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      Feasibility and impact study of a reward-based mobile application to improve adolescents’ snacking habits

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          Abstract

          Objective

          Adolescents’ snacking habits are driven by both explicit reflective and implicit hedonic processes. Hedonic pathways and differences in sensitivity to food rewards in addition to reflective determinants should be considered. The present study evaluated the feasibility and impact of a mobile phone-delivered intervention, incorporating explicit reflective and implicit rewarding strategies, on adolescents’ snack intake.

          Design

          Adolescents ( n 988; mean age 14·9 ( sd 0·70) years, 59·4 % boys) completed a non-randomized clustered controlled trial. Adolescents ( n 416) in the intervention schools ( n 3) were provided with the intervention application for four weeks, while adolescents ( n 572) in the control schools ( n 3) followed the regular curriculum. Outcomes were differences in healthy snacking ratio and key determinants (awareness, intention, attitude, self-efficacy, habits and knowledge). Process evaluation data were collected via questionnaires and through log data of the app.

          Results

          No significant positive intervention effects on the healthy snack ratio ( b=−3·52 ( se 1·82), P>0·05) or targeted determinants were observed. Only 268 adolescents started using the app, of whom only fifty-five (20·5 %) still logged in after four weeks. Within the group of users, higher exposure to the app was not significantly associated with positive intervention effects. App satisfaction ratings were low in both high and low user groups. Moderation analyses revealed small positive intervention effects on the healthy snack ratio in high compared with low reward-sensitive boys ( b=1·38 ( se 0·59), P<0·05).

          Conclusions

          The intervention was not able to improve adolescents’ snack choices, due to low reach and exposure. Future interventions should consider multicomponent interventions, teacher engagement, exhaustive participatory app content development and tailoring.

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          Most cited references49

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          Sex Differences in Video Game Play:: A Communication-Based Explanation

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            Effect Sizes in Cluster-Randomized Designs

            L. Hedges (2007)
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              Why obese children cannot resist food: the role of impulsivity.

              Facing the undesirable health consequences of being obese, an important question is why some people are not able to resist eating to excess. It is theorized that increased impulsivity at least partly underlies the inability to control eating behaviour; being more impulsive is supposed to make it more difficult to resist food intake. Thirty-three obese children in a residential setting and 31 lean control children are tested. Impulsivity is measured with two behavioural measures (inhibitory control and sensitivity to reward) and questionnaires. Results show that the obese children in treatment were more sensitive to reward and showed less inhibitory control than normal weight children. In addition, the obese children with eating binges were more impulsive than the obese children without eating binges. Most interesting finding was that the children that were the least effective in inhibiting responses, lost less weight in the residential treatment program. To conclude: impulsivity is a personality characteristic that potentially has crucial consequences for the development and maintenance, as well as treatment of obesity.
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                Author and article information

                Journal
                Public Health Nutrition
                Public Health Nutr.
                Cambridge University Press (CUP)
                1368-9800
                1475-2727
                August 2018
                April 02 2018
                August 2018
                : 21
                : 12
                : 2329-2344
                Article
                10.1017/S1368980018000678
                29607800
                83039a86-ef6c-4bbe-a889-4b8705c908bc
                © 2018

                https://www.cambridge.org/core/terms

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