Usability and Engagement Testing of mHealth Apps in Paediatric Obesity: A Narrative Review of Current Literature.

Niamh Arthurs,Sarah Browne,Louise Tully,Grace O’Malley

doi:10.3390/ijerph19031453

Abstract

Mobile health (mHealth) platforms have become increasingly popular for delivering health interventions in recent years and particularly in light of the COVID-19 pandemic. Childhood obesity treatment is an area where mHealth interventions may be useful due to the multidisciplinary nature of interventions and the need for long-term care. Many mHealth apps targeting youth exist but the evidence base underpinning the methods for assessing technical usability, user engagement and user satisfaction of such apps with target end-users or among clinical populations is unclear, including for those aimed at paediatric overweight and obesity management. This review aims to examine the current literature and provide an overview of the scientific methods employed to test usability and engagement with mHealth apps in children and adolescents with obesity. A narrative literature review was undertaken following a systematic search. Four academic databases were searched. Inclusion criteria were studies describing the usability of mHealth interventions for childhood obesity treatment. Following the application of inclusion and exclusion criteria, fifty-nine articles were included for full-text review, and seven studies met the criteria for usability and engagement in a clinical paediatric population with obesity. Six apps were tested for usability and one for engagement in childhood obesity treatment. Sample sizes ranged from 6–1120 participants. The included studies reported several heterogenous measurement instruments, data collection approaches, and outcomes. Recommendations for future research include the standardization and validation of instruments to measure usability and engagement within mHealth studies in this population.

Highlights

This study aimed to provide a summary of usability and engagement testing methods of Mobile health (mHealth) interventions for childhood obesity treatment
Our findings show that literature describing appropriate methods of testing usability and user engagement with young people with overweight/obesity is limited
It is difficult to ascertain the direct effect of mHealth technologies on clinical outcome measures for paediatric obesity, including BMI and changes in physical activity (PA), sedentary activity and eating behaviours, as many studies involved other interventions in addition to mHealth apps

Summary

Introduction

Delivery of best-practice multidisciplinary, familybased treatment programmes requires extensive networks of adequately trained healthcare professionals, administration, appropriate clinical treatment spaces, and time [1]. Direct associations exist between treatment intensity, the involvement of parent/caregivers and healthcare outcomes for children [2,3,4]. There is a need, to ensure intervention intensities are designed to deliver meaningful clinical outcomes. Attrition rates for paediatric obesity treatment can present challenges to health systems, clinical teams and the provision of adequate resources and funding. Reasons for attrition and insufficient care for young people with obesity include long travel times for regular appointments, frequent absences from school and work and clinical settings that are not accessible for some families [5,6,7]. Providing early intervention for paediatric obesity is warranted as obesity can severely impact on the quality of life of the young person and increase their

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