Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study

BackgroundWith the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majo...

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Main Authors: Krzyzanowski, Michelle C, Kizakevich, Paul N, Duren-Winfield, Vanessa, Eckhoff, Randall, Hampton, Joel, Blackman Carr, Loneke T, McCauley, Georgia, Roberson, Kristina B, Onsomu, Elijah O, Williams, John, Price, Amanda Alise
Format: Article
Language:English
Published: JMIR Publications 2020-08-01
Series:JMIR mHealth and uHealth
Online Access:https://mhealth.jmir.org/2020/8/e15156
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author Krzyzanowski, Michelle C
Kizakevich, Paul N
Duren-Winfield, Vanessa
Eckhoff, Randall
Hampton, Joel
Blackman Carr, Loneke T
McCauley, Georgia
Roberson, Kristina B
Onsomu, Elijah O
Williams, John
Price, Amanda Alise
author_facet Krzyzanowski, Michelle C
Kizakevich, Paul N
Duren-Winfield, Vanessa
Eckhoff, Randall
Hampton, Joel
Blackman Carr, Loneke T
McCauley, Georgia
Roberson, Kristina B
Onsomu, Elijah O
Williams, John
Price, Amanda Alise
author_sort Krzyzanowski, Michelle C
collection DOAJ
description BackgroundWith the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise. ObjectiveWe developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population. MethodsWe developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected. ResultsOf the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period. ConclusionsRams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.
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spelling doaj.art-a2ffb95b3aaf4437aaa9b99f23c5bda72022-12-21T20:17:27ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222020-08-0188e1515610.2196/15156Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability StudyKrzyzanowski, Michelle CKizakevich, Paul NDuren-Winfield, VanessaEckhoff, RandallHampton, JoelBlackman Carr, Loneke TMcCauley, GeorgiaRoberson, Kristina BOnsomu, Elijah OWilliams, JohnPrice, Amanda AliseBackgroundWith the increasing use of mobile devices to access the internet and as the main computing system of apps, there is a growing market for mobile health apps to provide self-care advice. Their effectiveness with regard to diet and fitness tracking, for example, needs to be examined. The majority of American adults fail to meet daily recommendations for healthy behavior. Testing user engagement with an app in a controlled environment can provide insight into what is effective and not effective in an app focused on improving diet and exercise. ObjectiveWe developed Rams Have Heart, a mobile app, to support a cardiovascular disease (CVD) intervention course. The app tracks healthy behaviors, including fruit and vegetable consumption and physical activity, throughout the day. This paper aimed to present its functionality and evaluated adherence among the African American college student population. MethodsWe developed the app using the Personal Health Informatics and Intervention Toolkit, a software framework. Rams Have Heart integrates self-reported health screening with health education, diary tracking, and user feedback modules to acquire data and assess progress. The parent study, conducted at a historically black college and university-designated institution in southeastern United States, consisted of a semester-long intervention administered as an academic course in the fall, for 3 consecutive years. Changes were made after the cohort 1 pilot study, so results only include cohorts 2 and 3, comprising a total of 115 students (n=55 intervention participants and n=54 control participants) aged from 17 to 24 years. Data collected over the study period were transferred using the secure Hypertext Transfer Protocol Secure protocol and stored in a secure Structured Query Language server database accessible only to authorized persons. SAS software was used to analyze the overall app usage and the specific results collected. ResultsOf the 55 students in the intervention group, 27 (49%) students in cohort 2 and 25 (45%) in cohort 3 used the Rams Have Heart app at least once. Over the course of the fall semester, app participation dropped off gradually until exam week when most students no longer participated. The average fruit and vegetable intake increased slightly, and activity levels decreased over the study period. ConclusionsRams Have Heart was developed to allow daily tracking of fruit and vegetable intake and physical activity to support a CVD risk intervention for a student demographic susceptible to obesity, heart disease, and type 2 diabetes. We conducted an analysis of app usage, function, and user results. Although a mobile app provides privacy and flexibility for user participation in a research study, Rams Have Heart did not improve compliance or user outcomes. Health-oriented research studies relying on apps in support of user goals need further evaluation.https://mhealth.jmir.org/2020/8/e15156
spellingShingle Krzyzanowski, Michelle C
Kizakevich, Paul N
Duren-Winfield, Vanessa
Eckhoff, Randall
Hampton, Joel
Blackman Carr, Loneke T
McCauley, Georgia
Roberson, Kristina B
Onsomu, Elijah O
Williams, John
Price, Amanda Alise
Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
JMIR mHealth and uHealth
title Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
title_full Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
title_fullStr Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
title_full_unstemmed Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
title_short Rams Have Heart, a Mobile App Tracking Activity and Fruit and Vegetable Consumption to Support the Cardiovascular Health of College Students: Development and Usability Study
title_sort rams have heart a mobile app tracking activity and fruit and vegetable consumption to support the cardiovascular health of college students development and usability study
url https://mhealth.jmir.org/2020/8/e15156
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