Acceptability of CommitFit - a Lifestyle mHealth App for Adolescents: From Design Stage to Feasibility Study

Context: While many studies have assessed usability or feasibility of mobile health applications (mHealth apps) by adults, few have examined their acceptability by adolescents, i.e., whether adolescents would use these apps for lifestyle or behavioral changes in their daily lives

Objective: This qualitative study aims to understand adolescents’, their caregivers’, and clinicians’ acceptability of CommitFit, a behavioral lifestyle mHealth app, from design stage to feasibility study.

Study Design: Two stages of assessment were conducted to explore the acceptability of CommitFit app – first, during the design phase and second, after CommitFit was used in a feasibility study. During the design phase, six adolescents, seven caregivers and twelve clinicians were presented with a static prototype of CommitFit that uses gamification to incentivize health behavior goal setting and achievement. In these six focus groups, all participants were asked about their perceived acceptability of the app. In the second/implementation phase, ten other adolescents downloaded and used the functional app for two weeks before participating in semi-structured interviews where they were asked about the retrospective acceptability of the app. We conducted abductive analysis with foundation in Grounded Theory approach to analyze the data using Dedoose, a qualitative analysis tool.

Setting: Online engagement with adolescents, their caregivers, and experienced clinicians in Missouri.

Population Studied: Adolescents, caregivers, and clinicians in Missouri.

Intervention: CommitFit, a behavioral lifestyle mHealth app that has been designed to promote improved health behaviors among adolescents.

Outcome Measures: Acceptability of CommitFit by adolescents, their caregivers, and clinicians from design stage to feasibility study.

Results: Seven domains from the Theoretical Framework of Acceptability were assessed: affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness, and selfefficacy. Seven acceptability domains, and an additional theme – intervention motivational aspects – were recognized by all groups as significant for adolescents to continuously use CommitFit for behavioral and lifestyle changes.

Conclusions: Results from this study will promote the successful adoption and use of CommitFit, a behavioral lifestyle mHealth app, among adolescents