title: A Mobile, Avatar-Based App for Improving Body Perceptions Among Adolescents: A Pilot Test.
abstract: BACKGROUND
  One barrier to effectively treating weight issues among adolescents is that they tend to use social comparison instead of objective measures to evaluate their own health status. When adolescents correctly perceive themselves as overweight, they are more likely to adopt healthy lifestyle behaviors.
  
  
  OBJECTIVE
  The purpose of this pilot test was to develop and assess acceptability and usability of an avatar-based, theoretically derived mobile app entitled Monitor Your Avatar (MYA).
  
  
  METHODS
  The MYA app was engineered for high school adolescents to identify, using avatars, what they thought they looked like, what they wanted to look like, and what they actually looked like based on body measurements.
  
  
  RESULTS
  The MYA app was pilot-tested with male and female adolescents aged 15-18 years to assess for acceptability and usability. A total of 42 students created and viewed their avatars. The majority of the adolescents were female (28/42, 67%), age 16 years (16/42, 38%), white (35/42, 83%), non-Hispanic (36/42, 86%), in grade 10 (20/42, 48%), healthy weight for females (23/28, 82%), and obese for males (7/14, 50%). The adolescents had positive reactions to the avatar app and being able to view avatars that represented them. All but one student (41/42, 98%) indicated some level of comfort viewing the avatars and would use the app in the future to see how their bodies change over time.
  
  
  CONCLUSIONS
  Avatar-based mobile apps, such as the MYA app, provide immediate feedback and allow users to engage with images that are personalized to represent their perceptions and actual body images. This pilot study adds to the increasing but limited research of using games to improve health outcomes among high school adolescents. There is a need to further adapt the MYA app and gather feedback from a larger number of high school adolescents, including those from diverse backgrounds.
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.
authors.forename: Annmarie A
authors.identifier: http://orcid.org/0000-0003-0761-5764
authors.initials: AA
authors.lastname: Lyles
authors.affiliation: Ira A Fulton School of Engineering, Arizona State University, Tempe, AZ, United States.
authors.forename: Ashish
authors.identifier: http://orcid.org/0000-0003-3722-0720
authors.initials: A
authors.lastname: Amresh
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, United States.
authors.forename: Jennifer
authors.identifier: http://orcid.org/0000-0002-4956-7169
authors.initials: J
authors.lastname: Huberty
authors.affiliation: College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.
authors.forename: Michael
authors.identifier: http://orcid.org/0000-0002-1981-4245
authors.initials: M
authors.lastname: Todd
authors.affiliation: Center for Health Promotion and Disease Prevention, College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States.
authors.forename: Rebecca E
authors.identifier: http://orcid.org/0000-0002-9011-0689
authors.initials: RE
authors.lastname: Lee
keywords: Web-based; adolescents; avatars; eHealth; mHealth; perceptions; usability testing