Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Study protocol

Using a gamified monitoring app to change adolescents’ snack intake: the development of the REWARD app and evaluation design

Authors: W. Van Lippevelde, J. Vangeel, N. De Cock, C. Lachat, L. Goossens, K. Beullens, L. Vervoort, C. Braet, L. Maes, S. Eggermont, B. Deforche, J. Van Camp

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents’ eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the ‘Snack Track School’ app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds.

Methods

The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents.

Discussion

When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs).

Trial registration

NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.
Literature
1.
Diethelm K, Janckovic N, Moreno LA, Huybrechts I, De Henauw S, De Vriendt T, Gonzales-Gross M, Leclercq C, Gotrand F, Gilbert CC, the HELENA group. Food intake of European adolescents in the light of different food-based dietary guidelines: results of the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) Study. Public Health Nutr. 2012;15:386–98.CrossRefPubMed
2.
Duffey KJ, Huybrechts I, Mouratidou T, Libuda L, Kersting M, De Vriendt T, Gottrand F, Widhalm K, Dallongeville J, Hallstrom L, the HELENA group. Beverage consumption among European adolescents in the HELENA study. Eur J Clin Nutr. 2012;66:244–52.CrossRefPubMed
3.
Vereecken CA, De Henauw S, Maes L. Adolescents’ food habits: results of the health behavior in school-aged children survey. Br J Nutr. 2005;94(3):423–31.CrossRefPubMed
4.
Matthys C, De Henauw S, Devos C, De Backer G. Estimated energy intake, macronutrient intake and meal pattern of Flemish adolescents. Eur J Clin Nutr. 2003;57:366–75.CrossRefPubMed
5.
De Cock N, Van Lippevelde W, Vervoort L, Vangeel J, Maes L, Eggermont S, Braet C, Lachat C, Huybregts L, Goossens L, Beullens K, Kolsteren P, Van Camp J. Sensitivity to reward is associated with snack and sugar-sweetened beverage consumption in adolescents. Eur J Nutr. 2015.
6.
Nicklaus S, Remy E. Early origins of overeating: tracking between early food habits and later eating patterns. Curr Obes Rep. 2013;2:179–84.CrossRef
7.
8.
Gopinath B, Louie JCY, Flood VM, Burlutsky G, Hardy LL, Baur LA, Mitchell P. Influence of obesogenic behaviors on health-related quality of life in adolescents. Asia Pac J Clin Nutr. 2014;23:121–7. Ref socio-ecolog model.PubMed
9.
Kolbe L, Story M. Preventing childhood obesity. Washington, DC: National Academies Press; 2005.
10.
Crosby RA, Kegler MC, DiClemente RJ. Understanding and applying theory in health promotion practice and research. In: DiClemente RJ, Crosby RA, Kegler MC, editors. Emerging theories in health promotion practice and research: strategies for improving the public health. San Francisco: Josey-Bass; 2002.
11.
Kremers SPJ, de Bruyn G-J, Visscher TLS, van Mechelen W, de Vries NK, Brug J. Environmental influences on energy balance-related behaviors: a dual-process view. Int J Behav Nutr Phys Act. 2006;3:9.CrossRefPubMedPubMedCentral
12.
De Bourdeaudhuij I, Van Cauwenberghe E, Spittaels H, Oppert J-M, Rostami C, Brug J, Van Lenthe F, Lobstein T, Maes L. School-based interventions promoting both physical activity and healthy eating in Europe: a systematic review within the HOPE project. Obes Rev. 2010;12:205–16.CrossRef
13.
Van Cauwenberghe E, Maes L, Spittaels H, van Lenthe FJ, Brug J, Oppert JM, De Bourdeaudhuij I. Effectiveness of school-based interventions in Europe to promote healthy nutrition in children and adolescents: systematic review of published and ‘grey’ literature. Br J Nutr. 2010;103(6):781–97.CrossRefPubMed
14.
Stice E, Shaw H, Marti CN. A meta-analytic review of obesity prevention programs for children and adolescents: the skinny on interventions that work. Psychol Bull. 2006;132(5):667–91.CrossRefPubMedPubMedCentral
15.
Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: a meta-regression. Health Psychol. 2009;28(6):690–701. doi:10.​1037/​a0016136. Review.CrossRefPubMed
16.
Carver CS, Scheier MF. Control theory: a useful conceptual framework for personality -social, clinical, and health psychology. Psychol Bull. 1982;92:111–35.CrossRefPubMed
17.
Michie S, Hardeman W, Fanshawe T, Prevost T, Taylor L, Kinmonth AL. Investigating theoretical explanations for behavior change: the case study of ProActive. Psychol Health. 2008;23(1):25–39.CrossRefPubMed
18.
Berridge KC. Food reward: brain substrates of wanting and liking. Neurosci Biobehav Rev. 1996;20:1–25.CrossRefPubMed
19.
20.
Davis C, Strachan S, Berkson M. Sensitivity to reward: implications for overeating and overweight. Appetite. 2004;42:131–8.CrossRefPubMed
21.
Verbeken S, Braet C, Lammertyn J, Goossens L, Moens E. How is reward sensitivity related to bodyweight in children? Appetite. 2012;58:478–83.CrossRefPubMed
22.
23.
Hardin M, Ernst M. Functional brain imaging of development‐related risk and vulnerability for substance use in adolescents. J Addict Med. 2009;3:47–54.CrossRefPubMedPubMedCentral
24.
Deutsch R, Strack F. Duality in models in social psychology: from dual processes to interacting systems. Psychol Inq. 2006;17:166–72.CrossRef
25.
Moskowitz GB, Skurnik I, Galinski AD. The history of dual-process notions, and the future of preconscious control. In: Dual process theories in social psychology. New York: Guilford Press; 1999. p. 12–36.
26.
Bargh JA, Chartrand TL. The unbearable automaticity of being. Am Psychol. 1999;54:462–79.CrossRef
27.
28.
29.
30.
31.
32.
Konstantopoulos S. The power of the test for treatment effects in three-level cluster randomized designs. J Res Educ Eff. 2008;1:66–88.
33.
Bartholomew LK, Parcel GS, Kok G, Gottlieb NH. Planning health promotion programs: an Intervention Mapping Approach. San Francisco: Jossey-Bass; 2006. p. 8–14.
34.
McClain AD, Chappuis C, Nguyen-Rodriguez ST, Yaroch AL, Spruijt-Metz D. Psychosocial correlates of eating behavior in children and adolescents: a review. Int J Behav Nutr Phys Act. 2009;6(54). doi:10.​1186/​1479-5868-6-54.
35.
Martens MK, Van Assema P, Brug J. Why do adolescents eat what they eat? Personal and social environmental predictors of fruit, snack and breakfast consumption among 12–14-year-old Dutch students. Public Health Nutr. 2005;8(8):1258–65.CrossRefPubMed
36.
Pearson N, Ball K, Crawford D. Predictors of changes in adolescents’ consumption of fruits, vegetables and energy-dense snacks. Br J Nutr. 2011;105:795–803.CrossRefPubMed
37.
Story M, Neumark- Sztainer D, French S. Individual and environmental influences on adolescent eating behaviors. J Am Diet Assoc. 2002;102(3):40–51.CrossRef
38.
Kadzin AE. Acceptability of aversive procedures and medication as treatment alternatives for deviant child behavior. J Abnorm Child Psychol. 1984;12(2):289–301.CrossRef
39.
NUBEL. The Belgian Food composition table. 5th ed. 2009.
40.
41.
42.
Petty RE, Cacioppo JT. The elaboration likelihood model of persuasion. In: Berkowits L, editor. Advances in experimental social psychology. New York: Academic Press; 1986. p. 123–205.
43.
Zajonc RB. Mere exposure: a getaway to subliminal. Curr Dir Psychol Sci. 2001;10:224–8.CrossRef
44.
Fazio RH. On the automatic activation of associated evaluations: an overview. Cognit Emot. 2001;15:115–41.CrossRef
45.
Latham GP, Locke EA. New developments in and directions for goal-setting research. Eur Psychol. 2007;12:290–300.CrossRef
46.
Baranowski T, Buday R, Thompson DI, Baranowski J. Playing for real: video games and stories for health-related behavior change. Am J Prev Med. 2008;34(1):74–82.CrossRefPubMedPubMedCentral
47.
Dickey M. Engaging by design: how engagement strategies in popular computer and video games can inform instructional design. Educ Technol Res Dev. 2005;53(2):67–83.CrossRef
48.
Annetta LA. The “I’s” have it: a framework for serious educational game design. Rev Gen Psychol. 2010;14(2):105–12.CrossRef
49.
Baranowski T, Baranowski J, Thompson D, Buday R. Behavioral science in video games for children’s diet and physical activity change: key research needs. J Diabet Sci Technol. 2011;5(2):229–33.CrossRef
50.
Peng W, Lin JH, Pfeiffer KA, Winn B. Need satisfaction supportive game features as motivational determinants: an experimental study of a self-determination theory guided exergame. Media Psychol. 2012;15(2):175–96.CrossRef
51.
Huybrechts I, Vereecken C, De Bacquer D, Vandevijvere S, Van Oyen H, Maes L, Vanhauwaert E, Temme L, De Backer G, De Henauw S. Reproducibility and validity of a diet quality index for children assessed using a FFQ. Brit J Nutr. 2010;104:135–44.CrossRefPubMed
52.
Rodriguez G, Moreno LA. Is dietary intake able to explain differences in body fatness in children and adolescents? Nutr Metab Cardiovasc. 2006;16(4):294–301.CrossRef
53.
54.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice‐Hall; 1986.
55.
Vereecken C, De Henauw S, Maes L, Moreno L, Manios Y, Phillipp K, Grp HS. Reliability and validity of a healthy diet determinants questionnaire for adolescents. Public Health Nutr. 2009;12(10):1830–8.CrossRefPubMed
56.
Gardner B. Habit as automaticity, not frequency. Euro Health Psychologist. 2012;14:32–6.
57.
58.
Singh AS, Vik FN, Chinapaw MJM, Uijtdewilligen L, Verloigne M, Fernandez-Alvira JM, et al. Test-retest reliability and validity of the ENERGY child questionnaire on energy balance-related behaviors and their potential behavioral determinants: the ENERGY project. Int J Behav Nutr Phys Act. 2011;8:136.CrossRefPubMedPubMedCentral
59.
Hartley JEK, Torsheim R, Currie C, et al. FASIII Development Study Report 2013.
60.
Van Stralen MM, Te Velde SJ, Singh AS, De Bourdeaudhuij I, Martens MM, Van der Sluis M, et al. EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project: design and methodology of the ENERGY cross-sectional survey. BMC Public Health. 2011;11:65.CrossRefPubMedPubMedCentral
61.
Hamel LM, Robbins LB. Computer- and web-based interventions to promote healthy eating among children and adolescents: a systematic review. J Adv Nurs. 2013;69:16–30.CrossRefPubMed
62.
Franken IHA, Muris P, Rassin E. Psychometric properties of the Dutch BIS/BAS Scales. J Psychopathol Behav Assess. 2005;27:25–30.CrossRef
63.
Cooper A, Gomez R, Aucote H. The Behavioral Inhibition System and Behavioral Approach System (BIS/BAS) Scales: Measurement and structural invariance across adults and adolescents. Personal Individ Differ. 2007;43:295–305.CrossRef
64.
Yu R, Branje SJT, Keijsers L, Meeus WHJ. Psychometric characteristics of Carver and White’s BIS/BAS scales in Dutch adolescents and their mothers. J Pers Assess. 2011;93:500–7.CrossRefPubMed
65.
Muris P, Meesters C, de Kanter E, Timmerman PE. Behavioral inhibition and behavioral activation system scales for children: relationships with Eysenck’s personality traits and psychopathological symptoms. Personal Individ Differ. 2005;38:831–41.CrossRef
66.
Decaluwé V. Child Eating Disorder Examination-Questionnaire. Dutch translation and adaptation of the Eating Disorder Examination-Questionnaire. In: Fairburn CG, Beglin SJ. 1999.
67.
Goossens L, Braet C. Screening for eating pathology in the pediatric field. Int J Pediatr Obes. 2010;5(6):483–90.CrossRefPubMed
68.
Decaluwé V, Braet C. Prevalence of binge-eating disorder in obese children and adolescents seeking weight-loss treatment. Int J Obes. 2003;27(3):404–9.CrossRef
69.
Petersen AC, Crockett LJ, Richards MH, Boxer AM. Measuring pubertal status: reliability and validity of a self-report measure. J Youth Adolesc. 1988;7:117–33.CrossRef
70.
Bolca S, Huybrechts I, Verschraegen M, De Henauw S, Van de Wiele T. Validity and reproducibility of a self-administered semi-quantitative food-frequency questionnaire for estimating usual daily fat, fibre, alcohol, caffeine and theobromine intakes among Belgian post-menopausal women. Int J Environ Res Public Health. 2009;6:121–50.CrossRefPubMedPubMedCentral
71.
Huybrechts I, De Bacquer D, Matthys C, De Backer G, De Henauw S. Validity and reproducibility of a semi-quantitative food-frequency questionnaire for estimating calcium intake in Belgian preschool children. Br J Nutr. 2006;95:802–16.CrossRefPubMed
72.
Moreno LA, Rodriguez G. Dietary risk factors for development of childhood obesity. Curr Opin Clin Nur Metab Care. 2007;10:336–41.CrossRef
73.
Van den Bulck J, Beullens K. Television and music video exposure and adolescent alcohol use while going out. Alcohol Alcohol (Oxford, Oxfordshire). 2005;40(3):249–53.CrossRef
74.
Tanis M, Jansz J. Gaming for different reasons: What motivates people to play a specific video game. In: Annual conference of the ICA, Montreal, Canada. 2008.
75.
Vorderer P, Bryant J (Eds). Playing video games: motives, responses, and consequences. New York: Routledge; 2006.
76.
77.
Brockmeyer JH, Fox CM, Curtiss KA, McBroom E, Burkhart KM, Pidruzny JN. The development of the game engagement questionnaire: a measure of engagement in video game-playing. J Exp Soc Psychol. 2009;45(4):624–34.CrossRef
78.
Lemmens J, Valkenburg P, Peter J. Development and validation of a game addiction scale for adolescents. Media Psychol. 2009;12(1):77–95.CrossRef
79.
King DL, Delfabbro PH, Griffiths MD. The role of structural characteristics in problematic video game play: an empirical study. Int J Ment Heal Addict. 2011;9(3):320–33.CrossRef
Metadata
Title
Using a gamified monitoring app to change adolescents’ snack intake: the development of the REWARD app and evaluation design
Authors
W. Van Lippevelde
J. Vangeel
N. De Cock
C. Lachat
L. Goossens
K. Beullens
L. Vervoort
C. Braet
L. Maes
S. Eggermont
B. Deforche
J. Van Camp
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3286-4

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue

Study protocol

‘Let’s Move It’ – a school-based multilevel intervention to increase physical activity and reduce sedentary behaviour among older adolescents in vocational secondary schools: a study protocol for a cluster-randomised trial

Research article

Comparing the quality of pro- and anti-vaccination online information: a content analysis of vaccination-related webpages

Research article

Perceived benefits and negative consequences of alcohol consumption in women living with HIV: a qualitative study

Research article

Partnership capacity for community health improvement plan implementation: findings from a social network analysis

Research article

Sexual violence and general functioning among formerly abducted girls in Northern Uganda: the mediating roles of stigma and community relations - the WAYS study

Research article

Prevalence of osteoporosis in China: a meta-analysis and systematic review