Design and rationale of an innovative intervention addressing inadequate vegetable intake among young adults using social media and mobile gaming Authors: Monica Nour, Professor Judy Kay, Professor Margaret Allman-Fairnelli Presented by Monica Nour (Dietitian, PhD Candidate) The Charles Perkins Centre, The University of Sydney The University of Sydney Page 1
Background Association between fruit and vegetable consumption and all cause mortality Mortality All causes Portions of fruit and vegetables consumed in the previous day HRs (95% CI) 0<1 1<3 3<5 5<7 7+ 1 0.86 (0.79 to 0.95) 0.71 (0.63 to 0.81) 0.64 (0.53 to 0.76) 0.58 (0.46 to 0.71) Cancer 1 0.89 (0.76 to 1.04) 0.81 (0.69 to 0.95) 0.75 (0.62 to 0.91) 0.75 (0.59 to 0.96) CVD 1 0.91 (0.78 to 1.05) 0.82 (0.70 to 0.95) 0.80 (0.66 to 0.96) 0.69 (0.53 to 0.88) Oyebode et al 2014 The University of Sydney Page 2
Initiatives to encourage fruit and/or vegetable intake in Australia Government Campaigns % Australian s eating 2 serves of fruit and 5 serves of vegetables a day 60 50 Fruit Vegetables 40 Public Health Initiatives 30 20 10 0 18-34 35-44 45-54 55-64 Australian Health Survey: First Results, 2014-15 The University of Sydney Page 3
Program Planning 1. Needs Assessment 2. Reviewing the evidence 3. Intervention mapping & formative research 4. Final testing RCT The University of Sydney Page 4
Just how much vegetables do young adults eat? How much variety are they having? Consumed 3-4 vegetable varieties 1.2 serves 18% < ½ serve When are vegetables eaten? Lunch Snack Snack Breakfast Dinner The University of Sydney Page 5
Focus groups to assess barriers and enablers Identified correct serve size 2/32 Lack of knowledge Cost I don t know how to cook vegetables so they taste nice, they always end up soggy and bland Poor cooking skills 18/32 Recalled 5 a day recommendation Time I don t have much spare time so recipes that are quick and easy appeal to me The University of Sydney Page 6
1. Needs Assessment Lunch Snack Breakfast Snack Dinner The University of Sydney Page 7
In 2015 95% of young adults owned a smart phone Could we use this technology to intervene with young adults? 91% used it for social networking & gaming The University of Sydney Page 8 Pew Internet research data
Program Planning 1. Needs Assessment 2. Reviewing the evidence 3. Intervention mapping & formative research 4. Final testing RCT The University of Sydney Page 9
Review of technology based interventions Study Nitzke et al. 2007 Hebden et al 2013 LaChause 2012 Partridge et al. 2015 Shahril et al. 2013 Overall effect size Effect size(95% CI) 0.11 (0.02, 0.20) 0.12 (-0.43, 0.67) 0.00 (-0.25, 0.25) 0.40 (0.15, 0.65) 0.17 (-0.02, 0.30) 0.15 (0.04, 0.26) -0.5 0 0.5 1 Nour, Chen, Allman-Farinelli, JMIR 2016 Social media and gaming effective for improving nutrition knowledge and The University of Sydney attitudes Page 10
Program Planning 1. Needs Assessment 2. Reviewing the evidence 3. Intervention mapping & formative research 4. Final testing RCT The University of Sydney Page 11
Applying the COM-B Behaviour change framework to a Facebook support page and mobile app Standard goal setting and self-monitoring app Gamified goal setting and self-monitoring app The University of Sydney Page 12
Applying the COM-B Behaviour change framework Psychological Knowledge: BCT 1 Provide information on behaviour-health link Gamified app rewards improvement in knowledge quiz on vegetable types and serving sizes The University of Sydney Page 13
Applying the COM-B Behaviour change framework Psychological Self-monitoring: BCT 12 Promote self-monitoring of behaviour The University of Sydney Page 14
Applying the COM-B Behaviour change framework Physical Skill building: BCT 9 & 17 Model the behaviour & Prompt practice The University of Sydney Page 15
Applying the COM-B Behaviour change framework Physical Cues to action and stimulus control: BCT 15 Teach to use prompts or cues The University of Sydney Page 16
Applying the COM-B Behaviour change framework Physical Cues to action and stimulus control: BCT 15 Teach to use prompts or cues The University of Sydney Page 17
Applying the COM-B Behaviour change framework Reflective Goal setting: BCT10 Prompt specific goal setting Review of goals: BCT 11 Prompt review of behavioural goals The University of Sydney Page 18
Applying the COM-B Behaviour change framework Reflective Rewards/Incentives: BCT 14 Provide Contingent Rewards Gamified version only John Smith Social support: BCT 3 & 20 Provide information about others approval & Plan social support or social change The University of Sydney Page 19
Program Planning 1. Needs Assessment 2. Reviewing the evidence 3. Intervention mapping & formative research 4. Final testing in Factorial design The University of Sydney Page 20
In order to optimise delivery before an RCT a factorial design will be used to determine best components Application type Participants randomised into 2 x2 factorial design Facebook intervention No Facebook intervention Gamified N=250 N=250 Standard N=250 N=250 The University of Sydney Page 21
Acknowledgement Kevin McGeechan (Biostatistician) School of IT research students Kartik Gupta Lie Ming Tang Jisu Jung The University of Sydney Page 22