Designing a Healthy Eating Mobile App for Low-Income Families

The global prevalence of childhood obesity has risen significantly in the last two decades. Childhood obesity has serious and long-lasting impacts on child and subsequent health through co-morbidities such as diabetes, heart disease, kidney disease, and hypertension. Family food insecurity, and child overweight and obesity, are significantly correlated with socioeconomic status. Families with economic challenges are less likely to integrate fruits and vegetables into daily meals, are more likely to have high levels of child "screen time", and are less likely to participate in regular physical activity.

Historically, access to mobile technologies has been unevenly distributed based on socioeconomic factors. Today, access to mobile technologies has become more equitable. This has opened up a number of opportunities to design and disseminate more engaging and interactive health behavior interventions with better reach. Health behavior interventions may be tailored for sub-populations based on their needs. The accessibility of behavioral interventions for families is very limited. Additionally, there is limited research to indicate how to design cost-effective health behavior technology-mediated tools to be acceptable and efficacious for low-income and underserved families.

Vanderbilt's Approach:

Shelagh Mulvaney, Associate Professor of Nursing and Biomedical Informatics, has built a program of research focused on tailoring health behavior technologies to the needs of specific user groups such as adolescents and adults with diabetes, underserved adults in Federally Qualified Health Centers, and youth with HIV. In a current project, funded by the US Department of Agriculture, Dr. Mulvaney works with colleagues at the University of Kentucky Office of Population Science and Community Impact, the Vanderbilt School of Engineering, and mobile interaction designers to develop an app called Children Eating Well (CHEW).

Through extensive user-centered design and mixed methods research, Mulvaney and colleagues have iteratively designed an app to prevent childhood obesity that meets the needs of low-income families with young children. The app features that the families identified as most useful include a healthy shopping tool, healthy culturally-appropriate recipes that interact with the shopping experience, location-based behavioral prompts to improve healthy food choices, family-based health behavior goal setting and tracking and individually-tailored educational materials. The app will be implemented in 24 counties in Kentucky Head Start centers in a quasi-experimental design to evaluate usability and efficacy.