Over three-quarters of Hispanic women in the US are overweight or obese. High rates of excess body weight place these women at heightened risk for a variety of illnesses and health conditions, such as Type 2 diabetes, coronary heart disease, and osteoarthritis. Since children tend to share their parents'eating habits, it is no surprise that Hispanic children have the highest rates of obesity for any racial/ethnic group in the US. The reasons for these high rates are varied, and involve cultural and socioeconomic factors. Documented barriers to healthy eating among Hispanics include high cost of food, lack of accessibility to food, lack of availability of fresh or frozen foods, and lack of knowledge abou healthy eating habits. Previous studies have demonstrated that food purchasing is a modifiable behavior and that nutritional education can effectuate changes in food consumption of certain nutrients. While a number of healthy eating mobile applications ("apps") have been developed, none of these have combined the ability to create a user-generated a grocery list, analyze nutritional value and cost of food, and promote the USDA's MyPlate visual method. Moreover, none of the apps targets the Hispanic population, incorporating Spanish language, culturally-tailored food shopping suggestions, educational and motivational text messages, and peer support via social media. This proposed SBIR Phase I study, rooted in theories of health behavior change and oriented towards reducing obesity and overweight among Hispanics, would be the first effort to develop and evaluate such an app. The proposed medical technology intervention is feasible and cost-effective, given the prevalence of smart phone use among Hispanics. We will conduct formative evaluations in Phase I to test the usability, feasibility, an preliminary effectiveness of the app. In Phase II, we will conduct a two-group randomized control trial to compare the proposed mobile health intervention with another mainstream healthy eating app that only provides the nutritional value of different foods. Key outcomes include: (a) changes in user motivational readiness to eat recommended servings of fruits and vegetables per day;(b) changes in the value that users ascribe to healthy eating;and (c) healthy food purchasing and consumption behavior. A matching website that can be synced with the user's mobile app will also be developed in Phase II. The subsequent Phase II application will lead to an innovative, accessible, mobile and web-based healthy food purchasing program designed to improve healthy eating habits for Hispanic women and their families, with the goal of thereby reducing obesity and overweight in this population.
The proposed Phase I effort will develop and test innovative strategies for using widely available smartphones to improve food purchasing practices among Hispanic women, a group with exceptionally high rates of overweight and obesity. The approach used in this culturally tailored, client-centered, health behavioral theory-guided, and technology-based mobile intervention has the potential to improve health outcomes by helping Hispanic women make healthier and more cost-effective food purchasing decisions for themselves and their families.