre and post online surveys; the primary outcome is obesity risk score, using Townsend's Healthy Kids survey. Data analysis and preparation of the 6th manuscript are in process. We are also using internal funds to continue enrolling more families to disseminate the app further and collect valuable evaluation data. OBJECTIVE 3 (EDUCATION) a) Formal Classroom Instruction In Years 1 and 2, we developed a CHEW curriculum module to enhance existing undergraduate courses. It focuses on the WIC program and leveraging mobile technology to promote healthy nutrition. The module provides instructional materials and assessments for each course based on the level/experience of students and course objectives. We implemented the CHEW curriculum module during Years 1-7 in 4 undergraduate courses and made updates annually as needed. During Year 7, we developed and implemented a new upper-level course for TSU undergraduate students focused on nutrition, the WIC program, and mobile applications.Four of the 6 students travelled to St. Croix to attend a 2-day conference in honor of WIC's 50thanniversary as an experiential learning activity. Process Measures Reached (Years 1-7): 941 students 1. NUFS 2010 Basic Nutrition: 576 2. NUFS 3120 Nutrition in the Global Community:66 3. NUFS 3330 Maternal and Child Nutrition:241 4. UNIV 3278 / CS 4278: 52 5. NUFS 4620 Special Problems in Food and Nutrition (new in Year 7):6 Student Majors: Dental Hygiene/Nursing/Health Science: 42% Nutrition/Food Science/Family & Consumer Science: 9% Computer Science: 4% Agricultural Science/Biology: 2% Public Health: 2% Early Childhood Education: 1% Other: 28% Unknown: 12% Outcomes: Student Performance 1. Digital Technology Review Assignment (NUFS 2010) Students were asked to select, use, and evaluate a popular nutrition app and its features. Grades: 76% of students earned A or B. 2. Exam questions (NUFS 2010) Multiple-choice exam questions assess knowledge of common features of nutrition apps and benefits of using digital technology for health behaviors. On average, 2.3 out of 3 exam questions were answered correctly. 3. Digital Technology Review Assignment (NUFS 3120) Students were asked to select, use, and evaluate a popular nutrition app and its features. Grades: 80% of students earned A or B. 4. WIC Food Item Shopping Trip Assignment (NUFS 3120) Students were assigned a WIC food package and instructed to conduct a shopping trip to "purchase" foods from the assigned package, record availability of items, prices, and what they would purchase, then write a reflection paper. Grades: 87% of students earned A or B. 5. Development of recipe using WIC food items (NUFS 3330) Students were instructed to develop a healthy recipe using only WIC approved food items. Grades: 81% of students earned A or B. 6. Special Problems in Food and Nutrition (NUFS 4620) Students evaluated and revised recipes with 5 or less ingredients using WIC-approved food items. Students researched and created a visual presentation on available mobile applications that WIC participants can use for meal planning. The 4 students who attended the conference gave presentations on their recipes and tips for using digital technology. This impactful hands-on learning opportunity helped to promote nutrition-related career paths. b) Mentored Training Experiences: The CHEW project hosted mentored training experiences focused on childhood obesity prevention, nutrition, and mobile technology. Trainees received hands-on experiential training through various CHEW project activities. Learning Objectives: 1. Increase knowledge, skills, and competencies in mobile health and obesity prevention research and extension 2. Apply knowledge, skills, and competencies in mobile health and obesity prevention research and extension 3. Consider educational and career opportunities relevant to public health nutrition and obesity prevention Process Measure: Trainees reached (Years 1-7): Twenty-five students and fellows were trained under the CHEW project. This included 2 high school, 15 undergraduate, 4 graduate, and 2 medical students. One post-doctoral fellow trained with CHEW for 5 years, and a second post-doctoral fellow for 2 years. The post-docs and half of the students were supported on the CHEW grant, while other students were paid through other programs or completed a practicum experiences for degree programs. On average we hosted 4-5 students/fellows each year, with many participating for multiple years. Trainee Outcomes: The first CHEW post-doctoral fellow, Summer Weber, PhD, RD, accepted a position as a Social Science Research Analyst at the USDA Food and Nutrition Service in 2022, which includes overseeing research grants focused on the WIC program. The second post-doctoral fellow, Jessica Thompson, PhD, accepted a faculty position at Pennsylvania State University in the College of Health and Human Development. Seven students/fellows contributed as authors on 3 CHEW journal articles and the fourth manuscript that is under review. Students have prepared and presented 6 posters at local university conferences, a regional nutrition society conference, and a national prevention research conference.
Publications
- Type:
Journal Articles
Status:
Submitted
Year Published:
2024
Citation:
Thompson JR, Weber SJ, Mulvaney SA, Goggans S, Brown MF, Faiola A, Maamari L, Hull PC. Parental perceptions of priorities and features for a mobile application to promote healthy lifestyle behaviors in preschool children: A mixed method evaluation. Submitted to JMIR mHealth uHealth, 2024. (under review).
- Type:
Journal Articles
Status:
Published
Year Published:
2023
Citation:
Weber SJ, Mulvaney SA, Faiola A, Brown MF, Koyama T, Sun L, Goggans S, Hull PC. Commercially available mobile apps with family behavioral goal setting and tracking for parents: Review and quality evaluation. JMIR Pediatr Parent, 6:e41779, 2023. (accepted 8/29/23, published 10/23).
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2024
Citation:
Goggans S, Thompson JR, Weber S, Mulvaney S, Faiola A, Brown M, Maamari L, Hull PC. Parental Perceptions of Priorities and Features in the Development of an Obesity Risk Reduction Mobile Application. Poster presentation at the American Society of Preventive Oncology annual conference, Chicago (IL), 3/17/2024. (Presenter: Susanna Goggans, medical student)
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2024
Citation:
Maamari L, Thompson JR, Brown M, Goggans S, Hull PC. Recipe Creation for a Mobile Application to Encourage Healthy Food Choices Among Parents of Preschool-age children. Poster presentation at the Kentucky Academy of Nutrition and Dietetics annual conference, Louisville (KY), 3/5/2024. (Presenter: Lynn Maamari, graduate student)
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2024
Citation:
Goggans S, Thompson JR, Brown M, Maamari L, Burus T, Canedo C, Hull PC. Adapting an Engagement Index for a Childhood Obesity Reduction mHealth Application. Poster presentation at University of Kentucky 19th Annual Center for Clinical and Translational Science (CCTS) Spring Conference, Lexington (KY), 4/9/2024. (Presenter: Susanna Goggans, medical student)
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2023
Citation:
Maamari L, Thompson JR, Brown M, Goggans S, Hull PC. Recipe Creation for a Mobile Application to Encourage Healthy Food Choices Among Parents of Preschool-age children. Poster presentation at University of Kentucky Markey Cancer Center Research Day, Lexington (KY), 5/12/2023. (Presenter: Lynn Maamari, graduate student)
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2023
Citation:
Goggans S, Thompson JR, Brown M, Maamari L, Hull PC. Parental Perceptions of Priorities and Features in the Development of an Obesity Risk Reduction Mobile Application. Poster presentation at University of Kentucky Markey Cancer Center Research Day, Lexington (KY), 5/12/23. (Presenter: Susanna Goggans, medical student)
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Progress 04/15/22 to 04/14/23
Outputs
Target Audience: Low-income and ethnically-diverse families with 2-4 year-old children that are eligible for WIC or other assistance programs WIC program staff and other community organization staff High school, undergraduate, and graduate students and post-doctoral fellows Changes/Problems:
Nothing Reported
What opportunities for training and professional development has the project provided?Two students, a post-doctoral trainee, and a staff person attended a university-wide conference and presented a poster using the CHEW project data. How have the results been disseminated to communities of interest?We submitted a peer-reviewed journal a research manuscriptin which we evaluated the quality of commercially available mobile applications that target parents and are related to setting and tracking goals.The results will be published in an open-access journal so that interested people outside of universities can access the article for free online.? What do you plan to do during the next reporting period to accomplish the goals?During the Year 7 NCE, we will finalize and submit the manuscript in progress, mentioned above. We will make refinements/additions to the CHEW mobile app user interface and educational content. We will enroll and collect data from parents for the app evaluation study. As reported previously, to make up for previous delays that resulted from the PI change of institution, grant transfer, and the pandemic, we expanded our study plans to recruit participants for the app evaluation phase through a variety of methods and settings, instead of limiting it to WIC clinics.We will analyze the app evaluation study data and prepare a manuscript with the results. We willimplement the curriculum module in Fall 2023, and Spring 2024 courses. We will develop and implement a new upper-level special topic course for TSU undergraduate students focused on nutrition, the WIC program, and mobile applications. We will continue training 1 graduate student, 2 medical students, and 1 post-doctoral fellow.
Impacts
What was accomplished under these goals?
OBJECTIVE 1 (Extension: Mobile app development) We implemented updates to the CHildren Eating Well (CHEW) mobile app goal setting/tracking features and graphic user interface that were recommended by the user experience/graphic design vendor. We conducted user testing interviews to inform refinements to the app graphic interface and features. We made additions to the app's educational content and designed a new quiz and goals targeting the parent's nutrition and physical activity behaviors, to reinforce parental role modeling of healthy behaviors for their children. OBJECTIVE 2 (Research:App evaluation) We finalized and submitted to a peer-reviewed journal a research manuscriptin which we evaluated the quality of commercially available mobile applications that target parents and are related to setting and tracking goals.We continued working on an additional manuscript, in which we conducted mixed methods qualitative and quantitative analysis of the interview data collected during the previous grant year. We performed the data analysis and drafted a majority of this manuscript, which we plan to submit to a peer-reviewed journal in Y7.In addition, we collected pre and post surveys from the participants in the user testing interviews conducted during this year to test and refine the data collection procedures for the app evaluation. OBJECTIVE 3 (EDUCATION) a) Formal Classroom Instruction We continued to implement the CHEW curriculum module in undergraduate courses, which is focused on leveraging technologies for obesity prevention. The module provides a flexible menu of instructional materials and assessments for the instructor to select the specific set of materials that fit best for each course, based on the level/experience of students and overall course objectives. A total of 110 students were reached through courses at Tennessee State University in the Summer 2022 and Fall 2022 semesters (68 in NUFS 2010 Basic Nutrition and 42 in NUFS 3330 Maternal and Child Nutrition). b) Mentored Training Experiences: We continued to host mentored training experiences focused on childhood obesity prevention, technology, research, and extension. Trainees received hands-on experiential training through being immersed in the various CHEW project activities. Learning Objectives: 1. Increase knowledge, skills, and competencies in mobile health and obesity prevention research and extension 2. Apply knowledge, skills, and competencies in mobile health and obesity prevention research and extension 3. Consider educational and career opportunities relevant to public health nutrition and obesity prevention Process Measures: Trainees reached (4 total): Grant-supported Trainees: 1 graduate student, and 1 post-doctoral fellow Unpaid Interns: 1 medical student, 1 post-doctoral fellow Trainee Outcomes: These trainees have participated as co-authors in the manuscripts mentioned above.Two students and a post-doctoral trainee worked together to submit an abstract and poster to present at a university-wide conference. They also submitted the abstract to a forthcoming research day sponsored by the university's cancer center (will take place in Year 7). The CHEW post-doctoral fellow who has been supported by this grant for the past 5 years (Summer Weber, PhD) completed her training with our team and accepted a position as a Social Science Research Analyst at the USDA Food and Nutrition Service.
Publications
- Type:
Conference Papers and Presentations
Status:
Other
Year Published:
2023
Citation:
Goggans S, Thompson JR, Brown M, Maamari L, Hull PC. Parental Perceptions of Priorities and Features in the Development of an Obesity Risk Reduction Mobile Application. Poster presentation at University of Kentucky 19th Annual Center for Clinical and Translational Science (CCTS) Spring Conference, Lexington (KY), 3/27/2023. (Presenter: Susanna Goggans, medical student)
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Progress 04/15/21 to 04/14/22
Outputs
Target Audience: Low-income and ethnically-diverse families with 2-4 year-old children that are eligible for WIC WIC program staff and other community organization staff High school, undergraduate, and graduate students and post-doctoral fellows Changes/Problems:As previously reported, the PD (Dr. Hull) moved to University of Kentucky (UK) in June 2020. The process of transferring the grant to UK took a year andwas completed in May 2021, then it took additional time to set up accounts and subawards. This transfer and transition process plus the COVID-19 pandemic caused delays, sowe have expanded and accelerated our data collection plans to make up for the delay, as described above. What opportunities for training and professional development has the project provided?The postdoctoral fellow and students have attended online webinars related to childhood obesity and research.? How have the results been disseminated to communities of interest?We have drafted a manuscript on the review of mobile apps, which we plan to submit in late July/early August 2022. The results will be published in an open-access journal so that interested people outside of universities can access the article for free online.? What do you plan to do during the next reporting period to accomplish the goals?We will finalize the app review manuscript and submit it to an open-access journal in late July/early August. We are also working on another manuscript, in which we are conducting qualitative analysis of the interviews conducted during this grant year. We are currently analyzing the data and will prepare and submit the manuscript in Oct/Nov 2022. We will continue with our plans to do a final round of user testing and finalize refinements to the app graphic interface, launch the next evaluation phase of the study, recruit participants, conduct data collection, and prepare additional manuscripts for publication. We will also continue the education activities in Objective 3.To make up for the delays that resulted from the change of institutions and the COVID-19 pandemic, we have expanded our study recruitment strategies and accelerated the data collection timeline.Our team will disseminate the app through multiple in-person and digital strategies. In-person dissemination strategies will include promotion of the app through clinics, childcare centers, cooperative extension programs, and other community-based organizations. We will also promote the app at public community events. Digital dissemination will involve advertising the CHEW app via social media, websites, listservs, research registries and app stores.?
Impacts
What was accomplished under these goals?
Reporting Period:4/15/2021 - 4/14/22 OBJECTIVE 1 (CHEW App Development) and 2 (App Evaluation) We continued with our plans to conduct qualitative interviews with target users to inform refinement of the personalized goal setting and goal tracking features of the CHEW app. We recruited 26 parents of 2-5 year-old children and conducted qualitative interviews. We contracted a new user experience/graphic design vendor through the PD's new institution, University of Kentucky, who used the findings from the qualitative interviews to finish the graphic design interface of the goal tracking and goal setting screens, integrate them into the overall app, and make updates to the flow of screens to enhance the user experience and engagement. Some key findings and recommendations that were incorporated include: 1) added positive reinforcement of daily logging of goal progress and making improvements in goals through earning "badges"; 2) moved the notifications section to the home page so the user sees when they have a new notification there; 3) added the ability for the user to download the shopping list when Wi-Fi or cellular data connectivity is not available during grocery shopping; and 4) added a Resource Library to store the daily educational tip notifications sent to users so they can refer to them later. Next, we recruited and conducted user testing interviews with 5 participants in the target audience to evaluate and get user feedback on clickable versions of the screens with new or updated designs. Features for which the participants expressed high interest in the shopping list, meal planning, recipes, and quizzes for goal setting. The goals of most interest to users included helping your child get to bed earlier each night, serving your child healthier options, and helping your child eat more fruits and vegetables. Recommended enhancements to the Shopping List feature from users included adding: 1) ability to multiply the number of servings for a recipe and automatically adjust the quantity in the shopping list; 2) easy access to the wellness resources section on the homepage; and 3) additional topics of interest to the wellness resources section, such as sleeping routines, building well balanced meals with each food group, and tips for physical activity. Then the software developer worked on implementing the additions and enhancements to the app, and the study team performed quality assurance checks of the app as each component was added. Also, the software developer transferred all of the CHEW app content databases to a Content Management System (CMS) called Strapi. This CMS serves as a content dashboard for the CHEW project team, to edit or delete existing content and to add new content (e.g., recipes, wellness resource educational information, push notifications with educational tips). We had to make some adjustments to the database content to make it compatible with the CMS, and now this system will help ensure easy updating and maintenance of the app. In addition, the study team has been working on a manuscript. The purpose is to review and evaluate the quality of commercially available mobile applications that target parents and are related to setting and tracking goals. A total of 16 apps were identified through searches to review. Half (8) of the apps contained features allowing users to track health-related goals, such as nutrition, physical activity, and other lifestyle behaviors. Among these, 6 included nutrition, food or meal-related behaviors; 7 included sleep or bedtime behaviors, and 5 include physical activity-related behaviors. We used the Mobile App Rating Scale (MARS) to assess the quality of the apps. Two of the five apps with the highest quality ratings focused on nutrition and food/meal-related behaviors. Only one of the apps targeted parents with children ages 4-6 years old, and none were designed for parent with children in the preschool age range of 2-4 years. Thus, our app review confirmed that there is a gap in the scientific field regarding commercially available app for parents of preschool age regarding nutrition and wellness-related goal setting and goal tracking. This finding is significant because this is a gap that the CHEW app can fill. OBJECTIVE 3 (EDUCATION) a) Formal Classroom Instruction We continued to implement the curriculum module that we developed in Year 1 to enhance existing undergraduate courses, which is focused on technologies for obesity prevention. The module provides a flexible menu of instructional materials and assessments for the instructor to select the specific set of materials that fit best for each course, based on the level/experience of students and overall course objectives. Process Measures: Students reached (70 total): 1. NUFS 2010 Basic Nutrition (Faculty: Jennifer Brindley (adjunct, fall 2021), Sharon L Suggs (spring 2022): 64 students Majors: 48 Dental Hygiene/Nursing/Health Science, 2 Psychology, 6 Biology 1 ag science, 3 Family & Consumer Sciences, 4 Other 2. NUFS 3120 Nutrition in the Global Community (Faculty: Jennifer Brindley): 8 students Majors: 6 majors in food Science, 1 ag science, 1 chemistry 3. NUFS 3330 Maternal and Child Nutrition (Faculty: Fiona Lewis and then JenniferBrindley): 14 students Majors: 14 non-nutrition concentrations Outcomes Measures: Student Performance 1. Digital Technology Review Assignment - NUFS 2010 The students were asked to select, use, and evaluate a popular nutrition app and its features. Assignment Grades: 27/40 = 68% A, 8/40 = 20% B, 3/40 = 8% C, 0 D, 2/40 = 5% F 2. Exam questions - NUFS 2010: Multiple-choice exam questions were used to assess knowledge of common features of nutrition apps and the benefits of using digital technology for health behaviors and health outcomes. Exam Questions: 3 exam questions, average of 2.2 questions answered correctly: 91% correctly recognized digital technology 94% correctly identified benefit of technology 40% correctly identified dietary intake input feature of nutrition tracking technology 3. Digital Technology Review Assignment - NUFS 3120 The students were asked to select, use, and evaluate a popular nutrition app and its features. Assignment Grades: Digital Tech assignment: 7/8 88% A, 1 not completed 4. WIC Food Item Shopping Trip Assignment - NUFS 3120 The students assigned a WIC food package and instructed to conduct a shopping trip to "purchase" foods from the assigned food package. They were instructed to record the availability of approved brands, prices for each item, and record the specific types and amounts of foods they would purchase. Then they wrote a reflection paper on the shopping experience. Students did the Digital Technology assignment also. Assignment Grades: 5/8 = 63% A; 2/8 = 25% B, 1 not completed 5. Development of a recipe using WIC food items - NUFS 3330 The students were instructed to develop a healthy recipe using only WIC approved food items. Assignment Grades:6/14 43% A, 8/14 not completed b) Mentored Training Experiences: We continued to host mentored training experiences focused on childhood obesity prevention, technology, research, and extension. Trainees received hands-on experiential training through being immersed in the various CHEW project activities. Learning Objectives: 1. Increase knowledge, skills, and competencies in mobile health and obesity prevention research and extension 2. Apply knowledge, skills, and competencies in mobile health and obesity prevention research and extension 3. Consider educational and career opportunities relevant to public health nutrition and obesity prevention Trainees (3): Grant-supported Trainees: 1 undergraduate student and 1 post-doctoral fellow Unpaid Interns: 1 undergraduate student
Publications
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Progress 04/15/20 to 04/14/21
Outputs
Target Audience: Low-income and ethnically-diverse families with 2-4 year-old children that are eligible for WIC WIC program staff and other community organization staff High school, undergraduate, and graduate students and post-doctoral fellows Changes/Problems:As mentioned above, the transfer of the grant to a new institution and the COVID-19 pandemic causeddelays, so we expanded and accelerated recruitment plan to make up for the delay and keep the study on track. What opportunities for training and professional development has the project provided?The postdoctoral fellow and students have attended online webinars related to childhood obesity and research.The postdoctoral fellow mentored the two undergraduate students in contributing to data analysis for the published manuscript and were included as co-authors.? How have the results been disseminated to communities of interest?We published the manuscript with qualitative interview results in an open-access journal so that interested people outside of universities can access the article for free online.? What do you plan to do during the next reporting period to accomplish the goals?We will continue with our plans to do a final round of user testing and finalize refinements to the app graphic interface, launch the evaluation phase of the study, recruit participants, conduct data collection, and prepare manuscripts for publication. We will also continue the education activities in Objective 3.To make up for the delays that resulted from the change of institutions and the COVID-19 pandemic, we have expanded our study recruitment strategies and accelerated the data collection timeline.Our team will disseminate the app through multiple in-person and digital strategies. In-persondissemination strategies will include promotion of the app through clinics, cooperative extension programs, federally-qualified health centers, and other community-based organizations. Using a train-the-trainer approach for the in-person strategies, our team will train partner organization staff on how to promote the app in these various settings. We will also promote the app at public community events. Digital dissemination will involve advertising the CHEW app via social media, websites, listservs, research registries and app stores.
Impacts
What was accomplished under these goals?
Due to the PD (Dr. Hull) moving to University of Kentucky (UK) in June 2020, the remainder of Year 4 (6/1/2020 to 4/14/2021) was a transition period while the universities and USDA carried out the process of transferring the grant to UK.Due to this transition, we had to delay launching the next phase of the study involving larger scale deployment and evaluation of the CHEW app until after completion of the grant transfer, in order to be able to access the full budget for data collection costs. The grant transfer was completed in May 2021, at the beginning of Year 5. Even without the grant transfer, we would have had to delay launching the evaluation study phase at any rate because of the COVID-19 pandemic that started in March 2020. During the Year 4 transition period, the core team members continued development and research activities under Objectives 1 and 2 that did not involve new data collection, and we continued the education activities under Objective 3. Under Objective 1 (CHEW app development), Dr. Hull and core team members continued refining the CHEW app's nutrition education content, particularly the user interface for the goal-tracking features.Under Objective 2 (app evaluation),we conducted in-depth qualitative data analysis of the previously collected user experience interviews and drafted a scientific manuscript to report on the findings. We submit the manuscript to a peer-reviewed journal, which was accepted for publication.The outcomes of the education activities under Objective 3 are listed below. a) Formal Classroom Instruction We continued to implement the curriculum module that we developed in Year 1 to enhance existing undergraduate courses, which is focused on technologies for obesity prevention. The module provides a flexible menu of instructional materials and assessments for the instructor to select the specific set of materials that fit best for each course, based on the level/experience of students and overall course objectives. Process Measures: Students reached in Year 3 (164 total): 1. NUFS 2010 Basic Nutrition (Faculty: Elyse Shearer): 101 students Majors: 73 Dental Hygiene/Nursing/Health Science, 1 Nutrition, 4 Agriculture, 4 Fashion Merchandising, 19 Other 2. NUFS 3120 Nutrition in the Global Community (Faculty: Veronica Oates): 18 students Majors: 8 Food and Nutritional Science, 10 other 3. NUFS 3330 Maternal and Child Nutrition (Faculty: Veronica Oates and Elyse Shearer): 45 students Majors: 15 non-nutrition Outcomes Measures: Student Performance 1. Digital Technology Review Assignment - NUFS 2010: The students were asked to select, use, and evaluate a popular nutrition app and its features. Assignment Grades: 50% received an A, 9.8% received a B, 10.8% received a C, 2.9% received a D, 26.5% received an F. 2. Exam questions - NUFS 2010: Multiple-choice exam questions were used to assess knowledge of common features of nutrition apps and the benefits of using digital technology for health behaviors and health outcomes. Exam Questions: 3 exam questions, average of 2.2 questions answered correctly. 3. WIC Food Item Shopping Trip Assignment - NUFS 3120 The students were assigned a WIC food package and instructed to conduct a shopping trip to "purchase" foods from the assigned food package. They were instructed to record the availability of approved brands, prices for each item, and record the specific types and amounts of foods they would purchase. Then they wrote a reflection paper on the shopping experience. Assignment Grades: 72.2% received an A, 11.1% received a B, 0% received a C, 0% received a D, 16.7% received an F. 4. Development of a recipe using WIC food items - NUFS 3330 The students were instructed to develop a healthy recipe using only WIC approved food items. Assignment Grades: 71.4% received an A, 21.4%% received a B, 7.2% received a C, 0% received a D, 0% received an F. b) Mentored Training Experiences: We continued to host mentored training experiences focused on childhood obesity prevention, technology, research, and extension. Trainees received hands-on experiential training through being immersed in the various CHEW project activities. Learning Objectives: 1. Increase knowledge, skills, and competencies in mobile health and obesity prevention research and extension 2. Apply knowledge, skills, and competencies in mobile health and obesity prevention research and extension 3. Consider educational and career opportunities relevant to public health nutrition and obesity prevention Trainees (3): Grant-supported Trainees: 1 undergraduate student and 1 post-doctoral fellow Unpaid Interns: 1 undergraduate student
Publications
- Type:
Journal Articles
Status:
Published
Year Published:
2021
Citation:
Weber SJ, Shearer E, Mulvaney SA, Schmidt D, Thompson T, Jones J, Ahmad H, Coe M, Hull PC. Prioritization of Features for Mobile Apps for Families in a Federal Nutrition Program for Low-Income Women, Infants, and Children: User-Centered Design Approach. JMIR Formative Research 5(7):e30450, 2021.
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