Development, usability, formative assessment, and story immersion of Nutrigame, a mHealth nutrition education app

Carina de Sousa Santos; Bruna Caroline Chaves Garcia; Ludiany Aparecida Moreira de Souza; Marliane Ferreira Gomes; Bianca Silva Fernandes; Elizabethe Adriana Esteves; Etel Rocha-Vieira

doi:10.5753/jis.2023.3274

Authors

Carina de Sousa Santos Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0002-3755-6358
Bruna Caroline Chaves Garcia Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0001-7798-1247
Ludiany Aparecida Moreira de Souza Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0002-2974-5431
Marliane Ferreira Gomes Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0003-0237-659X
Bianca Silva Fernandes Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0001-5007-1489
Elizabethe Adriana Esteves Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0003-1435-8364
Etel Rocha-Vieira Universidade Federal dos Vales do Jequitinhonha e Mucuri https://orcid.org/0000-0001-6908-7237

DOI:

https://doi.org/10.5753/jis.2023.3274

Keywords:

Food knowledge, NOVA classification, Dietary guidelines, Serious game, Game for health, Nutrition education

Abstract

The replacement of unprocessed and minimally processed foods with processed and ultra-processed ones can be a contributor to the increased prevalence of obesity amongst adults and adolescents. Mobile health (mHealth) innovations, such as mobile applications (apps), especially games, can be used to improve health behaviors and increase adolescent knowledge. The aim of this qualitative research was to describe the development, assessment, and story immersion of a mHealth nutrition education app developed to improve the food knowledge of adolescents. This study employed the stepwise approach model to the mHealth app development, according to the person-based approach and evidence-based behavior change techniques. The mHealth app was based on the concepts of the NOVA system food classification, present in the Brazilian dietary guidelines. The developed app, Nutrigame – your food guide, is a story-based serious game set in the food routine of an adolescent who needs to choose what to eat, when, where, and with whom the meals are taken. The first version of the app was tested by a group of adolescents (convenience sample, n=6, mean age: 15.8 ± 0.9 years) for 30 days. To assess usability, feasibility, engagement (user testing), and formative evaluation from the user's perspective, five individual interviews. After the last interview, the participants were required to complete a 13-item immersion scale, adapted from the narrative transportation scale to assess story immersion game. The final version of the game was adapted to meet the suggestions presented by the adolescents. All steps used for the app development are described. The gamification elements chosen led to the comprehension of the main learning contents. The mean story immersion score (30.3 ± 1.9) demonstrates the participant's involvement with the game's narrative. This study can provide useful insights to public health researchers and nutrition educators who are planning to develop a mHealth nutrition education app from a practical perspective.

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