title: Using a gamified monitoring app to change adolescents' snack intake: the development of the REWARD app and evaluation design.
abstract: As the snacking pattern of European adolescents is of great concern, effective interventions are necessary. Till now health promotion efforts in children and adolescents have had only limited success in changing adolescents' eating patterns and anthropometrics. Therefore, the present study proposes an innovative approach to influence dietary behaviors in youth based on new insights on effective behavior change strategies and attractive intervention channels to engage adolescents. This article describes the rationale, the development, and evaluation design of the 'Snack Track School' app. The aim of the app is to improve the snacking patterns of Flemish 14- to 16-year olds.
  
  
  
  The development of the app was informed by the systematic, stepwise, iterative, and collaborative principles of the Intervention Mapping protocol. A four week mHealth intervention was developed based on the dual-system model with behavioral change strategies targeting both the reflective (i.e., active learning, advance organizers, mere exposure, goal-setting, monitoring, and feedback) and automatic processes (i.e., rewards and positive reinforcement). This intervention will be evaluated via a controlled pre-post design in Flemish schools among 1400 adolescents.
  
  
  
  When this intervention including strategies focused on both the reflective and automatic pathway proves to be effective, it will offer a new scientifically-based vision, guidelines and practical tools for public health and health promotion (i.e., incorporation of learning theories in intervention programs).
  
  
  
  NCT02622165 registrated November 15, 2015 on clinicaltrials.gov.
authors: Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium. wendy.vanlippevelde@ugent.be.
authors: W
authors: 0000-0002-8535-0215
authors: W
authors: Van Lippevelde
authors: Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium.
authors: J
authors: J
authors: Vangeel
authors: Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.
authors: N
authors: N
authors: De Cock
authors: Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.
authors: C
authors: C
authors: Lachat
authors: Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
authors: L
authors: L
authors: Goossens
authors: Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium.
authors: K
authors: K
authors: Beullens
authors: Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
authors: L
authors: L
authors: Vervoort
authors: Department of Developmental, Personality and Social Psychology, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
authors: C
authors: C
authors: Braet
authors: Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors: L
authors: L
authors: Maes
authors: Leuven School for Mass Communication Research, KU Leuven, Parkstraat 45 -bus 3603, Leuven, Belgium.
authors: S
authors: S
authors: Eggermont
authors: Department of Public Health, Ghent University, 4K3, De Pintelaan 185, 9000, Ghent, Belgium.
authors: B
authors: B
authors: Deforche
authors: Department of Food Safety and Food Quality, Ghent University, Coupure links 653, 9000, Ghent, Belgium.
authors: J
authors: J
authors: Van Camp
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy; D001530:Belgium; D004032:Diet; D005246:Feedback; D005247:Feeding Behavior; D005260:Female; D006040:Goals; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007858:Learning; D008297:Male; D063731:Mobile Applications; D012107:Research Design; D012201:Reward; D012574:Schools; D000068356:Self-Control; D062410:Snacks; D011795:Surveys and Questionnaires; D017216:Telemedicine; D018910:Video Games
keywords: Adolescents; App; Conditioning; Diet; Dual-system model; Intervention; Learning theories; Nutrition; Obesity; Overweight; Snacks; mHealth