Development and implementation of a smartphone-based good diet and walking promotion program

Good diet and physical activity are essential to prevent lifestyle-related diseases. However, it's hard to change unhealthy behavior. The aim of this mixed methods feasibility study was to demonstrate the acceptability and practicality of a smartphone-based health program, which combines a food logging with pedometer steps. 21 workers in a large manufacturing company were agreed to participate. They were asked to capture and upload each meal image and daily data of pedometer steps for one week. A remote dietitian evaluated each participant's nutritious balance every day, and gave reports by e-mail. At the end, a questionnaire and a semi-structured interview were administered to the participants. A semi-structured interview was also conducted to the dietitian. All 21 participants completed the program. Twelve (57%) answered that it was good opportunity to consider their health habits. At the beginning, 12 had no intention to improve their dietary habits; however, 5 of them had intention after the program. Qualitative data revealed that one week was not enough to change behavior. In terms of usability of the smartphone application, nine (49%) felt it was easy to use while six (29%) had some difficulties. Fifteen (70%) answered that the dietitian's feedback was useful, and they wanted to get personalized and tailored advises in order to achieve their goal. The program was effective in evoking participants' intention to improve their health behavior. Further outcome-based assessment is needed to elaborate the program to determine an appropriate length of time and frequency of feedback from the dietitian.