Health Behaviours

Evaluating and redesigning an app for childhood obesity prevention and management

Almost a quarter of children in the United Kingdom are overweight or obese by the time they start school. The UK Department of Health and Social Care’s national policy for combating childhood obesity has critical outcomes centred on sugar and caloric consumption reduction. The former Health Education England (now the South East School of Public Health, Workforce Training and Education Directorate, NHS England Health) developed a mobile intervention for families and associated health care professionals to provide a digital learning resource and tool aimed at encouraging healthy lifestyles to prevent obesity. 

Funded by Health Education England, we conducted a mixed-methods evaluation of parents’ barriers and facilitators to engaging with the app and with the target health behaviours (physical activity and healthy eating). We found boredom, forgetting, usability, motivation, and accessibility were key barriers to engagement with the app and behaviours. Novelty, gamification, reminders, goal setting, progress monitoring and feedback, and suggestions for healthy foods and activities were highlighted as potential app features that could help address these barriers. Based on our findings, we conducted a theory- and evidence-based redesign of the app and are developing this app for evaluation. A second funded mixed-methods evaluation will test the redesigned app in a larger sample of parents, children and young people, and healthcare professionals to evaluate its impact on families’ health behaviours and healthcare professionals’ perceived self-efficacy at discussing weight-related concerns with families. 

Relevant publications: 

Evaluating the impact of digital technologies on childhood asthma care 

Despite asthma being the most common chronic childhood condition in the UK, current standards of care are not yet sufficient. The UK has high rates of uncontrolled asthma and emergency visits, which have significant negative impacts on children’s and families’ quality of life and increases burden on the healthcare system. NHS sites in London have already adopted a novel integrated care pathway, which focuses on early interventions, treating the whole child, and personalising care. Technology has the potential to enhance this existing pathway by providing new opportunities for symptom and medication monitoring. 

As part of a collaboration led by King’s College London and funded by an NIHR i4i grant, we are conducting a technical nested study within a randomised control trial evaluating two technologically-enhanced asthma care pathways for children. The randomised control trial is comparing the impact of Propeller Health (a sensor and mobile app for medication tracking) and Respiri (a ‘Wheezo’ device and mobile app for monitoring wheeze) with the non-technologically-enhanced integrated care pathway. Our lab is evaluating families’ and healthcare professionals’ engagement with devices and their perceptions of its usability through system usage data and validated questionnaires. We will analyse our findings in collaboration with the qualitative nested study to draw conclusions about the reach, adoption, implementation, and maintenance of users’ engagement with the devices. 

Relevant publications: