ABSTRACT
BACKGROUND: Mobile health (mHealth) apps for weight loss (weight loss apps) can be useful diet and exercise tools for individuals in need of losing weight. Most studies view weight loss app users as these types of individuals, but not all users have the same needs. In fact, users with disordered eating behaviors who desire to be underweight are also utilizing weight loss apps; however, few studies give a sense of the prevalence of these users in weight loss app communities and their perceptions of weight loss apps in relation to disordered eating behaviors. OBJECTIVE: The aim of this study was to provide an analysis of users' body mass indices (BMIs) in a weight loss app community and examples of how users with underweight BMI goals perceive the impact of the app on disordered eating behaviors. METHODS: We focused on two aspects of a weight loss app (DropPounds): profile data and forum posts, and we moved from a broader picture of the community to a narrower focus on users' perceptions. We analyzed profile data to better understand the goal BMIs of all users, highlighting the prevalence of users with underweight BMI goals. Then we explored how users with a desire to be underweight discussed the weight loss app's impact on disordered eating behaviors. RESULTS: We found three main results: (1) no user (regardless of start BMI) starts with a weight gain goal, and most users want to lose weight; (2) 6.78% (1261/18,601) of the community want to be underweight, and most identify as female; (3) users with underweight BMI goals tend to view the app as positive, especially for reducing bingeing; however, some acknowledge its role in exacerbating disordered eating behaviors. CONCLUSIONS: These findings are important for our understanding of the different types of users who utilize weight loss apps, the perceptions of weight loss apps related to disordered eating, and how weight loss apps may impact users with a desire to be underweight. Whereas these users had underweight goals, they often view the app as helpful in reducing disordered eating behaviors, which led to additional questions. Therefore, future research is needed.
ABSTRACT
OBJECTIVE: We investigate the technology affordances associated with and anticipated from an online human immunodeficiency virus (HIV) prevention awareness platform, myHealthImpactNetwork, intended to reach black female college students. This population is at increased risk for HIV transmission, but is not often studied. In addition, this population regularly uses digital tools, including Web sites and social media platforms, to engage in health information seeking. MATERIALS AND METHODS: We conducted 11 focus groups with 60 black female college students attending 2 universities in the United States. Focus groups were recorded, transcribed, and analyzed using content analyses. RESULTS: Contrary to our proposition, the participants' information needs did not align with the anticipated benefits associated with the technology affordances of the prevention awareness platform. Concerns about personal online social capital, reputation management, and stigma limited participants' willingness to engage with the HIV prevention content on the website. DISCUSSION: Although the participants use digital tools as a primary means of becoming informed about health, concerns that friends, family, and others in their social networks would assume that they were HIV infected limited their willingness to engage with myHealthImpactNetwork. Print media and conversations with health care professionals were preferred channels for obtaining HIV prevention information. CONCLUSIONS: Perceptions of stigma associated with HIV negatively impact health information seeking and sharing in the online social networks in which black college students engage. However, by understanding the unanticipated consequences, researchers can effectively design for cultures and subcultures infected and affected by health disparities.
