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Usability and Acceptability of a Digital Health App to Support Infant Feeding and Lifestyle Behaviors: Mixed Methods
Madhumitha Ayyappan1, Nowel Tan2, Sarithra Jayasekaran3
1Duke-NUS Medical School, 8 College Rd, Singapore, 169857, Singapore, 65 93871908.
Insights
A new digital health app shows good usability and acceptability for parents of infants, offering evidence-based guidance for healthy feeding behaviors and lifestyle habits to prevent childhood obesity.
Area of Science:
- Digital Health
- Pediatrics
- Public Health
Background:
- Childhood obesity presents significant long-term health challenges.
- Early establishment of healthy infant feeding and lifestyle behaviors is crucial.
- Digital health applications offer a promising avenue for parental engagement and behavior promotion.
Purpose of the Study:
- To evaluate the usability and acceptability of the Feeding, Lifestyle, Activity Goals (FLAG) app.
- To assess the app's effectiveness in providing evidence-based guidance for infant health behaviors.
- To identify areas for app improvement in promoting healthier eating and lifestyle habits.
Main Methods:
- A mixed methods pilot study involving 26 parents of infants (0-24 months).
- Participants used the FLAG app for 7 days.
- Usability assessed via System Usability Scale; acceptability explored through questionnaires and thematic analysis.
Main Results:
- The app achieved acceptable usability (mean score 71.3).
- Parents found the app valuable for organizing care, self-reflection, and receiving personalized advice.
- Identified challenges included UI issues, data entry burden, and content delivery.
Conclusions:
- The FLAG app demonstrates good usability and acceptability among parents.
- Refinements to the user interface, data entry, and content are needed.
- Further large-scale evaluation is warranted to assess impact on early-life health and obesity prevention.
Background:
Childhood obesity is a global health concern with long-term cardiometabolic and psychosocial consequences. Establishing healthy feeding and lifestyle behaviors from infancy is critical to population health efforts with a life course perspective. Recently, digital health applications have gained traction in reaching out to parents and promoting healthy feeding behaviors.
Objective:
The aim of this study was to evaluate the usability and acceptability of the Feeding, Lifestyle, Activity Goals app in providing parents with evidence-based guidance and tailored advice to promote healthier eating behaviors and lifestyle habits among infants.
Methods:
We conducted a mixed methods pilot study among parents of infants aged 0 to 24 months recruited from a tertiary maternity and children's hospital in Singapore. Participants used the digital health app for 7 days. Usability was assessed using the validated System Usability Scale (score range 0-100, with ≥70 indicating acceptable usability). Acceptability was explored via open-ended questionnaires on satisfaction, relevance, and user experience, with qualitative data analyzed thematically by 2 independent coders to ensure rigor.
Results:
A total of 26 parents of infants aged 3 weeks to 23 months completed the study. The app demonstrated good usability, with a mean System Usability Scale score of 71.3 (SD 11.0). Parents valued its role in organizing infant care; promoting self-reflection on parenting practices; and providing personalized, evidence-based recommendations. These benefits were particularly appreciated by first-time parents and those with multiple caregiving responsibilities. Challenges included an unintuitive user interface, high manual data entry burden, and advisory content that was occasionally overly general or text heavy. These insights highlight clear priorities for onward efforts in optimization.
Conclusions:
Results of our mixed methods evaluation indicate that our digital health app demonstrated good usability and acceptability among parents of infants. Targeted refinements to the interface, data entry processes, and content delivery are warranted before large-scale evaluation to determine its impact on early-life health behaviors and obesity prevention.
