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Participants' experiences with and perceptions of a digital health intervention to reduce sugar-sweetened beverage intake: A mixed methods summative evaluation of iSIPsmarter”

Year: 2026

Type: article

Abstract: iSIPsmarter is a promising digital health intervention targeting sugar-sweetened beverage (SSB) intake among Appalachian adults. This summative evaluation describes participants' post-program perceptions of barriers to adherence and iSIPsmarter's utility and perceived impact. An electronic survey was administered that included established measures and open-ended questions. Four focus groups were held. Measures assessed adherence barriers and perceptions of iSIPsmarter's utility and impact. Using a convergent mixed methods approach, quantitative data were summarized descriptively and qualitative data were content coded. Data sources triangulated by indicator. 91% (116/127) of participants completed the survey, with a subset ( n = 28) participating in focus groups. Participants were ~ 45 years old and primarily female and non-Hispanic White; ~50% made <$55,000 per year. 5/29 adherence barriers were rated as a little or major problem by >20% of participants, all of which reflected personal (e.g., competing priorities) and program-related (e.g., time required) factors. Personal and program-related factors were also key adherence barriers identified in qualitative sources. Overall, participants were positive about iSIPsmarter's utility, with <25% replying negatively to any survey item. Qualitative sources identified 7 positive (e.g., supporting accountability) and 6 negative (e.g., user interface not optimized for smartphones) attributes of iSIPsmarter. Across quantitative and qualitative sources, participants consistently identified positive impacts related to SSB and, to a lesser degree, weight. iSIPsmarter was generally well-received by participants who completed summative evaluation activities. Findings highlight six considerations for improving experiences with and perceptions of digital health interventions, including within underserved rural regions like Appalachia, and suggest specific refinements for enhancing iSIPsmarter. • Appalachian adults perceived iSIPsmarter's utility and impact positively. • Personal factors were more common to adherence than technology or design ones. • Participants valued daily text messages that promoted tracking and accountability. • Suggestions to enhance experiences with digital health interventions are presented.

Source: Internet Interventions

DOI: 10.1016/j.invent.2026.100921