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Parents' Perspectives on the Theoretical Domains Framework Elements Needed in a Pediatric Health Behavior App: A
Christopher C Cushing1,2, David A Fedele3, Erin E Brannon4
1Clinical Child Psychology Program, University of Kansas, Lawrence, KS, United States.
Insights
Parents prefer specific mobile app features for pediatric health behaviors, prioritizing physical activity and diet over sleep. This study gathered parent input on features linked to the Theoretical Domains Framework (TDF) for better mHealth intervention design.
Area of Science:
- Pediatric Health
- Mobile Health Interventions
- Behavioral Science
Background:
- Pediatric studies often exclude parent stakeholders in intervention design.
- Many pediatric mobile health (mHealth) interventions lack effective post-trial dissemination.
- Commercial health apps may not be evidence-based or consider stakeholder preferences.
Purpose of the Study:
- To assess parent preferences for mobile app features aligned with Theoretical Domains Framework (TDF) elements.
- To inform the development of theory-based, parent-preferred mHealth interventions for children.
Main Methods:
- A crowdsourced social validity study involving 183 parents.
- Parents rated preferences for mHealth app features corresponding to TDF domains (capability, motivation, opportunity).
- Participants were recruited via Amazon Mechanical Turk.
Main Results:
- Broad parent acceptance of communication, motivation, and opportunity domains in mHealth apps.
- Parents prioritized features enhancing procedural knowledge, self-monitoring, and skill development for physical activity and diet over sleep.
- Goal-setting and incentive features were deemed most useful for physical activity.
Conclusions:
- This study offers a cost-effective method for engaging numerous stakeholders in applying health behavior theory to mHealth.
- The approach translated the TDF into parent-understandable terms, yielding valuable feature preferences.
- Developed consumer opinions directly link to TDF elements, guiding future pediatric mHealth app development.
Background:
Most pediatric studies do not include parent stakeholders in the design of the intervention itself and many pediatric mobile health (mHealth) interventions are not meaningfully disseminated after the trial period ends. Consequently, the consumer desire for mobile apps targeting pediatric health behavior is likely to be met by commercial products that are not based in theory or evidence and may not take stakeholder preferences into account.
Objective:
The aim was to assess parent preference for mobile app features that map onto specific Theoretical Domains Framework (TDF) elements.
Methods:
This study was a crowdsourced social validity study of 183 parents who were asked to rate their preferences for mobile app features that correspond to elements of the TDF. The TDF organizes a large number of theoretical models and constructs into three components: (1) capability, (2) motivation, and (3) opportunity. Parents of children were recruited through Amazon Mechanical Turk.
Results:
The majority of participants were Caucasian and mean age was 36.9 (SD 8.0) years. Results revealed broad acceptability of communication, motivation, and opportunity domains. However, the degree to which each domain was valued varied within behavioral category. Parents demonstrated a preference for increasing procedural knowledge for physical activity and diet behaviors over sleep (F2,545=5.18, P=.006). Similarly, parents valued self-monitoring as more important for physical activity than sleep (F2,546=4.04, P=.02). When asked about the value of features to help children develop skills, parents preferred those features for dietary behavior over sleep (F2,546=3.57, P=.03). Parents perceived that goal-setting features would be most useful for physical activity over sleep and diet (F2,545=5.30, P=.005). Incentive features within the app were seen as most useful for physical activity over sleep (F2,546=4.34, P=.01).
Conclusions:
This study presents a low-cost strategy for involving a large number of stakeholders in the discussion of how health behavior theory should be applied in a mHealth intervention. Our approach is innovative in that it took a scientific framework (ie, TDF) and made it digestible to parents so that they could then provide their opinions about features that might appear in a future app. Our survey items discriminated between various health behaviors allowing stakeholders to communicate the different health behaviors that they would like a TDF feature to change. Moreover, we were able to develop a set of consumer opinions about features that were directly linked to elements of the TDF.
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