JMIR Publications

ABSTRACT

Background:

The link between chronic diseases and the Big 6 lifestyle risk behaviors (ie, poor diet, physical inactivity, smoking, alcohol use, sedentary recreational screen time and poor sleep) is well established. It is critical to target these lifestyle risk behaviors as they often co-occur and emerge in adolescence. Smartphones have become an integral part of everyday life, and many adolescents already use mobile apps to monitor their lifestyle behaviors and improve their health. Smartphones may be a valuable platform to engage adolescents with interventions to prevent key chronic disease risk behaviors.

Objective:

This paper describes the development, usability and acceptability of the Health4Life app, a self-monitoring, smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors.

Methods:

Development of the Health4Life app was an iterative process conducted in collaboration with adolescents and experts. The development process consisted of three stages: 1) scoping the literature; 2) end-user consultations which included a web-based survey (N = 815) and focus group (N = 12) among adolescents; 3) app development and beta-testing. Following this development work, 232 adolescents were asked to rate the usability and acceptability of the app.

Results:

The process resulted in a self-monitoring smartphone app which allows adolescent users to track and set goals for the Big 6 health behaviors, utilizing in-app rewards and notifications to enhance engagement. Adolescent feedback was positive overall in terms of user-friendly design, content, relevance, and helpfulness. Commonly identified areas for improvement were to increase interactive features, and display recorded health behaviors differently to improve interpretability.

Conclusions:

The Health4Life app is a co-designed, self-monitoring, smartphone app for adolescents that concurrently targets the Big 6 lifestyle behaviors. Adolescents rated the app as highly acceptable and usable. The app has the potential to efficiently and effectively modify important risk factors for chronic disease among young people and is currently being evaluated in a world first trial of 6,640 secondary school students in 71 schools across Australia.