Development of 'Twazon': An Arabic App for Weight Loss.

BACKGROUND: Weight gain and its related illnesses have become a major public health issue across the world, with Saudi Arabia and other Gulf countries seeing dramatic increases in obesity and overweight, and yet there is very little information on how to intervene with this demographic due to cultural and linguistic barriers. As the use of smartphones and apps has also increased in the region, information communication technologies could be a cost-effective means of facilitating the delivery of behavior-modification interventions directly to the target population. Although there are existing apps that offer lifestyle-modification tools, they do not give consideration to the evidence-based practices for weight management. This offers an opportunity to create an Arabic language weight loss app that offers localized content and adheres to evidence-informed practices that are needed for effective weight loss. OBJECTIVE: This paper describes the process of developing an Arabic weight loss app designed to facilitate the modification of key nutritional and physical activity behaviors among Saudi adults, while taking into consideration cultural norms. METHODS: The development of the Twazon app involved: (1) reviewing all available Arabic weight loss apps and compared with evidence-based practices for weight loss, (2) conducting a qualitative study with overweight and obese Saudi women to ascertain their preferences, (3) selecting which behavioral change strategies and guidelines to be used in the app, (4) creating the Saudi Food Database, (5) deciding on graphic design for both iPhone operating system and Android platforms, including user interface, relational database, and programming code, and (6) testing the beta version of the app with health professionals and potential users. RESULTS: The Twazon app took 23 months to develop and included the compilation of an original Saudi Food database. Eight subjects gave feedback regarding the content validity and usability of the app and its features during a pilot study. The predominant issue among the group was the lack of information explaining how to use the app. This has since been resolved through the implementation of a tutorial. No other changes were required to be made. CONCLUSIONS: Information communication technologies, such as smartphone apps, may be an effective tool for facilitating the modification of unhealthy lifestyle habits in Saudi; however, consideration must be given to the target population, cultural norms, and changing trends in the global market. The effectiveness of the app will be better determined during a 6-month intervention with 200 overweight and obese Saudi women.

Do Arabic weight-loss apps adhere to evidence-informed practices?

Mobile technology has been used successfully for promoting health and weight loss and for treating obesity. There is a high prevalence of smartphone and tablet users among the Saudi population. This study aimed to identify whether current Arabic weight-loss apps had features that adhered to evidence-informed practices. The six most relevant app stores were systematically searched using the Arabic words for weight and diet (n = 298). All apps that met the inclusion criteria (n = 65) were downloaded and examined for adherence to 13 evidence-informed practices. Latent class analysis identified two subgroups of apps: self-monitoring (15 % of apps) and advice-giving apps (85 %). The median number of evidence-informed practices was 1 (1, 2), with no apps having more than six and only nine apps including four to six. Meal planning was the most common feature (38 % of apps). These findings identify serious weaknesses in the currently available Arabic weight-loss apps. Thus, existing and future apps should include more features based on the best available evidence in the context of Arab culture.

What overweight women want from a weight loss app: a qualitative study on arabic women.

BACKGROUND: Overweight and obesity are international public health issues. With mobile and app use growing globally, the development of weight loss apps are increasing along with evidence that interventions using technology have been effective in the treatment of obesity. Although studies have been conducted regarding what content health professionals would recommend within weight loss apps, there are limited studies that explore users' viewpoints. There is specifically a paucity of research that takes the cultural background of the user into consideration, especially in Middle Eastern countries where the lives and weight loss intervention needs of women not only vary vastly from the West, but the obesity rate is also increasing exponentially. OBJECTIVE: The current study sought to explore the proposed features of an Arabic weight loss app by seeking the experiences and opinions of overweight and obese Saudi Arabian users in order to design a mobile phone app to fit their needs. METHODS: Focus group discussions were conducted with a purposive sample of volunteer overweight and obese Saudi women (BMI ≥ 25) who were older than 18 years and who owned a mobile phone. The most common Arabic and English weight loss mobile apps were downloaded to initiate dialogue about app usage and to get their opinions on what an ideal weight loss app would look like and the features it would include. All transcribed, translated discussions were thematically analyzed, categorized for each of the main topics of the discussion, and specific quotations were identified. RESULTS: Four focus groups were conducted with a total of 39 participants. Most participants owned an Android mobile phone and only a few participants were aware of the availability of health-related apps. Barriers to weight loss were identified including: motivation, support (social and professional), boring diets, customs, and lifestyle. Diverse themes emerged as suggestions for an ideal weight loss app including: Arabic language and culturally sensitive; motivational support and social networking; dietary and physical activity tools; and a tailorable, user-friendly interface. CONCLUSIONS: This study identifies weight loss app features from the users' perspective, which should be considered in the development of a weight loss app for this population.