Usability and Feasibility of PmEB: A Mobile Phone Application for Monitoring Real Time Caloric Balance

Obesity is a major public health challenge with over 65% of US adults either overweight or obese. Estimated annual costs of obesity are $78.5 billion. Self-monitoring is a critical skill for successful weight management. However, self-monitoring is labor-intensive, and compliance is often difficult. In this paper, the authors describe the Patient-Centered Assessment and Counseling Mobile Energy Balance (PmEB) mobile phone application that allows users to self-monitor caloric balance in real time. The application was developed and applied in a four-phase iterative research and development methodology. A usability study and a preliminary feasibility study were conducted. The 1 month feasibility study measured compliance and satisfaction among a sample of 15 participants randomized to one of three groups: (1) a paper diary group, (2) a PmEB group with one daily prompt, and (3) a PmEB group with three daily prompts. PmEB scored highly on usability, compliance, and satisfaction. In addition, mobile phone group users scored PmEB the same as or better than Paper Group members scored the paper diary in nearly all categories. Thematic analysis of comments revealed very positive reviews of PmEB as well as areas for improvement. PmEB is both usable and feasible for weight management self-monitoring, and the iterative pilot study methodology was effective in improving its usability.

[1]  Jeffrey Rubin,et al.  Handbook of Usability Testing: How to Plan, Design, and Conduct Effective Tests , 1994 .

[2]  Jakob Nielsen,et al.  Usability inspection methods , 1994, CHI 95 Conference Companion.

[3]  John Garcia and Andrew R. Gustavson The Science of Self-Report , 1997 .

[4]  E. Muth,et al.  The Harris-Benedict studies of human basal metabolism: history and limitations. , 1998, Journal of the American Dietetic Association.

[5]  D. Gustafson,et al.  An Evidence-Based Approach to Interactive Health Communication: A Challenge to Medicine in the Information Age , 1998 .

[6]  V. Stevens,et al.  Participants' evaluation of a weight-loss program. , 1999, Journal of the American Dietetic Association.

[7]  B. Qi,et al.  The adoption of eating behaviors conducive to weight loss. , 2000, Eating behaviors.

[8]  B E Ainsworth,et al.  Compendium of physical activities: an update of activity codes and MET intensities. , 2000, Medicine and science in sports and exercise.

[9]  R. Wing,et al.  Successful weight loss maintenance. , 2003, Annual review of nutrition.

[10]  S. Shiffman,et al.  Capturing momentary, self-report data: A proposal for reporting guidelines , 2002, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[11]  J. Smyth,et al.  Ecological Momentary Assessment Research in Behavioral medicine , 2003 .

[12]  E. Finkelstein,et al.  National medical spending attributable to overweight and obesity: how much, and who's paying? , 2003, Health affairs.

[13]  R. L. Collins,et al.  The feasibility of using cellular phones to collect ecological momentary assessment data: application to alcohol consumption. , 2003, Experimental and clinical psychopharmacology.

[14]  S. Shiffman,et al.  Assessment Methods for Patient-Reported Outcomes , 2003 .

[15]  Lawrence M. Fagan,et al.  Medical informatics: computer applications in health care and biomedicine (Health informatics) , 2003 .

[16]  S. Shiffman,et al.  Patient compliance with paper and electronic diaries. , 2003, Controlled clinical trials.

[17]  D. Ahern,et al.  Science and the advancement of eHealth: a call to action. , 2003, American journal of preventive medicine.

[18]  Ramesh Farzanfar,et al.  Just-in-Time Technology to Encourage Incremental, Dietary Behavior Change , 2003, AMIA.

[19]  G. Eysenbach The Impact of the Internet on Cancer Outcomes , 2003, CA: a cancer journal for clinicians.

[20]  Jean Scholtz,et al.  Toward a Framework for Evaluating Ubiquitous Computing Applications , 2004, IEEE Pervasive Comput..

[21]  Jean Scholtz,et al.  Towards a Discipline for Evaluating Ubiquitous Computing Applications [Technical Report] , 2004 .

[22]  Mikael Palmblad,et al.  Electronic diaries and questionnaires: Designing user interfaces that are easy for all patients to use , 2004, Quality of Life Research.

[23]  Stephen S Intille,et al.  An Ecological Framework for Cancer Communication: Implications for Research , 2005, Journal of medical Internet research.

[24]  Tammy Toscos,et al.  Chick clique: persuasive technology to motivate teenage girls to exercise , 2006, CHI Extended Abstracts.

[25]  Yvonne Rogers,et al.  Pride and prejudice: learning how chronically ill people think about food , 2006, CHI.

[26]  William G. Griswold,et al.  PmEB: a mobile phone application for monitoring caloric balance , 2006, CHI Extended Abstracts.

[27]  Brandon Brown,et al.  Reflecting on health: a system for students to monitor diet and exercise , 2006, CHI EA '06.