{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:13:39Z","timestamp":1760238819911,"version":"build-2065373602"},"reference-count":57,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2020,9,6]],"date-time":"2020-09-06T00:00:00Z","timestamp":1599350400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003086","name":"Eusko Jaurlaritza","doi-asserted-by":"publisher","award":["KK-2019\/00028","KK-2019\/00032"],"award-info":[{"award-number":["KK-2019\/00028","KK-2019\/00032"]}],"id":[{"id":"10.13039\/501100003086","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Obesity is a preventable chronic condition that, in 2016, affected more than 1.9 billion people globally. Several factors have been identified that have a positive impact on long-term weight loss programs such as personalized recommendations, adherence strategies, weight and diet follow-up or physical activity tracking. Recently, various applications have been developed which help patients to self-manage their condition. These apps implement either one or some of these identified factors; however, there is not a single application that combines all of them following a holistic approach. In this context, we developed the OBINTER platform, which assists patients during the weight loss process by targeting user engagement during the longer term. The solution includes a mobile application which allows users to fill out dietetic questionnaires, receive dietetic and nutraceutical plans, track the evolution of their weight and adherence to the diet, as well as track their physical activity via a wearable device. Furthermore, an adherence strategy has been developed as a tool to foster the app usage during the whole weight loss process. In this paper, we present how the OBINTER approach gathers all of these features as well as the positive results of a usability testing study performed to assess the performance and usability of the OBINTER platform.<\/jats:p>","DOI":"10.3390\/s20185060","type":"journal-article","created":{"date-parts":[[2020,9,6]],"date-time":"2020-09-06T23:12:49Z","timestamp":1599433969000},"page":"5060","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["OBINTER: A Holistic Approach to Catalyse the Self-Management of Chronic Obesity"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7164-9577","authenticated-orcid":false,"given":"Roberto","family":"\u00c1lvarez","sequence":"first","affiliation":[{"name":"Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Mikeletegi 57, 20009 Donostia-San Sebasti\u00e1n, Spain"},{"name":"Biodonostia Health Research Institute, eHealth Group, 20014 San Sebasti\u00e1n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-7620","authenticated-orcid":false,"given":"Jordi","family":"Torres","sequence":"additional","affiliation":[{"name":"Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Mikeletegi 57, 20009 Donostia-San Sebasti\u00e1n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8194-2467","authenticated-orcid":false,"given":"Garazi","family":"Artola","sequence":"additional","affiliation":[{"name":"Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Mikeletegi 57, 20009 Donostia-San Sebasti\u00e1n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5179-415X","authenticated-orcid":false,"given":"Gorka","family":"Epelde","sequence":"additional","affiliation":[{"name":"Vicomtech Foundation, Basque Research and Technology Alliance (BRTA), Mikeletegi 57, 20009 Donostia-San Sebasti\u00e1n, Spain"},{"name":"Biodonostia Health Research Institute, eHealth Group, 20014 San Sebasti\u00e1n, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0411-9784","authenticated-orcid":false,"given":"Sara","family":"Arranz","sequence":"additional","affiliation":[{"name":"AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnol\u00f3gico de Bizkaia, Astondo Bidea, Edificio 609, 48160 Derio, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard","family":"Marrugat","sequence":"additional","affiliation":[{"name":"AZTI, Food Research, Basque Research and Technology Alliance (BRTA), Parque Tecnol\u00f3gico de Bizkaia, Astondo Bidea, Edificio 609, 48160 Derio, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.1016\/S0002-8223(98)00704-4","article-title":"Obesity as a Chronic Disease: Modern Medical and Lifestyle Management","volume":"98","author":"Rippe","year":"1998","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"21","DOI":"10.3810\/pgm.2009.11.2074","article-title":"The Medical Risks of Obesity","volume":"121","year":"2009","journal-title":"Postgrad. Med."},{"key":"ref_3","unstructured":"World Health Organization (2020, July 29). Data and Statistics. Available online: https:\/\/www.euro.who.int\/en\/health-topics\/noncommunicable-diseases\/obesity\/data-and-statistics."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1016\/S0140-6736(20)31024-2","article-title":"Obesity could shift severe COVID-19 disease to younger ages","volume":"395","author":"Kass","year":"2020","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lighter-Fisher, J., Phillips, M., Hochman, S., Sterling, S., Johnson, D., Francois, F., and Stachel, A. (2020). Obesity in Patients Younger Than 60 Years Is a Risk Factor for COVID-19 Hospital Admission. Clin. Infect. Dis.","DOI":"10.1093\/cid\/ciaa415"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1002\/oby.22831","article-title":"High Prevalence of Obesity in Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) Requiring Invasive Mechanical Ventilation","volume":"28","author":"Simonnet","year":"2020","journal-title":"Obesity"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Scheen, A.J., Marre, M., and Thivolet, C. (2020). Prognostic factors in patients with diabetes hospitalized for COVID-19: Findings from the CORONADO study and other recent reports. Diabetes Metab., 21.","DOI":"10.1016\/j.diabet.2020.05.008"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e79","DOI":"10.2196\/mhealth.4169","article-title":"Expert Involvement and Adherence to Medical Evidence in Medical Mobile Phone Apps: A Systematic Review","volume":"3","author":"Subhi","year":"2015","journal-title":"JMIR mHealth uHealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.jand.2014.07.005","article-title":"Diet or Exercise Interventions vs Combined Behavioral Weight Management Programs: A Systematic Review and Meta-Analysis of Direct Comparisons","volume":"114","author":"Johns","year":"2014","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e17816","DOI":"10.2196\/17816","article-title":"Use of a Smartphone-Based Mobile App for Weight Management in Obese Minority Stroke Survivors: Pilot Randomized Controlled Trial With Open Blinded End Point","volume":"8","author":"Ifejika","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1093\/fampra\/cmz020","article-title":"Effectiveness of randomized controlled trial of a mobile app to promote healthy lifestyle in obese and overweight patients","volume":"36","author":"Parraza","year":"2019","journal-title":"Fam. Pr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1016\/j.amepre.2018.07.005","article-title":"Effectiveness of an App and Provider Counseling for Obesity Treatment in Primary Care","volume":"55","author":"Bennett","year":"2018","journal-title":"Am. J. Prev. Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Simpson, S.A., Matthews, L., Pugmire, J., McConnachie, A., McIntosh, E., Coulman, E., Hughes, K., Kelson, M., Morgan-Trimmer, S., and Murphy, S. (2020). An app-, web- and social support-based weight loss intervention for adults with obesity: The HelpMeDoIt! feasibility RCT. Public Health Res., 8.","DOI":"10.3310\/phr08030"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1038\/ijo.2016.186","article-title":"Mobile applications for obesity and weight management: Current market characteristics","volume":"41","author":"Nikolaou","year":"2016","journal-title":"Int. J. Obes."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2094","DOI":"10.1016\/j.jand.2018.05.011","article-title":"Defining Adherence to Dietary Self-Monitoring Using a Mobile App: A Narrative Review","volume":"118","author":"Payne","year":"2018","journal-title":"J. Acad. Nutr. Diet."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Thomas, J.G., and Bond, D.S. (2014). Review of Innovations in Digital Health Technology to Promote Weight Control. Curr. Diabetes Rep., 14.","DOI":"10.1007\/s11892-014-0485-1"},{"key":"ref_17","first-page":"94","article-title":"Efectos de una mejor adherencia a la dieta mediterr\u00e1nea por intervenci\u00f3n digital (estudio MEDADIS) en pacientes con sobrepeso y obesidad","volume":"2","author":"Marcos","year":"2017","journal-title":"J. Negat. No Posit. Results"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e13747","DOI":"10.2196\/13747","article-title":"Push Notifications From a Mobile App to Improve the Body Composition of Overweight or Obese Women: Randomized Controlled Trial","volume":"8","author":"Recio","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e13461","DOI":"10.2196\/13461","article-title":"Long-Term Weight Management Using Wearable Technology in Overweight and Obese Adults: Systematic Review","volume":"8","author":"Fawcett","year":"2020","journal-title":"JMIR mHealth uHealth"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1111\/obr.12909","article-title":"The effectiveness of wearable technologies as physical activity interventions in weight control: A systematic review and meta-analysis of randomized controlled trials","volume":"20","author":"Yen","year":"2019","journal-title":"Obes. Rev."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Tejpal, S., Sanghera, N., Manoharan, V., Planas-Iglesias, J., Myler, K., and Klein-Seetharaman, J. (2019). Towards personalised molecular feedback for weight loss. BMC Obes., 6.","DOI":"10.1186\/s40608-019-0237-5"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1007\/s13679-013-0072-9","article-title":"Obesity, Complexity, and the Role of the Health System","volume":"2","author":"Frood","year":"2013","journal-title":"Curr. Obes. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.amepre.2013.04.025","article-title":"Evidence-based strategies in weight-loss mobile apps","volume":"45","author":"Pagoto","year":"2013","journal-title":"Am. J. Prev. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1109\/52.469759","article-title":"Architectural Blueprints\u2014The \u201c4+1\u201d View Model of Software Architecture","volume":"12","author":"Kruchten","year":"1995","journal-title":"IEEE Softw."},{"key":"ref_25","unstructured":"Cockburn, A. (2020, July 29). Hexagonal Architecture. Alistair Cockburn. Available online: https:\/\/alistair.cockburn.us\/hexagonal-architecture\/."},{"key":"ref_26","unstructured":"Yusuf, S. (2016). Ionic Framework by Example, Packt Publishing."},{"key":"ref_27","unstructured":"US Food and Drug Administration (2020, September 05). Guidance for Industry. Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims, Available online: https:\/\/www.fda.gov\/media\/77832\/download."},{"key":"ref_28","unstructured":"The European Patients\u2019 Academy on Therapeutic Innovation (EUPATI) (2020, July 24). Patient-Reported Outcomes (PROs) Assessment 2019. Available online: https:\/\/www.eupati.eu\/clinical-development-and-trials\/patient-reported-outcomes-pros-assessment\/."},{"key":"ref_29","unstructured":"Locklear, T., Abernethy, A., Flynn, K.E., Riley, W., and Johnson, L.L. (2020, September 05). Patient-Reported Outcomes. NIH Collaboratory Coordinating Center. Available online: https:\/\/dcricollab.dcri.duke.edu\/sites\/NIHKR\/KR\/PRO%20Resource%20Chapter.pdf."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1249\/01.MSS.0000078924.61453.FB","article-title":"International Physical Activity Questionnaire: 12-Country Reliability and Validity","volume":"35","author":"Craig","year":"2003","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1808","DOI":"10.1017\/S0007114509993837","article-title":"Relative validity of a semi-quantitative food-frequency questionnaire in an elderly Mediterranean population of Spain","volume":"103","author":"Zazpe","year":"2010","journal-title":"Br. J. Nutr."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1586\/erm.12.73","article-title":"Role of fatty acid-based functional lipidomics in the development of molecular diagnostic tools","volume":"12","author":"Ferreri","year":"2012","journal-title":"Expert Rev. Mol. Diagn."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Fernandez-Luque, L., Singh, M., Ofli, F., Mejova, Y.A., Weber, I., Aupetit, M., Jreige, S.K., Elmagarmid, A., Srivastava, J., and Ahmedna, M. (2017). Implementing 360\u00b0 Quantified Self for childhood obesity: feasibility study and experiences from a weight loss camp in Qatar. BMC Med. Inform. Decis. Mak., 17.","DOI":"10.1186\/s12911-017-0432-6"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/j.1753-4887.1997.tb01578.x","article-title":"Healthy Traditional Mediterranean Diet: An Expression of Culture, History, and Lifestyle","volume":"55","author":"Trichopoulou","year":"1997","journal-title":"Nutr. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.3945\/jn.110.135566","article-title":"A Short Screener Is Valid for Assessing Mediterranean Diet Adherence among Older Spanish Men and Women","volume":"141","author":"Estruch","year":"2011","journal-title":"J. Nutr."},{"key":"ref_36","unstructured":"Fitbit (2020, July 24). Fitbit Inspire and Inspire HR Fitness Trackers. Available online: https:\/\/www.fitbit.com\/us\/products\/trackers\/inspire."},{"key":"ref_37","unstructured":"Sabat\u00e9, E. (2003). Adherence to Long-Term Therapies: Evidence for Action, WHO Press."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1056\/NEJMra050100","article-title":"Adherence to Medication","volume":"353","author":"Osterberg","year":"2005","journal-title":"N. Engl. J. Med."},{"key":"ref_39","unstructured":"NHS (2020, July 24). Start the NHS Weight Loss Plan. Available online: https:\/\/www.nhs.uk\/live-well\/healthy-weight\/start-the-nhs-weight-loss-plan\/."},{"key":"ref_40","first-page":"3","article-title":"Teamwork vs. Individual Responsibility","volume":"6","author":"Algashaam","year":"2015","journal-title":"Int. J. Sci. Eng. Res."},{"key":"ref_41","unstructured":"US Department of Health & Human Services (2020, July 24). User Interface Design Basics, Available online: https:\/\/www.usability.gov\/what-and-why\/user-interface-design.html."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e30","DOI":"10.2196\/jmir.1349","article-title":"Usability Testing of an Online Self-management Program for Adolescents With Juvenile Idiopathic Arthritis","volume":"12","author":"Stinson","year":"2010","journal-title":"J. Med. Internet Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1016\/j.cmpb.2013.10.006","article-title":"A usability evaluation of medical software at an expert conference setting","volume":"113","author":"Bond","year":"2014","journal-title":"Comput. Methods Programs Biomed."},{"key":"ref_44","unstructured":"Yamamoto, S., and Mori, H. (2019). Usability Evaluation of a Co-created Big Data Analytics Platform for Health Policy-Making. Human Interface and the Management of Information. Visual Information and Knowledge Management. Lecture Notes in Computer Science, Springer."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jbi.2015.02.006","article-title":"The value of Retrospective and Concurrent Think Aloud in formative usability testing of a physician data query tool","volume":"55","author":"Peute","year":"2015","journal-title":"J. Biomed. Inform."},{"key":"ref_46","unstructured":"Sauro, J. (2020, July 24). 10 Things to Know about the Single Ease Question (SEQ). MeasuringU. Available online: https:\/\/measuringu.com\/seq10\/."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Jordan, P.W., Thomas, B., McClelland, I.L., and Weerdmeester, B. (1996). Usability Evaluation in Industry, CRC Press.","DOI":"10.1201\/9781498710411"},{"key":"ref_48","first-page":"10","article-title":"Determining What Individual SUS Scores Mean: Adding an Adjective Rating Scale","volume":"4","author":"Bangor","year":"2009","journal-title":"J. Usability Stud."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1302\/0301-620X.96B5.32434","article-title":"Assessing treatment outcomes using a single question","volume":"96","author":"Hamilton","year":"2014","journal-title":"Bone Jt. J."},{"key":"ref_50","unstructured":"Lookback (2020, July 24). Simple and Powerful User Research. Available online: https:\/\/lookback.io\/."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Nielsen, J., and Landauer, T.K. (1993). A mathematical model of the finding of usability problems. CHI \u201993: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, ACM Press.","DOI":"10.1145\/169059.169166"},{"key":"ref_52","unstructured":"Krug, S., and Matcho, M. (2010). Rocket Surgery Made Easy: The Do-It-Yourself Guide to Finding and Fixing Usability Problems, New Riders."},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Kurosu, M. (2009). The Factor Structure of the System Usability Scale. Human Centered Design. Lecture Notes in Computer Science, Springer.","DOI":"10.1007\/978-3-642-02806-9"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Tullis, T., and Albert, B. (2013). Chapter 6: Self-Reported Metrics. Measuring the User Experience, Morgan Kaufmann. [2nd ed.].","DOI":"10.1016\/B978-0-12-415781-1.00006-6"},{"key":"ref_55","unstructured":"Reichheld, F. (2006). The Ultimate Question: Driving Good Profits and True Growth, Harvard Business School Press. [1st ed.]."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Young, S.W.H. (2014). Improving Library User Experience with A\/B Testing: Principles and Process. J. Libr. User Exp.","DOI":"10.15788\/M2RP42"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Aslan, S., Ciocca, G., and Schettini, R. (2018, January 2\u20135). Semantic Food Segmentation for Automatic Dietary Monitoring. Proceedings of the IEEE 8th International Conference on Consumer Electronics, Berlin, Germany.","DOI":"10.1109\/ICCE-Berlin.2018.8576231"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/18\/5060\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:07:18Z","timestamp":1760177238000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/20\/18\/5060"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,6]]},"references-count":57,"journal-issue":{"issue":"18","published-online":{"date-parts":[[2020,9]]}},"alternative-id":["s20185060"],"URL":"https:\/\/doi.org\/10.3390\/s20185060","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2020,9,6]]}}}