Relationship of Social Cognitive Theory Concepts to Dietary Habits of Pregnant Women

Designing and Developing a Mobile App for Management and Treatment of Gestational Diabetes in Nepal: User-Centered Design Study

BACKGROUND

Mobile apps can aid with the management of gestational diabetes mellitus (GDM) by providing patient education, reinforcing regular blood glucose monitoring and diet/lifestyle modification, and facilitating clinical and social support.

OBJECTIVE

This study aimed to describe our process of designing and developing a culturally tailored app, Garbhakalin Diabetes athawa Madhumeha-Dhulikhel Hospital (GDM-DH), to support GDM management among Nepalese patients by applying a user-centered design approach.

METHODS

A multidisciplinary team of experts, as well as health care providers and patients in Dhulikhel Hospital (Dhulikhel, Nepal), contributed to the development of the GDM-DH app. After finalizing the app's content and features, we created the app's wireframe, which illustrated the app's proposed interface, navigation sequences, and features and function. Feedback was solicited on the wireframe via key informant interviews with health care providers (n=5) and a focus group and in-depth interviews with patients with GDM (n=12). Incorporating their input, we built a minimum viable product, which was then user-tested with 18 patients with GDM and further refined to obtain the final version of the GDM-DH app.

RESULTS

Participants in the focus group and interviews unanimously concurred on the utility and relevance of the proposed mobile app for patients with GDM, offering additional insight into essential modifications and additions to the app's features and content (eg, inclusion of example meal plans and exercise videos).The mean age of patients in the usability testing (n=18) was 28.8 (SD 3.3) years, with a mean gestational age of 27.2 (SD 3.0) weeks. The mean usability score across the 10 tasks was 3.50 (SD 0.55; maximum score=5 for "very easy"); task completion rates ranged from 55.6% (n=10) to 94.4% (n=17). Findings from the usability testing were reviewed to further optimize the GDM-DH app (eg, improving data visualization). Consistent with social cognitive theory, the final version of the GDM-DH app supports GDM self-management by providing health education and allowing patients to record and self-monitor blood glucose, blood pressure, carbohydrate intake, physical activity, and gestational weight gain. The app uses innovative features to minimize the self-monitoring burden, as well as automatic feedback and data visualization. The app also includes a social network "follow" feature to add friends and family and give them permission to view logged data and a progress summary. Health care providers can use the web-based admin portal of the GDM-DH app to enter/review glucose levels and other clinical measures, track patient progress, and guide treatment and counseling accordingly.

CONCLUSIONS

To the best of our knowledge, this is the first mobile health platform for GDM developed for a low-income country and the first one containing a social support feature. A pilot clinical trial is currently underway to explore the clinical utility of the GDM-DH app.

Nutrition and health challenges among low-income families of young children in the post COVID-19 era: a qualitative study

BACKGROUND/OBJECTIVES

In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions.

SUBJECTS/METHODS

In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audio-recorded, transcribed, and coded using MaxQDA software.

RESULTS

Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies.

CONCLUSIONS

Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.

Analyzing consumer behaviour towards food and nutrition labeling: A comprehensive review

Studying consumer behaviour towards food and nutrition labelling (F&NL) is increasingly becoming important across the world. Bibliometric analysis is a way to identify influential research, track trends, and understand methodologies in any field. In this paper, we used bibliometric analysis and a review of theories too to critically evaluate theories and concepts used in studying consumer behaviour towards F&NL. Using the Scopus database, we obtained 1017 articles, which were further filtered to perform various analyses like Co-occurrence and co-authorship network analysis. We found limited East and Southeast Asia-based research. Personal beliefs, attitudes, and past experiences were identified as influencers of consumer behaviour regarding food labelling. Trending topics were food waste, purchase intention, and sustainability labels.

Applying social cognitive theory to predict physical activity and dietary behavior among patients with type-2 diabetes

INTRODUCTION

Non-communicable diseases, arising out of changing lifestyle habits of people, are the foremost causes of mortality and morbidity worldwide. Most of these diseases occur in low and middle-income countries. Chronic diseases can be managed with the help of health behaviors such as proper diet, physical exercise, adherence to medication, and avoidance of health risk behaviors such as smoking, alcohol consumption, sedentary lifestyle, etc. The social cognitive theory addresses the role of personal and environmental factors in an individual's health behavior. The current study aims to understand the role of social cognitive theory on physical activity and dietary behavior amongst individuals diagnosed with type-2 diabetes.

METHODS

A correlational study was conducted among 225 participants with type-2 diabetes, who are under medication. The data was collected using social cognitive questionnaire for physical activity & dietary behavior and Health-Promoting Lifestyle Profile II. Descriptive statistics, Pearson's correlation coefficient and multiple linear regression analysis were used to analyze the data.

RESULTS

It was found from the study results that, all the domains of social cognitive theory were significantly correlated with physical activity (p<0.001) and the SCT domains- self-regulation (p<0.001), social support (p<0.001), and outcome expectancy (p<0.05) were significantly correlated with dietary behavior. The results of multiple linear regressions indicated that the domains self- regulation and self- efficacy were the significant predictor for physical activity behavior (R2=.21, p ≤ 0.001) while the domains social support and self-regulation were the significant predictor of dietary behavior (R2=.09, p ≤ 0.001).

CONCLUSION

The study results show that there is an influence of social cognitive domains on physical activity and dietary behaviour. Further, this study suggests that social cognitive theory based intervention can be used to promote healthy behaviour.