Users’ Experiences With the NoHoW Web-Based Toolkit With Weight and Activity Tracking in Weight Loss Maintenance: Long-term Randomized Controlled Trial

Elina Mattila*, Susanne Hansen, Lise Bundgaard, Lauren Ramsey, Alice Dunning, Marlene N. Silva, Marja Harjumaa, Miikka Ermes, Marta M. Marques, Marcela Matos, Sofus C. Larsen, Jorge Encantado, Inês Santos, Graham Horgan, Ruairi O'Driscoll, Jake Turicchi, Cristiana Duarte, António L. Palmeira, R. James Stubbs, Berit Lilienthal HeitmannLiisa Lähteenmäki

*Corresponding author for this work

    Research output: Contribution to journalArticleScientificpeer-review

    3 Citations (Scopus)

    Abstract

    Background: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness. Objective: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)—a DBCI that targets weight loss maintenance—over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption. The secondary aim is to objectively describe the measured use of the TK and its association with user experience. Methods: An 18-month, 2×2 factorial randomized controlled trial was conducted. The trial included 3 intervention arms receiving an 18-week active intervention and a control arm. The user experience of the TK was assessed quantitatively through electronic questionnaires after 1, 3, 6, and 12 months of use. The questionnaires also included open-ended items that were thematically analyzed. Focus group interviews were conducted after 6 months of use and thematically analyzed to gain deeper insight into the user experience. Log files of the TK were used to evaluate the number of visits to the TK, the total duration of time spent in the TK, and information on intervention completion. Results: The usability level of the TK was rated as satisfactory. User acceptance was rated as modest; this declined during the trial in all the arms, as did the objectively measured use of the TK. The most appreciated features were weekly emails, graphs, goal setting, and interactive exercises. The following 4 themes were identified in the qualitative data: engagement with features, decline in use, external factors affecting user experience, and suggestions for improvements. Conclusions: The long-term user experience of the TK highlighted the need to optimize the technical functioning, appearance, and content of the DBCI before and during the trial, similar to how a commercial app would be optimized. In a trial setting, the users should be made aware of how to use the intervention and what its requirements are, especially when there is more intensive intervention content.

    Original languageEnglish
    Article numbere29302
    Number of pages19
    JournalJournal of Medical Internet Research
    Volume24
    Issue number1
    DOIs
    Publication statusPublished - Jan 2022
    MoE publication typeA1 Journal article-refereed

    Funding

    This project has received funding from the European Union's Horizon 2020 research and innovation program under grant agreement number 643309.

    Keywords

    • Digital behavior change intervention
    • Focus groups
    • Mixed methods
    • Mobile phone
    • Technology acceptance
    • User experience
    • Weight-loss maintenance
    • Humans
    • Focus Groups
    • Exercise
    • Weight Loss
    • Surveys and Questionnaires
    • Internet

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