The document summarizes findings from focus groups about using a mobile health platform to track daily living observations from obese youth. Key findings included that both providers and patients value approaches that minimize time burden, build trust to avoid perceived judgment, and demonstrate tenacity through personalized outreach and coaching rather than brief interrogations. An ideal platform would incorporate quick daily entries reviewed by a health coach in coordination with provider visits.

1. Using a Mobile Health
Platform for Daily Life
Observations of Obese
Youth
Christina M. Sabee
Katherine K. Kim
Janelle Charles, Holly Logan, Edmund Nat Ying Young
San Francisco State University

2. Background and
Rationale
Only 30% of SF 9th 12-19: from 5% to
graders achieve all 18%
FITNESSGRAM
standards Obesity
33% girls and 22% Low
boys felt “sad or Depression Access to
hopeless” every
day for 2 weeks
Resources
Obesity
Adolescent depression disproportionately
is a risk factor for affects
obesity underprivileged

3. Observations of Daily
Living
• What is useful for patients to track about
themselves?
• What is useful for practitioners to learn about
patients’ daily observations?

4. Challenges for Low-Income Youth
with Obesity and
Anxiety/Depression
• Low income
• Lack of owned computers
• Don’t feel sick or know they have a
condition of concern
• Hospital/Medical model is not relevant
• Lack of tools to reach out from patient to
provider and provider to patient

5. Reaching Out to Patients
and Providers
• What communication methods work best for our
obese and depressed youth?
• How can our providers reach out to and manage
this youth population?
• What are the ideal characteristics for a platform
that tracks ODLs for both patients and providers?

6. Method
• Focus group interviews with:
o Youth in our target population
o Providers who serve our target population

7. Findings
Time
Providers
and
Patients
Tenacity Trust

8. Time
“Everybody wants to serve teens here and all
the providers would like to see more teens . . .
And then to maintain that requires a lot of
staff work. For instance, [medical assistants]
were calling the adolescences to come in for
their annual visits because they don‟t come in.
But that took a lot of their time to follow up
with them. And we haven‟t the resources to
keep it up.”

9. Time
“maybe like five [minutes], like five, a minute or two at
like each meal or something, but not like a huge
amount of time, like putting in a whole bunch of data
„cause that would get really boring.”
“when I, when I collect the data, I don‟t want any, I
don‟t want any more than like five touches. I don‟t
care about the time, but (laughter) if it takes me like I
have to type in my name and log in information”

10. Trust
“You know, it‟s a big, particularly the adolescents,
building trust is a big issue. . . . at some point, you
know, you realize what you‟re hearing or what they‟re
reporting is not reality.”

11. Trust
“There‟s the perception that they‟ll be… that their
disapproval may lead to some stern consequence like
being judged against or you know like bad writings on
your medical record you know or lectures or you know
no one wants to make someone else unhappy . . .
you wouldn‟t tell them that, you wouldn‟t be so open
with them because they‟re going to be intimately
disapproving of the things you‟re doing like, “WHAT!!!
That‟s really bad!” Whereas your friends won‟t be as
judgmental, I guess.”

12. Trust
“I think as long as it‟s, as long as you‟re talking to
someone who‟s closer to your age, it… for me, after
that it doesn‟t really matter where [the information] is
gonna be for the most part as long as you‟re talking to
someone who sort of feels like a friend, someone
closer to your age.”

13. Tenacity
“Yeah, you know what, ideally what would happen is
that the whole, with these guys and everybody here
knows. The whole health coaching model of having a
health coach come and huddle with me before the
visit. Show me this report we talk about o.k. what‟s the
game plan for the visit so that either before I go into
the room or after I leave the room, that health coach
is there, to sit there and coach the patient. That‟s the
way I would use it.”

14. Tenacity
“I think the way that they talk to you too because a
lot of the time when I go to the doctor, I feel like I‟m
getting interrogated. Like they go through a list of
everything they need to ask you and I‟m just like
“duh, duh, duh, duh” and I‟m like what about my
feelings (laughter) or like you know what about, how
do I… like kind of check-in on a more personal
level, „cause like having more of a conversation versus
like an interrogation.”

15. What does it mean?
• Health coaches may be invaluable
o More sustainable – less $$
o Teen patients may identify more with health coach
• “Judgment” and Face concerns can impede the
care process
• Use of mobile technology may benefit youth with
obesity and depression
o Needs to be quick and easy
o Needs to be reviewed by a trusted provider (health coach)
o Needs to be digested and reported efficiently