SmartAPPetite For Youth: pilot and feasibility study of an adolescent smartphone nutrition intervention

Canadian adolescents report poor dietary quality. Smartphone-based nutrition interventions have the potential to improve adolescent diets through food knowledge and purchasing. "SmartAPPetite for Youth" is a smartphone-based nutrition intervention for adolescents that addresses key gaps in the literature. The study objective is to evaluate the intervention for feasibility, acceptability, and usability before undertaking a full-scale randomized controlled study.

The study was conducted in March-June 2016, among adolescents aged 14 years attending a secondary school in London, Ontario. Participants received the SmartAPPetite application on their phones, which sent time-based healthy eating messages (max 3/day) and location-based "nudge" messages (max 5/day) for 8 weeks. To evaluate recruitment methods, performance of app features, suitability of study instruments, and overall feasibility (measured by the rate of study retention, with a target of 70%), data was collected via the following: (1) a pre-post youth survey; (2) assessing participant experience; and (3) researcher observations. The youth survey included demographic questions, and questions about nutrition perceptions, food intake behaviors, food knowledge, and food purchasing behaviors. Questions about participant experiences included how often they interacted with the app, what they liked, and what they thought should be improved.

Of 108 eligible adolescents, 59 consented to participate and 54 completed the follow-up survey. Most participants reported that the app benefitted them and stated that they would recommend the app to a friend. Results from the youth survey show that SmartAPPetite has the potential to influence food knowledge, food purchasing, and food intake behaviors. The implementation review identified some changes to our intervention study design, tools, and the app that are required for it to have the greatest impact in a scaled-up scientifically rigorous randomized controlled study.

The results of this pilot study show that the project is feasible, and that adolescents will accept the intervention and enjoy engaging with the app. The app was well accepted, and participants perceived that it was helpful in improving their food knowledge and health behaviors. The primary objective of this study identified some key lessons that can be built upon for a larger study. The impact of the app needs to be properly tested in a full-scale trial.