Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2019

Open Access 01-12-2019 | Obesity | Study protocol

Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial

Authors: Elisa Puigdomenech, Anne Martin, Alexandra Lang, Fulvio Adorni, Santiago Felipe Gomez, Brian McKinstry, Federica Prinelli, Laura Condon, Rajeeb Rashid, Maurizio Caon, Sarah Atkinson, Claudio L. Lafortuna, Valentina Ciociola, Janet Hanley, Lucy McCloughan, Conxa Castell, Mireia Espallargues, on behalf of the PEGASO Fit For Future Consortium

Published in: BMC Medical Informatics and Decision Making | Issue 1/2019

Login to get access

Abstract

Background

Behaviour change interventions targeting physical activity, diet, sleep and sedentary behaviour of teenagers show promise when delivered through smartphones. However, to date there is no evidence of effectiveness of multicomponent smartphone-based interventions. Utilising a user-centred design approach, we developed a theory-based, multi-dimensional system, PEGASO Fit For Future (PEGASO F4F), which exploits sophisticated game mechanics involving smartphone applications, a smartphone game and activity sensors to motivate teenagers to take an active role in adopting and maintaining a healthy lifestyle. This paper describes the study protocol to assess the feasibility, usability and effectiveness (knowledge/awareness and behavioural change in lifestyle) of the PEGASO system.

Methods

We are conducting a quasi-experimental controlled cluster trial in 4 sites in Spain, Italy, and UK (England, Scotland) over 6 months. We plan to recruit 525, in a 2:1 basis, teenagers aged 13–16 years from secondary schools. The intervention group is provided with the PEGASO system whereas the comparison group continues their usual educational routine. Outcomes include feasibility, acceptance, and usability of the PEGASO system as well as between and within group changes in motivation, self-reported diet, physical activity, sedentary and sleeping behaviour, anthropometric measures and knowledge about a healthy lifestyle.

Discussion

PEGASO F4F will provide evidence into the cross-cultural similarities and differences in the feasibility, acceptability and usability of a multi-dimensional smartphone based behaviour change intervention for teenagers. The study will explore facilitating factors, challenges and barriers of engaging teenagers to adapt and maintain a healthy lifestyle when using smartphone technology. Positive results from this ICT based multi component intervention may have significant implications both at clinical level, improving teenagers health and at public health level since it can present an influential tool against the development of chronic disease during adulthood.

Trial registration

https://clinicaltrials.gov Registration number: NCT02930148, registered 4 October 2016.
Literature
2.
go back to reference Moreno LA, Gottrand F, Huybrechts I, Ruiz JR, González-Gross M, De Henauw S, HELENA Study Group. Nutrition and lifestyle in european adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Adv Nutr. 2014;5(5):615S–23S.PubMedPubMedCentral Moreno LA, Gottrand F, Huybrechts I, Ruiz JR, González-Gross M, De Henauw S, HELENA Study Group. Nutrition and lifestyle in european adolescents: the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. Adv Nutr. 2014;5(5):615S–23S.PubMedPubMedCentral
3.
go back to reference Sawyer SM, Afifi RA, Bearinger LH, Blakemore S-J, Dick B, Ezeh AC, et al. Adolescence: a foundation for future health. Lancet. 2012;379:1630–40.PubMed Sawyer SM, Afifi RA, Bearinger LH, Blakemore S-J, Dick B, Ezeh AC, et al. Adolescence: a foundation for future health. Lancet. 2012;379:1630–40.PubMed
4.
go back to reference Black MM, Hurley KM. Investment in early childhood development. Lancet. 2014;384:1244–5.PubMed Black MM, Hurley KM. Investment in early childhood development. Lancet. 2014;384:1244–5.PubMed
5.
go back to reference Dick B, Ferguson BJ. Health for the world’s adolescents: a second chance in the second decade. J Adolesc Health. 2015;56:3–6.PubMed Dick B, Ferguson BJ. Health for the world’s adolescents: a second chance in the second decade. J Adolesc Health. 2015;56:3–6.PubMed
7.
go back to reference Ambrosini G. Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc. 2014;73:137–46.PubMed Ambrosini G. Childhood dietary patterns and later obesity: a review of the evidence. Proc Nutr Soc. 2014;73:137–46.PubMed
8.
go back to reference Rauner A, Mess F, Woll A. The relationship between physical activity, physical fitness and overweight in adolescents: a systematic review of studies published in or after 2000. BMC Pediatr. 2013;13:19.PubMedPubMedCentral Rauner A, Mess F, Woll A. The relationship between physical activity, physical fitness and overweight in adolescents: a systematic review of studies published in or after 2000. BMC Pediatr. 2013;13:19.PubMedPubMedCentral
9.
go back to reference Fatima Y, Doi SA, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16(2):137–49.PubMed Fatima Y, Doi SA, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16(2):137–49.PubMed
10.
go back to reference Liao Y, Liao J, Durand CP, Dunton GF. Which type of sedentary behaviour intervention is more effective at reducing body mass index in children? A meta-analytic review. Obes Rev. 2014;15(3):159–68.PubMed Liao Y, Liao J, Durand CP, Dunton GF. Which type of sedentary behaviour intervention is more effective at reducing body mass index in children? A meta-analytic review. Obes Rev. 2014;15(3):159–68.PubMed
11.
go back to reference Biddle SJ, Petrolini I, Pearson N. Nterventions designed to reduce sedentary behaviours in young people: a review of reviews. Br J Sports Med. 2014;48(3):182–6.PubMed Biddle SJ, Petrolini I, Pearson N. Nterventions designed to reduce sedentary behaviours in young people: a review of reviews. Br J Sports Med. 2014;48(3):182–6.PubMed
13.
go back to reference Diethelm K, Jankovic N, Moreno LA, Huybrechts I, De Henauw S, De Vriendt T, et al. 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. https://doi.org/10.1017/S1368980011001935.PubMed Diethelm K, Jankovic N, Moreno LA, Huybrechts I, De Henauw S, De Vriendt T, et al. 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. https://​doi.​org/​10.​1017/​S136898001100193​5.PubMed
16.
go back to reference NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017. https://doi.org/10.1016/S0140-6736(17)32129-3. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. Lancet. 2017. https://​doi.​org/​10.​1016/​S0140-6736(17)32129-3.
20.
go back to reference Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, Lewis S, Stoddart A, Van der Pol M, MacNee W, Sheikh A, Pagliari C, McKinstry B. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ. 2013. https://doi.org/10.1136/bmj.f6070.PubMedPubMedCentral Pinnock H, Hanley J, McCloughan L, Todd A, Krishan A, Lewis S, Stoddart A, Van der Pol M, MacNee W, Sheikh A, Pagliari C, McKinstry B. Effectiveness of telemonitoring integrated into existing clinical services on hospital admission for exacerbation of chronic obstructive pulmonary disease: researcher blind, multicentre, randomised controlled trial. BMJ. 2013. https://​doi.​org/​10.​1136/​bmj.​f6070.PubMedPubMedCentral
22.
go back to reference Ferrer-Roca O, Gonzalez-Méndez D. Health 4.0 in the i2i era. Int J Reliable Quality E-Healthcare. 2012;1(1):43–57. Ferrer-Roca O, Gonzalez-Méndez D. Health 4.0 in the i2i era. Int J Reliable Quality E-Healthcare. 2012;1(1):43–57.
25.
go back to reference Wong CA, Merchant RM, Moreno MA. Using social media to engage adolescents and young adults with their health. Healthc (Amst). 2014;2(4):220–4. Wong CA, Merchant RM, Moreno MA. Using social media to engage adolescents and young adults with their health. Healthc (Amst). 2014;2(4):220–4.
26.
go back to reference Vandewater EA, Denis LM. Media, social networking, and pediatric obesity. Pediatr Clin N Am. 2011;58(6):1509–19. Vandewater EA, Denis LM. Media, social networking, and pediatric obesity. Pediatr Clin N Am. 2011;58(6):1509–19.
29.
go back to reference Dute DJ, Bemelmans WJE, Breda J. Using Mobile Apps to Promote a Healthy Lifestyle Among Adolescents and Students: A Review of the Theoretical Basis and Lessons Learned. JMIR mHealth and uHealth. 2016;4(2):e39.PubMedPubMedCentral Dute DJ, Bemelmans WJE, Breda J. Using Mobile Apps to Promote a Healthy Lifestyle Among Adolescents and Students: A Review of the Theoretical Basis and Lessons Learned. JMIR mHealth and uHealth. 2016;4(2):e39.PubMedPubMedCentral
30.
go back to reference Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):1. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(1):1.
32.
go back to reference Harrell JS, McMurray RG, Baggett CD, Pennell ML, Pearce PF, Bangdiwala SI. Energy costs of physical activities in children and adolescents. Med Sci Sports Exerc. 2005;37:329–36.PubMed Harrell JS, McMurray RG, Baggett CD, Pennell ML, Pearce PF, Bangdiwala SI. Energy costs of physical activities in children and adolescents. Med Sci Sports Exerc. 2005;37:329–36.PubMed
35.
go back to reference Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean diet quality index in children and adolescents. Public Health Nutr. 2004;7(7):931–5.PubMed Serra-Majem L, Ribas L, Ngo J, Ortega RM, García A, Pérez-Rodrigo C, et al. Food, youth and the Mediterranean diet in Spain. Development of KIDMED, Mediterranean diet quality index in children and adolescents. Public Health Nutr. 2004;7(7):931–5.PubMed
36.
go back to reference Janz KF, Lutuchy EM, Wenthe P, Levy SM. Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A. Med Sci Sports Exerc. 2008;40:767–72.PubMed Janz KF, Lutuchy EM, Wenthe P, Levy SM. Measuring activity in children and adolescents using self-report: PAQ-C and PAQ-A. Med Sci Sports Exerc. 2008;40:767–72.PubMed
37.
go back to reference Rey-López JP, Ruiz JR, Ortega FB, Verloigne M, Vicente-Rodriguez G, Gracia-Marco L, et al. Reliability and validity of a screen time-based sedentary behaviour questionnaire for adolescents: the HELENA study. Eur J Pub Health. 2012. https://doi.org/10.1093/eurpub/ckr040. Epub 2011 Apr 15.PubMed Rey-López JP, Ruiz JR, Ortega FB, Verloigne M, Vicente-Rodriguez G, Gracia-Marco L, et al. Reliability and validity of a screen time-based sedentary behaviour questionnaire for adolescents: the HELENA study. Eur J Pub Health. 2012. https://​doi.​org/​10.​1093/​eurpub/​ckr040. Epub 2011 Apr 15.PubMed
38.
go back to reference Wolfson AR, Carskadon MA, Acebo C, Seifer R, Fallone G, Labyak SE, et al. Evidence for the validity of a sleep habits survey for adolescents. Sleep. 2003;26(2):213–6.PubMed Wolfson AR, Carskadon MA, Acebo C, Seifer R, Fallone G, Labyak SE, et al. Evidence for the validity of a sleep habits survey for adolescents. Sleep. 2003;26(2):213–6.PubMed
39.
go back to reference Turconi G, Celsa M, Rezzani C, Biino G, Sartirana MA, Roggi C. Reliability of dietary questionnaire on food habits, eating behaviours and nutritional knowledge of adolescents. Eur J Clin Nutr. 2003;57:753–63.PubMed Turconi G, Celsa M, Rezzani C, Biino G, Sartirana MA, Roggi C. Reliability of dietary questionnaire on food habits, eating behaviours and nutritional knowledge of adolescents. Eur J Clin Nutr. 2003;57:753–63.PubMed
40.
go back to reference Deci EL, Ryan RM. Intrinsic Motivation and Self-Determination in Human Behavior, vol. 2. New York: Plenum; 1985. Williams GC, Deci EL: Internalization of biopsychosocial values by medical students: a test of self-determination theory J Pers Soc Psychol 70:767–779, 199 Deci EL, Ryan RM. Intrinsic Motivation and Self-Determination in Human Behavior, vol. 2. New York: Plenum; 1985. Williams GC, Deci EL: Internalization of biopsychosocial values by medical students: a test of self-determination theory J Pers Soc Psychol 70:767–779, 199
43.
go back to reference Lewis JR, Mayes DK. Development and psychometric evaluation of the emotional metric outcomes (EMO) questionnaire. J Int J Hum Comput Int. 2014;30(9):685–702. Lewis JR, Mayes DK. Development and psychometric evaluation of the emotional metric outcomes (EMO) questionnaire. J Int J Hum Comput Int. 2014;30(9):685–702.
45.
go back to reference Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. 1st ed. Silverback Publishing: London; 2014. Michie S, Atkins L, West R. The behaviour change wheel: a guide to designing interventions. 1st ed. Silverback Publishing: London; 2014.
50.
go back to reference Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.PubMedPubMedCentral Schoeppe S, Alley S, Van Lippevelde W, Bray NA, Williams SL, Duncan MJ, et al. Efficacy of interventions that use apps to improve diet, physical activity and sedentary behaviour: a systematic review. Int J Behav Nutr Phys Act. 2016;13(1):127.PubMedPubMedCentral
52.
go back to reference Lau PWC, Mphil LEY, Wong DP. PhD,2 RansdellL A Systematic Review of Information and Communication Technology–Based Interventions for Promoting Physical Activity Behavior Change in Children and Adolescents. J Med Internet Res. 2011;13(3):e48.PubMedPubMedCentral Lau PWC, Mphil LEY, Wong DP. PhD,2 RansdellL A Systematic Review of Information and Communication Technology–Based Interventions for Promoting Physical Activity Behavior Change in Children and Adolescents. J Med Internet Res. 2011;13(3):e48.PubMedPubMedCentral
Metadata
Title
Promoting healthy teenage behaviour across three European countries through the use of a novel smartphone technology platform, PEGASO fit for future: study protocol of a quasi-experimental, controlled, multi-Centre trial
Authors
Elisa Puigdomenech
Anne Martin
Alexandra Lang
Fulvio Adorni
Santiago Felipe Gomez
Brian McKinstry
Federica Prinelli
Laura Condon
Rajeeb Rashid
Maurizio Caon
Sarah Atkinson
Claudio L. Lafortuna
Valentina Ciociola
Janet Hanley
Lucy McCloughan
Conxa Castell
Mireia Espallargues
on behalf of the PEGASO Fit For Future Consortium
Publication date
01-12-2019
Publisher
BioMed Central
Keywords
Obesity
Obesity
Published in
BMC Medical Informatics and Decision Making / Issue 1/2019
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-019-0958-x

Other articles of this Issue 1/2019

BMC Medical Informatics and Decision Making 1/2019 Go to the issue