Abstract
Hispanic adolescents have the highest rates of pediatric obesity relative to any other racial or ethnic groups. Digital lifestyle interventions for obesity prevention show promise in reducing weight status and promoting healthy lifestyles in youth but are highly underutilized among Hispanics. Understanding user engagement with these interventions is key for them to be efficacious. The following mixed methods study assessed user engagement in a pilot randomized controlled trial (RCT) of a family-based digital obesity prevention intervention (“Healthy Juntos”) for Hispanic parents and their 12-15 year old adolescents. Healthy Juntos is a web-based application that includes eight modules of content for parents and adolescents delivered over 10-12 weeks. Systems usage data were examined to understand frequency, time, intensity, and type of engagement; qualitative data from one-one interviews were used to understand participants’ likes and dislikes as well as any improvement suggestions. Of the 25 parent-adolescent dyads participating in the pilot RCT, 14 were randomly assigned to the Healthy Juntos condition and were included in the present study.Fifty-seven percent of parents completed between 88-100% of eight weekly modules while 36% of the adolescents completed at least 50% of the modules, with a strong positive correlation (r=0.825, p < 0.001) between parent and adolescent completion. Parents used the app for 20.43 ±13.02 days, with 44.89 ± 22.12 minutes of weekly usage; adolescents used the app for 8.21 ± 5.29 days, with 28.12 ± 22.56 minutes of weekly usage. Qualitative data supported quantitative findings, reinforcing parents' higher engagement and enthusiasm with the program and highlighting barriers to using it, such as time. Results from this project summarize how and why participants engaged with the intervention and allow us to determine the necessary changes for technological or procedural improvements that might impact future users’ engagement with the program.