Development and Usability Testing of a Facebook-based Obesity Prevention Program for Korean American Adolescents

Abstract

Background: Adolescent obesity rates have quadrupled in the past three decades in the United States. Although Korean American (KA) adolescents have had lower obesity rates than the national average, acculturation may increase the risk for obesity. No health educational resources specifically tailored for them are available. Currently, social networking sites (e.g., Facebook) have become popular among adolescents. Thus, a culturally tailored obesity prevention program for KA adolescents was developed using Facebook (Healthy Teens). The content of the program was developed by an expert panel based on social cognitive theory, and the online program was developed applying web usability principles for adolescents. Objective: To evaluate the usability of a Facebook-based obesity prevention program for KA adolescents. Methods: Initial usability testing was conducted using heuristic evaluation by four experts upon the completion of the development. The Healthy Teens program was revised based on the findings. Then, user testing was conducted using observation, think-aloud method, audiotaping, capturing of screen activity, and surveys. Twenty participants were recruited from two Korean language schools (mean age 15.40±1.50 years). Content analysis using inductive coding approach was performed on the user testing transcriptions by three coders. Descriptive statistics were used to analyze quantitative data (demographics, perceived usability, eHealth literacy, and health behaviors). Results: All participants were Facebook users and had used it for an average of 3.75 years and 1.86 hours daily. Content analysis identified 27 themes under the three categories of content, appearance, and navigation. Participants offered positive comments on content, such as "liked content related to Korean diet." However, they mentioned that some resources and graphics were not age appropriate. Although the Facebook platform provides very limited flexibility in building the site, participants reported that the appearance of the program was appropriate. Most participants did not experience difficulties navigating the program. Perceived usability was 62.25±6.29 (range 10-70). Conclusions: Our preliminary findings indicated that the Healthy Teens program was perceived usable and useful by KA adolescents and can be used as a robust platform to deliver health education to adolescents. Further research is needed to develop optimal usability guidelines that can be applied to develop such programs.