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

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.<br>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. <br>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.<br>3) The questionnaire was administered through Qualtrics.<br>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. <br>Ethical approval for all studies was obtained from the Social Ethics Committee of the Wageningen University &amp; Research.<br>

在名为“测量、分析并绘制空间模式的环境影响（及变化）：即时适应性干预的实证研究”（ZonMw）的项目中，我们收集了食品领域即时适应性干预（Just-In-Time Adaptive Interventions，JITAIs）的初始接受度、使用前接受度、参与度与易用性数据。相关研究结果被用于开发针对健康饮食改变的JITAI“EetWijzer”。
本数据包包含四项共创研究：1）面向普通人群14名参与者的4组焦点小组访谈；2）面向低读写能力水平6名参与者的1组焦点小组访谈；3）面向普通人群137名参与者的问卷调查研究；4）面向普通人群23名用户的β测试。参与者使用该应用两周，并在随访阶段填写问卷。
针对1）与2）项研究：受新冠疫情影响，焦点小组通过微软Teams（Microsoft Teams）线上开展。所有焦点小组均进行了录音，并于会后完成转写。研究采用归纳式主题分析法对转写文本进行分析，使用Atlas.ti 9.0.22版本软件执行编码工作：将编码附着于对应文本片段，随后聚类为契合研究问题且与讨论内容相关的特定主题。编码工作由三名研究人员共同完成，对附着的编码进行比对、讨论，必要时予以调整。
针对3）项研究：问卷调查通过Qualtrics平台发放。
针对4）项研究：β测试在荷兰瓦赫宁根市开展。本研究的EetWijzer应用可在谷歌应用商店（Google Play Store）供安卓（Android）手机下载安装。参与者安装应用后需创建账号，并选择一项希望达成的目标，例如更健康的零食选择、减少肉类摄入，或增加蔬菜与水果摄入。账号创建完成后，应用即启动，并在用户处于干预地理围栏（即瓦赫宁根市）范围内时，通过参与者智能手机采集的GPS数据追踪用户位置。当用户进入食品门店周边特定半径范围，且在该围栏内停留时长超过预设阈值时，应用会向用户发送提示；同时，会在每日与所选目标相关的固定时段发送提示：若目标为更健康的零食选择，提示时段为11:00、15:00与20:00；若目标为减少肉类摄入或增加蔬果摄入，提示时段为12:00与17:00。在到访门店时段与预设时段发送的提示，基于焦点小组与问卷调查中终端用户的偏好设计，内容包括所选目标的提醒、可食用食品建议与食谱。系统会根据用户所选目标、所处位置或当前时段，从应用内置的消息库中随机选取相关提示并发送。
所有研究均已获得瓦赫宁根大学及研究中心（Wageningen University & Research）社会伦理委员会的伦理批准。