title: Starting the Conversation - A Childhood Obesity Knowledge Project Using an App.
abstract: OBJECTIVE
  Starting the Conversationwas a pilot project to test an intervention for childhood obesity, a major public health epidemic, using a free smartphone application (app). The primary aim was to assess students' knowledge of nutritional indicators, physical exercise and use of screen time before and after the intervention.
  
  
  METHODS
  The study was conducted in 2011-2012. The sample, recruited from seven high schools in Snohomish County, Washington, was 65.3% minority participants. Of the 118 participants in the sample (n=118), 79 handwrote their responses (n=78) and 36 responded via the app (n=39). We compared the frequency and types of physical exercise, frequency of screen time, and nutritional variables of high school students. Participants used the cell phone app or a handwritten log to record their daily entries for 20 days.
  
  
  RESULTS
  Both males (n=43) and females (n=75) grades 9-12 used the app or handwritten entries. Participants who used the app ate less fast food and exercised more, as compared with those who recorded their entries by hand. Screen time usage decreased over the course of the study, based on a comparison of the post-survey level and the pre-survey level. Knowledge of recommended daily consumption of vegetables increased post-test in the app group and knowledge of water consumption increased significantly in both groups. There was no significant difference in BMI pre and post-test.
  
  
  CONCLUSIONS
  Patterns of nutritional intake, physical exercise and knowledge of these issues varied pre and post-test. It is critical to further examine factors associated with lack of physical activity and food intake patterns of youth using social media to further address the childhood obesity epidemic. Future research should focus on specific ethnic subgroups and an intervention at the school level aimed at the students with BMI ≥ 95thpercentile.
authors.affiliation: Snohomish County YMCA, Minority Achievers Program.
authors.forename: Hoa B
authors.initials: HB
authors.lastname: Appel
authors.affiliation: Bastyr University, Research Institute.
authors.forename: Bu
authors.initials: B
authors.lastname: Huang
authors.affiliation: University of Washington, School of Medicine.
authors.forename: Allison
authors.initials: A
authors.lastname: Cole
authors.affiliation: University of Washington, School of Medicine.
authors.forename: Rosalina
authors.initials: R
authors.lastname: James
authors.affiliation: Florida State University, College of Social Work.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Ai
keywords: Childhood obesity; app; nutritional intake; physical activity; screen time