Co-creation of a Just-In-Time Adaptive Intervention for healthy dietary changes: focus groups, survey data, beta test

Summary

In the project 'Measuring, analyzing and mapping environmental influences on (and changes in) spatial patterns: evidence for Just-In-Time Adaptive Interventions' (ZonMw) we collected data on the initial and pre-use acceptance, engagement and usability of Just-In-Time Adaptive Interventions (JITAIs) in the food domain. These results were used in the development of our JITAI 'EetWijzer' targeting healthy dietary changes. This data package consists of different co-creation studies: 1) four focus groups in 14 participants of the general population; 2) one focus group in 6 participants with low literacy levels; 3) a questionnaire study in 137 participants from the general population; 4) a beta test with 23 users from the general population. They used the app for two weeks and answered questions at follow-up. 1 and 2) Due to Covid-19, focus groups were held online through Microsoft Teams. The focus groups were recorded and transcribed afterwards. The transcripts were analyzed using inductive thematic analysis. The Atlas.ti version 9.0.22 software was used to do the coding. Codes were attached to text segments and grouped afterwards into specific themes that captured the discussed items and were interesting in relation to the research questions. Coding was done by three persons and the attached codes were compared and discussed and adjusted if necessary. 3) The questionnaire was administered through Qualtrics. 4) The beta test was performed in the city of Wageningen, the Netherlands. Our EetWijzer app is available for Android phones in the google play store. After installing the app, participants created an account and choose a goal that they would like to work on, i.e., healthier snacking, eating less meat, or eating more vegetables and fruit. After creating an account, the app is activated and starts tracking the location of the user using GPS data collected by the smartphone of the participants when they are in the intervention geofence, i.e., the city Wageningen. Once activated, the app sends out a prompt to its user when the person enters a specific radius around a food outlet and when the person stays in this fence over a defined time threshold. It also sends prompts at moments during the day related to the chosen goal, i.e., 11.00h, 15.00h, and 20.00h for the goal healthier snacking and at 12.00h and 17.00h for the goals of eating less meat and more vegetables and fruit. The prompts that were send at the visited locations and at the pre-specified times were based on preferences of end-users as indicated during the focus groups and questionnaire study and consisted of reminders of the chosen goal, suggestions for food to be consumed, and recipes. Based on the chosen goal and on location or time, a related prompt was randomly selected and send from a list of messages in the app. Ethical approval for all studies was obtained from the Social Ethics Committee of the Wageningen University & Research.