title: Designing Health Apps to Support Dietetic Professional Practice and Their Patients: Qualitative Results From an International Survey.
abstract: BACKGROUND
  Dietitians are engaging with mobile health (mHealth) technologies, particularly with diet and nutrition apps in their patient care. Despite the plethora of apps available, the majority are not designed with a dietitian's input.
  
  
  OBJECTIVE
  The aim of this study was to identify the user preferences of dietitians in relation to tools, resources, and design features for smartphone health apps that would support their dietetic professional practice and their patients.
  
  
  METHODS
  As part of a larger international Web-based survey of health-app use among dietitians, three open-ended responses were included for specific exploration of app design features and additional resources or tools that could guide the development of apps for use in dietetic practice and patient care. Inductive thematic analysis of responses was conducted using the qualitative data analysis program, NVivo version 11 (QSR International Pty Ltd), to understand the design preferences and features valued by dietitians.
  
  
  RESULTS
  The responses from 381 dietitian respondents were analyzed. Five key themes were identified. Dietitians wanted access to credible apps, suggesting that dietetic associations should have greater involvement in reviewing and endorsing evidence-based apps for use in dietary counseling. Improvements to the usability of apps, relating to their ease of use and design, were also raised, as self-monitoring of dietary behaviors using existing nutrition apps was deemed to be burdensome. Furthermore, apps providing dietitian-oriented support were favored, for example, those with the ability to streamline the dietary assessment process, so that dietitians could spend more time on dietary counseling and negotiating patient goals for dietary and lifestyle behavior change. Provision of patient-oriented support, such as functionality to tailor apps to patient-specific needs, was also considered important. Finally, respondents valued apps that could integrate into their work systems to enhance the quality of the dietitian-patient relationship.
  
  
  CONCLUSIONS
  App developers should draw upon the features and characteristics valued by dietitians to guide their development of apps that support dietetic practice and enhance patient care. Moreover, to achieve better dietitian and patient-centered app design, it is imperative that app developers take a collaborative approach with dietitians, their professional associations, and their patients.
authors.affiliation: School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, Australia.
authors.forename: Juliana
authors.identifier: http://orcid.org/0000-0003-2844-6947
authors.initials: J
authors.lastname: Chen
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Jessica
authors.identifier: http://orcid.org/0000-0003-4380-1011
authors.initials: J
authors.lastname: Lieffers
authors.affiliation: School of Public Health and Charles Perkins Centre, The University of Sydney, Camperdown, Australia.
authors.forename: Adrian
authors.identifier: http://orcid.org/0000-0002-0369-4621
authors.initials: A
authors.lastname: Bauman
authors.affiliation: School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
authors.forename: Rhona
authors.identifier: http://orcid.org/0000-0001-5242-142X
authors.initials: R
authors.lastname: Hanning
authors.affiliation: School of Life and Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, Australia.
authors.forename: Margaret
authors.identifier: http://orcid.org/0000-0002-6478-1374
authors.initials: M
authors.lastname: Allman-Farinelli
keywords: app design; apps; dietetics; mHealth; smartphone