Design and Development of an mHealth Intervention for Parents to Promote Healthy Eating and Activity in Preschoolers

Objective To develop and test the feasibility of a mobile health (mHealth) intervention with parents to improve preschooler's eating and physical activity behaviors. Description Previously tested content from an in-person parent intervention, HEROs (HEalthy EnviROnments), is being developed and assessed in digital formats utilizing a user-centered design process. The intervention focuses on healthy eating (picky eating), physical activity (active play), and optimizing the home environment. Each topic includes theory-based modules and strategies for parents to engage with their child(ren). Evaluation An explanatory, sequential mixed methods approach was implemented to examine mobile device use, appeal for a digital program, and digital literacy of parents of preschoolers. Participants were recruited from rural Head Start centers in NY (n = 5) and CO (n = 5) via electronic flyers. A Qualtrics survey (33 items) was completed by 116 respondents with 16 of those completing a semi-structed, virtual (Zoom) interview (12 questions with probes). Respondents primarily use smartphones (63%) to access the internet, have a moderately high level of digital literacy (χ=29.8 + 5.9; possible score 8-40); and half (49%) preferred a digital program compared to in-person (16%) or a hybrid delivery (34%). Parents expressed varied preference and reasoning for information delivery modalities (eg, video, audio, text). The most feasible time for digital program engagement was described as when they had uninterrupted time (eg, child at school or after bedtime). Features that provided choice, opportunities to connect with other parents, and were interactive were favored. Findings informed the development of interactive wireframe illustrations. Multiple phases of wireframe testing will occur using user-centered methods to test functionality and usability (technical aspects), content (information delivery), and user experience (sensory, cognitive and emotional experiences) with potential users. Conclusions and Implications Collectively, these findings will inform the development of the HEROs mHealth intervention, including mobile app prototype development and testing. Funding Year 2021-68015-34557 Funding Acknowledgement This work is supported by the USDA National Institute of Food and Agriculture. To develop and test the feasibility of a mobile health (mHealth) intervention with parents to improve preschooler's eating and physical activity behaviors. Previously tested content from an in-person parent intervention, HEROs (HEalthy EnviROnments), is being developed and assessed in digital formats utilizing a user-centered design process. The intervention focuses on healthy eating (picky eating), physical activity (active play), and optimizing the home environment. Each topic includes theory-based modules and strategies for parents to engage with their child(ren). An explanatory, sequential mixed methods approach was implemented to examine mobile device use, appeal for a digital program, and digital literacy of parents of preschoolers. Participants were recruited from rural Head Start centers in NY (n = 5) and CO (n = 5) via electronic flyers. A Qualtrics survey (33 items) was completed by 116 respondents with 16 of those completing a semi-structed, virtual (Zoom) interview (12 questions with probes). Respondents primarily use smartphones (63%) to access the internet, have a moderately high level of digital literacy (χ=29.8 + 5.9; possible score 8-40); and half (49%) preferred a digital program compared to in-person (16%) or a hybrid delivery (34%). Parents expressed varied preference and reasoning for information delivery modalities (eg, video, audio, text). The most feasible time for digital program engagement was described as when they had uninterrupted time (eg, child at school or after bedtime). Features that provided choice, opportunities to connect with other parents, and were interactive were favored. Findings informed the development of interactive wireframe illustrations. Multiple phases of wireframe testing will occur using user-centered methods to test functionality and usability (technical aspects), content (information delivery), and user experience (sensory, cognitive and emotional experiences) with potential users. Collectively, these findings will inform the development of the HEROs mHealth intervention, including mobile app prototype development and testing.