All Title Author
Keywords Abstract

Adapting a Database of Text Messages to a Mobile-Based Weight Loss Program: The Case of the Middle East

DOI: 10.1155/2014/658149

Full-Text   Cite this paper   Add to My Lib


Obesity has become a worldwide epidemic. Qatar, a rapidly developing country in the Middle East, has seen a sharp increase in the prevalence of obesity. The increase can be attributed to several reasons, including sedentary lifestyles imposed by a harsh climate and the introduction of Western fast food. Mobile technologies have been used and studied as a technology to support individuals’ weight loss. The authors have developed a mobile application that implements three strategies drawn from proven theories of behavioral change. The application is localized to the cultural context of its proposed users. The objective of this paper is to present a method through which we adapted the messaging content of a weight loss application to the context of its users while retaining an effective degree of automation. The adaptation addressed body image, eating and physical exercise habits, and regional/cultural needs. The paper discusses how surveying potential users can be used to build a profile of a target population, find common patterns, and then develop a database of text messages. The text messages are automated and sent to the users at specific times of day, as suggested by the survey results. 1. Introduction Tackling the weight issue is a significant undertaking. Worldwide, the number of obese people has doubled in the past 20 years [1]. We explored ways in which mobile technologies can be adapted to meet environmental and cultural norms and thereby support individuals in their effort to lose weight. In this paper, we examine the case of the Middle East through the example of Qatar. According to the International Association for the Study of Obesity, the numbers for obesity for the Qatari population are alarming. The association ranks the country sixth on its list of the most obese countries worldwide. The numbers presented in [2] (cited by [3]) were overwhelming: for the 25–65 age group, 34.6% of the men were obese and 34.3% were overweight. For females in the same age group, 45.3% were obese and 33% were overweight. The figures are also alarming for children: [4] (cited by [3]) found that in the 12–17 age group, 28.7% of boys were overweight and 7.6% were obese. Additionally, 20.3% of the girls in the same age group were overweight and 4.5% were obese. A more recent study in Qatar [5] suggests slightly lower figures among children of 2–19 years old, but still a much higher percentage than the current 16.9% for American children in this age group as reported by the National Health and Nutrition Examination Survey (NHANES) [6]. Despite this disparity, the


[1]  WHO, Global Status Report on Noncommunicable Diseases, World Health Organization, Geneva, Switzerland, 2010.
[2]  A. Bener, J. Al-Suwaidi, K. Al-Jaber, S. Al-Marri, M. H. Dagash, and I. Elbagi, “The prevalence of hypertension and its associated risk factors in a newly developed country,” Saudi Medical Journal, vol. 25, no. 7, pp. 918–922, 2004.
[3]  IASO, International Association for the Study of Obesity, 2012,
[4]  A. Bener, “Prevalence of obesity, overweight, and underweight in Qatari adolescents,” Food and Nutrition Bulletin, vol. 27, no. 1, pp. 39–45, 2006.
[5]  L. Davallow, A. H. Ayash, I. El Assad, and A. Khidir, “The prevalence of obesity amongst school children and adolescents in Qatar,” in Proceedings of the Qatar Foundation Annual Research Forum, 2011.
[6]  C. L. Ogden, M. D. Carroll, B. K. Kit, and K. M. Flegal, Prelevance of Obesity in the United States, National Center for Health Statistics, Hyattsville, Md, USA, 2012.
[7]  M. Slackman, Privilege Pulls Qatar Toward Unhealthy Choices, 2010,
[8]  C. Bell, Obesity: A Big Problem for Fast Growing Qatar, 2012,
[9]  IctQatar, Supreme council of information and communication technology, 2012,
[10]  I. Haapala, N. C. Barengo, S. Biggs, L. Surakka, and P. Manninen, “Weight loss by mobile phone: a 1-year effectiveness study,” Public Health Nutrition, vol. 12, no. 12, pp. 2382–2391, 2009.
[11]  A. Brunstein, J. Brunstein, and S. L. Mansar, “Integrating health theories in health and fitness applications for sustained behavior change: current state of the art,” Creative Education, vol. 3, pp. 1–5, 2012.
[12]  S. T. Shen, M. Woolley, and S. Prior, “Towards culture-centred design,” Interacting with Computers, vol. 18, no. 4, pp. 820–852, 2006.
[13]  P. Sandrini, “Website localization and translation,” in Proceedings of the EU-High-Level Scientific Conference on Challenges of Multidimensional Translation (MuTra '05), 2005.
[14]  A. Huang, F. Barzi, R. Huxley et al., “The effects on saturated fat purchases of providing Internet shoppers with purchase-specific dietary advice: a randomised trial,” PLoS Clinical Trials, vol. 1, no. 5, article e22, 2006.
[15]  S. J. Woolford, S. J. Clark, V. J. Strecher, and K. Resnicow, “Tailored mobile phone text messages as an adjunct to obesity treatment for adolescents,” Journal of Telemedicine and Telecare, vol. 16, no. 8, pp. 458–461, 2010.
[16]  E. Mattila, R. Lappalainen, J. P?rkk?, J. Salminen, and I. Korhonen, “Use of a mobile phone diary for observing weight management and related behaviours,” Journal of Telemedicine and Telecare, vol. 16, no. 5, pp. 260–264, 2010.
[17]  E. L. Donaldson and S. Fallows, “A text message-based weight management intervention for overweight adults,” Journal of Human Nutrition and Dietetics, vol. 24, no. 4, pp. 385–386, 2011.
[18]  J. Redfern, A. Thiagalingam, S. Jan, et al., “Development of a set of mobile phone text messages designed for prevention of recurrent cardiovascular events,” European Journal of Preventive Cardiology, 2012.
[19]  S. L. Mansar and S. Kekre, “A founding framework for addressing obesity in Qatar using mobile technologies,” Communications in Computer and Information Science, vol. 221, part 3, pp. 402–412, 2011.
[20]  S. L. Mansar, A. Brunstein, S. Jariwala, and J. Brunstein, “Addressing obesity using a mobile application: an experiment design,” in Proceedings of the E-Health 2012, IADIS Multi Conference on Computer Science and Information Systems (MCCSIS '12), 2012.
[21]  W. Stroebe, Dieting, Overweight, and Obesity: Self-Regulation in Food-Rich Environment, American Psychological Association Press, Washington, DC, 2008.
[22]  W. Stroebe, W. Mensink, H. Aarts, H. Schut, and A. W. Kruglanski, “Why dieters fail: testing the goal conflict model of eating,” Journal of Experimental Social Psychology, vol. 44, no. 1, pp. 26–36, 2008.
[23]  S. L. Mansar, S. Jariwala, M. Shahzad, A. Anggraini, and N. Behih, “Localizing a weight loss mobile application,” in Information Systems and Technologies for Enhancing Health and Social Care, R. Martinho, R. Rijo, M. M. Cruz-Cunha, and J. Varaj?o, Eds., pp. 1–348, 2013.
[24]  M. A. Thompson and J. J. Gray, “Development and validation of a new body-image assessment scale,” Journal of Personality Assessment, vol. 64, no. 2, pp. 258–269, 1995.
[25]  R. F. Kushner, Roadmaps for Clinical Practice: Case Studies in Disease Prevention and Health Promotion—Assessment and Management of Adult Obesity: A Primer for Physicians, American Medical Association, Chicago, Ill, USA, 2003.
[26]  D. M. Garner and P. E. Garfinkel, “The eating attitudes test: an index of the symptoms of anorexia nervosa,” Psychological Medicine, vol. 9, no. 2, pp. 273–279, 1979.
[27]  WHO (World Health Organization), Physical Activity and Adults, 2011,
[28]  I. S. Kakeshita and S. D. S. Almeida, “Relationship between body mass index and self-perception among university students,” Revista de Saúde Pública, vol. 40, no. 3, pp. 497–504, 2006.
[29]  A. B. de Gonzalez, P. Hartge, J. R. Cerhan et al., “Body-mass index and mortality among 1.46 million white adults,” The New England Journal of Medicine, vol. 363, no. 23, pp. 2211–2219, 2010.
[30]  M. Badran and I. Laher, “Obesity in Arabic-speaking countries,” Journal of Obesity, vol. 2011, Article ID 686430, 9 pages, 2011.
[31]  R. Rosenheck, “Fast food consumption and increased caloric intake: a systematic review of a trajectory towards weight gain and obesity risk,” Obesity Reviews, vol. 9, no. 6, pp. 535–547, 2008.
[32]  J. H. Ledikwe, J. A. Ello-Martin, and B. J. Rolls, “Portion sizes and the obesity epidemic,” Journal of Nutrition, vol. 135, no. 4, pp. 905–909, 2005.
[33]  E. E. J. G. Aller, I. Abete, A. Astrup, M. Alfredo, and M. A. van Baak, “Starches, sugars and obesity,” Nutrients, vol. 3, no. 3, pp. 341–369, 2011.
[34]  Panel on Dietary Reference Intakes for Electrolytes and Water, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate, National Academies Press, Washington, DC, USA, 2005.
[35]  B. M. Popkin, K. E. D'Anci, and I. H. Rosenberg, “Water, hydration, and health,” Nutrition Reviews, vol. 68, no. 8, pp. 439–458, 2010.
[36]  CDC, Healthy Weight—It's Not a Diet, It's a Lifestyle!, 2011,
[37]  M. Saberi, Expert Advice: Eat Less Fast Food, 2011,
[38]  Zuckerbrot, Foods to Avoid at Popular Chain Restaurants, 2009,
[39]  Glamour, 21 Healthy Snacking Tips, 2010,
[40]  HSPH, 20 Exercise Tips, 2012,


comments powered by Disqus

Contact Us


微信:OALib Journal