Improving Nutritional Choices in Adolescents
Condition: Overweight and Obesity
MeSH terms: Overweight
Study type: Interventional

Summary: 
      The goal of this project is to test whether the mobile application helps Black adolescents
      make healthy food choices at the point of purchase.
    

Detailed description: 
      The epidemic of excess weight in childhood is impacted by exposure to, and consumption of,
      fast food and calorie dense foods prepared outside of the home. Black youth are more likely
      than their peers to live in communities with a high density of fast food restaurants. There
      is a need for interventions to help adolescents make healthy choices in these obesogenic
      environments.

      Previous research revealed that adolescents welcomed health-related text messages (based on
      Self Determination Theory and Motivational Interviewing) if they viewed them as personally
      relevant and if they were received at times when they faced dietary choices. Based on these
      findings, the following is hypothesized: that delivering messages (tailored to users'
      preferences and values) at a time and place when they are making a dietary choice (e.g., in a
      restaurant) will positively influence their choices.

      Thus, the Location Initiated Individualized Texts for African American Adolescent Health
      (LIITA3H) mobile application was developed. This app identifies when users were in a
      restaurant, automatically sends culturally relevant messages (based on focus group input from
      the target population) tailored to user preferences and the menu options at their location
      with the aim of prompting users to make a healthy choice, and allows users to submit an
      annotated photo response about their food choice.

      For this R21 project the following will be achieved: 1) the LIITA3H app will be enhanced by
      incorporating user input regarding its design and by allowing greater automation in the
      identification of eating venues, and 2) the impact of the app on the number of visits by
      users to restaurants, and on the number of calories users consume from these venues will be
      tested. This will provide data regarding effect size and will form the foundation for a large
      randomized trial in a larger population and including a greater range of eating venues. A
      better understanding of how 'just in time" personalized cues to action, made possible by new
      location-based technology, might alter behavior among a high risk population, will help
      future efforts to address obesity and other illnesses impacted by lifestyle choices.

      As of 2020, due to the influence of the public health emergency, lockdowns prevented any
      participants from engaging in going to restaurants as they previously would have. Due to the
      trial beginning in November 2019, no six month app based data was acquired before the
      lockdown, and research limitations were imposed. When behavioral research of this type was
      allowed to resume, months later, a very limited time remained before the funded study would
      have to end. Thus, certain aspects of the protocol and intervention were modified. To be
      pragmatic under these constrained circumstances, for new participants, the intervention was
      shortened from 6 months to 1 month. As behavioral change takes longer to be achieved, the 1
      month abbreviated trial focused on exploring the functionality of the app to lay the
      groundwork for future studies.
    

Intervention name(s): Full LIITA3H App; Partial LIITA3H App; LIITA3H Location only
Intervention type(s): Other; Other; Other
Intervention description(s): This is the full version of the LIITA3H mobile app that will use the Enhanced Location Identification (ELI) technology to identify when a user is in an eating venue and then deliver culturally and individually tailored point of purchase prompts (POP) to encourage healthy choices and will allow participants to take pictures of the food they purchase using the Self-report of Nutrients with Annotated Photos (SNAP) function.; This is a version of the LIITA3H mobile app that will track participants' location and allow them to submit photos of their food.; This is a version of the LIITA3H mobile app that will only track participants' location.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Other