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User-Centered Design and Development of a Web-based Tool to Support Healthy Feeding Behaviors by Parents of Urban Minority Youth (Preprint)


 BACKGROUND
 In the United States, childhood obesity prevalence is highest among preadolescents and adolescents. Research has increasingly highlighted the role of parenting, parental modeling and feeding practices, and the home environment in behavioral interventions for childhood obesity.
 
 
 OBJECTIVE
 As part of the development of a technology-enhanced intervention to promote healthy eating among urban minority preadolescents, research was concurrently conducted to develop a parent-focused health promotion tool to support positive feeding behaviors and the home food environment.
 
 
 METHODS
 Parents (n=25; 96% female; mean age=41 years; 60% Hispanic/Latino, 40% Black/African-American) were recruited from a child-focused community-based organization in New York City. Formative research (focus groups and parent-child dyad interviews) was conducted to identify barriers/facilitators to healthy feeding behaviors and characterize technology use (Summer 2016). Findings informed the design of a web-based health promotion tool, which was iteratively developed and assessed utilizing user-centered approaches to: confirm/finalize content (Fall 2016), assess the website wireframe (Winter 2016), and conduct usability testing (Spring-Summer 2017). Session notes and audio-recordings were reviewed throughout development to design and improve prototypes.
 
 
 RESULTS
 From formative research, parents preferred reading/looking up health-related information on larger laptop/tablet screens, but preferred smartphones when reading “on-the-go.” Suggestions for an online health tool included quick/easy/low-cost recipes, healthy tips for health feeding and involving their children around healthy dietary-related behaviors, clear tool navigation, and using pictures/visuals. When finalizing the tool wireframe and content, parents preferred a variety of motivational healthy feeding tips that encouraged positive interaction with their child, local family-oriented community events, and a simple, colorful layout with minimal clicking to access links. During usability testing, parents responded positively to the content (healthy feeding tips, recipes, coupon, and free community event) and clean layout, especially the use of bright color schemes and easy navigation. Suggestions included incorporating more fruit/vegetable images and directed action words (“click here”) to draw attention to coupon/community event links.
 
 
 CONCLUSIONS
 Formative research and user-centered approaches with parents of at-risk preadolescents resulted in a web-based, mobile-friendly health promotion tool. It will be tested as part of a larger technology-enhanced intervention using a two-group pilot randomized study, with the aim of reducing childhood obesity risk.
