title: Theory-Based Design and Development of a Socially Connected, Gamified Mobile App for Men About Breastfeeding (Milk Man).
abstract: BACKGROUND
  Despite evidence of the benefits of breastfeeding, <15% of Australian babies are exclusively breastfed to the recommended 6 months. The support of the father is one of the most important factors in breastfeeding success, and targeting breastfeeding interventions to the father has been a successful strategy in previous research. Mobile technology offers unique opportunities to engage and reach populations to enhance health literacy and healthy behavior.
  
  
  OBJECTIVE
  The objective of our study was to use previous research, formative evaluation, and behavior change theory to develop the first evidence-based breastfeeding app targeted at men. We designed the app to provide men with social support and information aiming to increase the support men can offer their breastfeeding partners.
  
  
  METHODS
  We used social cognitive theory to design and develop the Milk Man app through stages of formative research, testing, and iteration. We held focus groups with new and expectant fathers (n=18), as well as health professionals (n=16), and used qualitative data to inform the design and development of the app. We tested a prototype with fathers (n=4) via a think-aloud study and the completion of the Mobile Application Rating Scale (MARS).
  
  
  RESULTS
  Fathers and health professionals provided input through the focus groups that informed the app development. The think-aloud walkthroughs identified 6 areas of functionality and usability to be addressed, including the addition of a tutorial, increased size of text and icons, and greater personalization. Testers rated the app highly, and the average MARS score for the app was 4.3 out of 5.
  
  
  CONCLUSIONS
  To our knowledge, Milk Man is the first breastfeeding app targeted specifically at men. The development of Milk Man followed a best practice approach, including the involvement of a multidisciplinary team and grounding in behavior change theory. It tested well with end users during development. Milk Man is currently being trialed as part of the Parent Infant Feeding Initiative (ACTRN12614000605695).
authors.affiliation: School of Public Health, Curtin University, Perth, Australia.
authors.forename: Becky K
authors.identifier: http://orcid.org/0000-0003-3234-1742
authors.initials: BK
authors.lastname: White
authors.forename: Annegret
authors.identifier: http://orcid.org/0000-0002-9044-2990
authors.initials: A
authors.lastname: Martin
authors.forename: James A
authors.identifier: http://orcid.org/0000-0002-8789-3563
authors.initials: JA
authors.lastname: White
authors.forename: Sharyn K
authors.identifier: http://orcid.org/0000-0002-1551-2805
authors.initials: SK
authors.lastname: Burns
authors.forename: Bruce R
authors.identifier: http://orcid.org/0000-0002-7988-9740
authors.initials: BR
authors.lastname: Maycock
authors.forename: Roslyn C
authors.identifier: http://orcid.org/0000-0001-9016-1251
authors.initials: RC
authors.lastname: Giglia
authors.forename: Jane A
authors.identifier: http://orcid.org/0000-0003-0765-9054
authors.initials: JA
authors.lastname: Scott
keywords: app; breastfeeding; fathers; gamification; mHealth; mobile phone; smartphone; social connectivity