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      Young Adults’ Engagement With a Self-Monitoring App for Vegetable Intake and the Impact of Social Media and Gamification: Feasibility Study

      , PhD, APD 1 , , , PhD, APD 1 , , PhD, FDAA 1
      (Reviewer), (Reviewer)
      JMIR Formative Research
      JMIR Publications
      vegetables, young adults, mHealth, social media, experimental game

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          Social media and gamification have been used in digital interventions for improving nutrition behaviors of young adults, but few studies measure engagement.


          This feasibility study aimed to explore user engagement with a 4-week smartphone program for improving vegetable intake.


          A goal setting and self-monitoring app was developed for feasibility testing. We assessed if additional components of gaming and/or social media support increased engagement. A 2 × 2 factorial study design was used with participants randomly allocated to each group. Engagement with the app (usage) was captured via inbuilt software, which recorded total days of app usage (duration) and the frequency of logging vegetable intake. Uptake of the social media (Facebook) content was measured by tracking views, likes, and comments on posts.


          Out of the 110 potential participants who completed the prescreening questionnaire online, 97 were eligible (mean age 24.8 [SD 3.4]). In total, 49% (47/97) of participants were retained at 4 weeks. Attrition within the first week was the highest among users of the gamified app without social support (Facebook; P<.001). Over the intervention period, 64% (62/97) of participants logged into their app, with vegetable intake recorded on average for 11 out of 28 days. The frequency of recording decreased each week (mean 4 [SD 2] days in week 1 versus mean 2 [SD 2] days in week 4). No effects of gaming or social support on the frequency of recording vegetables or the duration of app engagement were found. However, regardless of the app type, the duration of app engagement was significantly associated with vegetable intake post intervention ( P<.001). In total, 60% of Facebook posts were viewed by participants but engagement was limited to likes, with no comments or peer-to-peer interaction observed.


          As duration of usage was associated with vegetable intake, a deeper understanding of factors influencing engagement is needed. Dimensions such as personal attributes and the setting and context require further exploration in addition to content and delivery.

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          Most cited references36

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          The influence of social networking sites on health behavior change: a systematic review and meta-analysis.

          Our aim was to evaluate the use and effectiveness of interventions using social networking sites (SNSs) to change health behaviors.
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            Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors.

            Nearly 40% of mortality in the United States is linked to social and behavioral factors such as smoking, diet and sedentary lifestyle. Autonomous self-regulation of health-related behaviors is thus an important aspect of human behavior to assess. In 1997, the Behavior Change Consortium (BCC) was formed. Within the BCC, seven health behaviors, 18 theoretical models, five intervention settings and 26 mediating variables were studied across diverse populations. One of the measures included across settings and health behaviors was the Treatment Self-Regulation Questionnaire (TSRQ). The purpose of the present study was to examine the validity of the TSRQ across settings and health behaviors (tobacco, diet and exercise). The TSRQ is composed of subscales assessing different forms of motivation: amotivation, external, introjection, identification and integration. Data were obtained from four different sites and a total of 2731 participants completed the TSRQ. Invariance analyses support the validity of the TSRQ across all four sites and all three health behaviors. Overall, the internal consistency of each subscale was acceptable (most alpha values >0.73). The present study provides further evidence of the validity of the TSRQ and its usefulness as an assessment tool across various settings and for different health behaviors.
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              A Social Cognitive Theory of Internet Uses and Gratifications: Toward a New Model of Media Attendance


                Author and article information

                JMIR Form Res
                JMIR Form Res
                JMIR Formative Research
                JMIR Publications (Toronto, Canada )
                Apr-Jun 2019
                10 May 2019
                : 3
                : 2
                : e13324
                [1 ] School of Life and Environmental Sciences Charles Perkins Centre The University of Sydney Camperdown Australia
                Author notes
                Corresponding Author: Monica Nour mnou2973@ 123456uni.sydney.edu.au
                Author information
                ©Monica Nour, Juliana Chen, Margaret Allman-Farinelli. Originally published in JMIR Formative Research (http://formative.jmir.org), 10.05.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org.as well as this copyright and license information must be included.

                : 7 January 2019
                : 21 February 2019
                : 1 March 2019
                : 30 March 2019
                Original Paper
                Original Paper

                vegetables,young adults,mhealth,social media,experimental game


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