Testing a Web-Based Interactive Comic Tool to Decrease Obesity Risk Among Racial and Ethnic Minority Preadolescents: Randomized Controlled Trial
Bibliographic record
Abstract
Background Childhood obesity prevalence remains high, especially in racial and ethnic minority populations with low incomes. This epidemic is attributed to various dietary behaviors, including increased consumption of energy-dense foods and sugary beverages and decreased intake of fruits and vegetables. Interactive, technology-based approaches are emerging as promising tools to support health behavior changes. Objective This study aimed to assess the feasibility and acceptability of Intervention INC (Interactive Nutrition Comics for Urban, Minority Preadolescents), a 6-chapter web-based interactive nutrition comic tool. Its preliminary effectiveness on diet-related psychosocial variables and behaviors was also explored. Methods A total of 89 Black or African American and Hispanic preadolescents with a mean age of 10.4 (SD 1.0) years from New York City participated in a pilot 2-group randomized study, comprising a 6-week intervention and a 3-month follow-up (T4) period. Of the 89 participants, 61% were female, 62% were Black, 42% were Hispanic, 53% were overweight or obese, and 34% had an annual household income of Results In total, 72% (33/45) and 60% (27/44) of the experimental and comparison groups, respectively, accessed their tool weekly. The mean total usability score was high and moderately high for the experimental and comparison groups, respectively (mean 4.01, SD 0.37 and mean 3.81, SD 0.51; P=.048), based on a 5-point Likert scale). Children in both groups found the tool acceptable, and few reported difficulties logging in or accessing content. Between-group effect sizes for beliefs and attitudes related to dietary intake, while favoring the experimental group at T3, were in the small range. These improvements in both groups were largely diminished by T4. However, between-group effect sizes for behaviors related to fruit, vegetable, and water intake, favoring the experimental group, were medium to large and were maintained at T4. Conclusions This pilot feasibility study suggests that an interactive comic tool may be an appealing and useful format to promote positive dietary behaviors in racial and ethnic minority preadolescents. However, further research, including a full-scale randomized controlled trial, is warranted to determine the effectiveness of Intervention INC. Trial Registration ClinicalTrials.gov NCT03165474; https://clinicaltrials.gov/study/NCT03165474 International Registered Report Identifier (IRRID) RR2-10.2196/10682
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.011 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".