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Mom-O-Meter - Worcester Polytechnic Institute

1. Toggle Baby Facts Screen Information Button Feedback Button Details Tab Input Tab Activity Type Menu Button Activity Menu Button Activity Duration Menu Button ubmit Button Next Baby Fact Screen Help Button Home Button The activity input screen is where you can input a new activity reading In addition to inputting activity readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Inputting an Activity Reading 1 Press the activity type menu button Select a type 2 Select activity type from the menu sanding Sitting Exercising 3 Press the activity menu button Select an activity emeng 4 Select the activity that best matches what you performed from the menu eal Standing Doing chores C 11 Page 5 Press the activity duration menu button gedet eege 6 Select the duration that best matches what you performed the activity for E 20 30 7 Press the submit button Submit 8 A confirmation message will display 7 The Nutrition Screen Overview Screen Description Bar Overview Tab Quick Overview Poorly Balanced Diet Food Tips Toggle Baby Facts Screen Informa
2. Sprint backlog Application UI Notifications Reminder component We decided to develop these two components first because our first objective was to demonstrate a prototype of the UI to the customers During this time the team focused on designing all the application screens as well as the flow of between the different screens The user interface design team designed the focus group sessions to be carried out during the second iteration The research team worked on usability design and testing to make sure that the application was intuitive and user friendly The team met with the customers on the following dates October 27 the team discussed the full set of requirements identified by the team and went over the scrum product backlog to make sure that we were not missing any required functionality November 3 the team presented the UI designs and got feedback from the sponsors which allowed the team to finalize the UI designs in order to start building the actual application screens Sprint 2 November 9 November 23 Sprint backlog Weight tracking Nutrition tracking Activity tracking components During the second sprint we conducted two focus groups get more in depth feedback about the usage of our system Therefore the team developed the weight nutrition and activity tracking components because these were the main components that the user would be interacting with In the meantime the user interface team focused
3. It is recommended you eat a variety of fruits consider trying one of these fruits display 2 or 3 fruits from library If the amount of vegetable entered is less than recommended suggest a vegetable from the library and show a tip to help eat more vegetables It is recommended you eat insert servings of vegetables per day considering trying one of these vegetables display 2 or 3 vegetables from library A good way to eat more vegetables is show tip If the same vegetables are always inputted the application will say It is recommended you eat a variety of vegetables consider trying one of these vegetables display 2 or 3 fruits from library Include the 7 ways to size up your portions guide from the book Include Understanding food labels from the book Tips to help eat more fruits General Keep a bowl of whole fruit on the table counter or in the refrigerator Refrigerate cut up fruit to store for later Buy fresh fruits in season when they may be less expensive and at their peak flavor E 1 Page Buy fruits that are dried frozen and canned in water or juice as well as fresh so that you always have a supply on hand Consider convenience when shopping Buy pre cut packages of fruit such as melon or pineapple chunks for a healthy snack in seconds Choose packaged fruits that do not have added sugars At meals At breakfast top your cereal with bananas or peaches add blueberries to pancakes drink
4. Tue 94440 Tue 9 21 10 Tue 9 2140 Tue 9 21 10 Tue 944 10 Tue 9440 Tue 944410 Tue 94440 Tue 94440 Tue 94410 Tue 944410 Tue 94410 Tue 10 1240 Tue 9710 Tue 9710 Tue 10 5410 Tue 914410 Tue 104240 Tue 10 540 Tue 10 5410 Actual Hours 1 580 hrs y Add 600 hrs 40 hrs 80 hrs 48 hrs 96 hrs 48 hrs 48 hrs 96 hrs 48 hrs 48 hrs 48 hrs 48 hrs 48 hrs 48 hrs 48 hrs 752 hrs 40 hrs 40 hrs 128 hrs 48 hrs 240 hrs 128 hrs 128 hrs August September October November I an 88 35 972 979 926 108 10M0 1047 10724 10781 ans 822 8 29 117 1144 A Term Planning Analysis Design Project Plan A Green 9 21 Gantt Chart kl System Request Project Requirements Feasiblity study 914 Gay 9 21 Technical kel Economic kl work plan 97 Gren 914 Task identification Time estimation staffing plan project charter CASE tool Standards list Risk Assessment Paper Eh G 1042 Introduction Background Motivation T Problem Statement Literature Review Methodology Proposed Solution Program Analysis amp Design Logical Flow Diagrams Use Cases Database Model Ul Design Use Scenarios Physical Architecture Logical Architecture Physical Design Logical Design Data Storage Program Prototype Development Environment Install SDK He
5. d Risk Assessment The following set of risks posed to our project includes both internal team risks e g limited mobile application development experience and external risks involving access to sponsors Likelihood of risk Potential impact on the project Ways to address this risk The development of the application may be slowed because several group members have limited programming experience especially regarding Android High probability of risk This risk actually poses two potential risks Either the application delivery date may be delayed a few extra weeks and or some components of the Two group members have significant programming experience and the other members do have some experience The workload and resource allocation is applications application may need to be set to maximize each moved out of scope member s ability 2 Likelihood of risk Potential impact on the Ways to address this risk project The current requirements may require too much design and programming time Low medium probability This risk will result in the finished product being smaller than currently scoped The team is working to develop prototypes already and will scope the work required to complete component to assure the highest value components make it into the application While this risk may not be fully prevented the impact can be minimized with scoping and identifying the highest pri
6. opened with let s talk about the weight input screen Repeated for the food input screen activity input view progress feedback and set reminders e What areas were difficult to understand or use o The purpose of asking this question was to go in depth about each of the tasks because these tasks represented the major functionality of our application The answers to these questions would help us identify what needed to be changed either by us or future development to improve the core functionality of our application The final set of questions was wrap up conclusion questions e What would you change or not change in the application o This question was designed to elicit any specific or generic changes about the application as well as potentially identify future development e What do find useful about the application o This question sought to confirm whether the features we had developed in the application namely the tasks we asked the volunteer to perform were actually useful to our intended user base e Would you use this application o This question would help gauge whether our target audience would actually use this application This question was important because it would not be unreasonable for the volunteer to give favorable answers to the other questions yet still say they would not use the application If the user answered no to this question we would follow up by asking why to determine whether there
7. Jenkins We have flushed out quite a few things so far this is great So this is just the main screen again with the icons Is there any way you would make this different The location of thebuttons or anything you guys would like to see What other information would you want there 2 So know with a lot of phones you can customize how it looks and where things are think mine is just a list of grid or something like that Jenkins Would you like anything more on the main screen What other things would like to have when you open the application Feedback for that area perhaps 1 think it s good its organized 2 Yeah think it s good too 1 And it s really simple too so Moore Simas You could even think of specifics as to color size round or square buttons Jenkins Or how you interact with it and where things are or what you want to see first Moore Simas It sounds like you guys use applications what appeals to you 1 Well it looks simple Harris Are the buttons big enough to use and can you read them alright D 16 Page 1 Does it look different on other phones or is it just the same Jenkins With Android phones there are different screen sizes so depending on the phone it could look a little different It will be much the same layout just a little stretched and larger What would be more appealing to you 1 Well my phone have to use a little mouse thing to scroll around so don t know when I
8. Price Range Android 144 396 65 Free 14 47 iOS 257 437 517 Free 299 99 Blackberry 12 198 24 Free 59 99 20 Page This particular project is focusing on weight gain during pregnancy therefore the search needs to be narrowed down to applications that address this particular segment Table 2 6 provides statistics of the applications available on Android market based on the query of pregnancy weight gain As one can easily tell this search yielded more results than simply a search for pregnancy The results appear to be skewed as there are seemingly more applications for a narrower search The search features of these application marketplace search engines will also display other results for just weight and gain While the results are slightly difficult to read there is no application specific to gestational weight gain These applications can display a varying degree of functionality from purely informational to complete disease management At the present time there are no applications that are specifically for gestational weight gain There are however applications that address certain functionality that our proposed plan will include Table 2 6 Applications Available Pertaining to Pregnancy Weight Gain uquery Androlib AppWorld 2010 Platform Total Applications Pregnancy Weight Gain Applications Price Range Android 144 396 670 Free S14 98 iOS 257 437 21 Fre
9. insert one of the benefit bullet points It is recommended that you get 30 minutes of moderate exercise most days of the week A Recommend exercise for pregnant women is insert one of the beginner sports bullets Benefits Bullets Helps reduce backaches constipation bloating and swelling May help prevent or treat gestational diabetes Increases your energy Improves your mood Improves your posture Promotes muscle tone strength and endurance Helps you sleep better Regular exercise helps keep you fit Regular exercise may improve your ability to cope with the pain of labor Beginner Sports Bullets Brisk Walking Swimming E 5 Page Cycling stationary or recumbent is recommended if you re in the later part of your pregnancy Aerobics there are classes specific for pregnant women or low impact or water aerobics are also good options Dancing If the same sport is always inputted the application will say If some exercise is inputted but less than 30 minutes most days Exercise during pregnancy offers many health benefits and you have done a good job with the amount of exercising you ve been doing If you feel comfortable doing so and haven t already trying lengthening your exercise routine by 5 minutes this week It is recommended that you do 30 minutes of moderate exercise on most days of the week to achieve a range of health benefits including insert one of the benefit bullet points If exercise is inputte
10. Developing Systems Structured RAD Agile Waterfall Parallel V Model Iterative System Prototyping Throwaway Prototyping Extreme Programming with unclear user requirements Poor Poor Poor Good Excellent Excellent Excellent With unfamiliar technology Poor Poor Poor Good Poor Excellent Poor That are complex Good Good Good Good Poor Excellent Poor That are reliable Good Good Excellent Good Poor Excellent Good With short time schedule Poor Good Poor Excellent Excellent Good Excellent With schedule visibility Poor Poor Poor Excellent Excellent Good Good 31 Page Structured design methodologies adopt a step by step approach to the SDLC and moves from one phase to the next These methodologies make use of modeling and diagramming techniques to describe a system s functionality by outlining the different business processes and the data that support them Some examples of structured design methodologies are waterfall and parallel development These methodologies include a series of steps planning analysis design and implementation that must be done in order Once we move to the next step it is very hard to go back to the previous step to make changes Thus these methodologies are not very flexible as they are tailored towards the dev
11. Tue 10 2640 Wed 1140410 2hrs Tue 10 2640 Wed 1140410 2 hrs Tue 10 2640 Wed 1140410 2hrs Tue 10 2640 Wed 114040 2 hrs Tue 10 2640 Wed 11 10 10 8hrs Tue 10 2640 Wed 1140410 2 hrs Tue 10 2640 Wed 114040 2 hrs Tue 10 2640 Wed 114040 2hrs Tue 10 2610 Wed 114040 6 hrs Fri 11240 Wed 11 2410 65 6 hrs Fri 11240 Wed 11 2410 49 6 hrs Fri 112M0 Tue 11 2340 6 hrs Fri 112M0 Tue 11 2340 6 hrs Frit4M240 Tue 11 2340 8 hrs Tue 11 2340 Wed 11 2440 10 hrs Tue 11 2340 Tue 11 2340 16 hrs Tue 11 2340 Tue 11 2340 4hrs Tue 11 2340 Tue 11 2340 4hrs Tue 11 2340 Tue 11 2340 4hrs ber November December January 10 7 10 24 10 31 1477 1144 11 21 11 28 1215 1242 1249 12 26 1 2 189 1m6 1 23 180 Mm B Term Implementation 10 26 G 41246 Sprint 10 26 11 10 User Interface 126 a 11 10 Screen Layout XML Markup 10 26 Ey 11 10 Home Screen Reminders Screen Weight Screens gt 2 w bi K bi bi H EI Food Screens Profile Screens Progress Screens Screen Display Cod 126 a 11 10 Android Activity Declarations Tab Helper Dialog Handler Google Health Hutritign Reading Sprint ill Graph Outputs Weight Over Time Chart Acitivity Over Time Chart Nutrition Over Time Chart User Interface Polish Home Screen Reminders Screens Weight Screens Activity Screens Food Screens Profile Screens Progress Screens SQL Database Implementat
12. lifting you re bending Rosal Dusting right C How many calories do burn while dusting D 24 Page A know at work the other day burned a lot cleaning Jenkins How about the sedentary activities We re trying to balance the active time vs sitting and laying down time C Do we get those Does anyone have sedentary time during the day A We re always burning calories cause the baby s always doing something our body is always doing something C don t know in the evening l II sit down with my husband and watch TV Jenkins That s kind of what we had in there watching TV C During the day it s pretty much running errands cleaning walking A Working C walking the dog I m unemployed right now but still have a very full day unfortunately Rosal Walking the dog is a good one B When you look through the pregnancy book they have stretches you can do at home haven t done them though so don t know Rosal We can include those A You look at the pictures though Jenkins Any other way you want to see that shown Besides the little bar we have Rosal What does the bar tell you A You should have red to green or something or green to red instead of red to red so that you know what zone you re in Like green is good yellow is okay red is you shouldn t be over there Rosal So you want it Jenkins Just straight across C was wondering that everything seems to be on the top h
13. pinto beans soy beans split peas tofu bean curd made from soy beans white beans bean burgers garden burgers veggie burgers tempeh texturized vegetable protein TVP Nuts amp seeds almonds cashews hazelnuts filberts mixed nuts peanuts peanut butter pecans pistachios pumpkin seeds sesame seeds sunflower seeds walnuts Fish Finfish such as catfish cod flounder haddock halibut herring mackerel pollock porgy salmon sea bass snapper swordfish trout tuna Shellfish such as clams crab crayfish lobster mussels octopus oysters scallops squid calamari shrimp Canned fish such as anchovies clams tuna sardines Choose lean or low fat meat and poultry If higher fat choices are made such as regular ground beef 75 to 80 lean or chicken with skin the fat in the product counts as part of the discretionary calorie allowance Click here for more details on discretionary calories If solid fat is added in cooking such as frying chicken in shortening or frying eggs in butter or stick margarine this also counts as part of the discretionary calorie allowance Click here for more details on discretionary calories Select fish rich in omega 3 fatty acids such as salmon trout and herring more often See Why is it important to include fish nuts and seeds Liver and other organ meats are high in cholesterol Egg yolks are also high in cholesterol but egg whites
14. was a question we failed to ask or if there is another outside reason that has nothing to do with the quality of our application an example of an outside reason would be a volunteer who is a non smartphone user 53 Page Sprint 6 February 19 March A Sprint backlog Bug fixes UI polishing User manual During this final sprint the team focused on fixing bugs polishing the Ul and summarizing and analyzing the results of the user interviews and writing up the final research paper A user manual see appendix Appendix C was also created to help users learn how to use the application The team conducted one last sprint review meeting on March 2 2011 to present the final product to the customers and discuss the future of the project 3 4 Summary The adoption of a structured agile approach to tackle the development process played a key role in allowing us develop the application in a timely manner We were able to divide the system into smaller components and concentrate on a small number of components per sprint to speed up development and finish the product within our proposed project timeline 54 Page 4 System architecture and implementation In this chapter we discuss our architectural approach towards designing and implementing the system We first talk about the Android development environment and how it fit in with our development strategies We will then delve into the high level overview of the architectural desig
15. Figure 4 3 that could be isolated and tested individually 4 2 1 Feedback engine The feedback engine is the component that generates both qualitative and quantitative feedback based on data the user has inputted over a period of time The activity nutrition and weight tracking components all rely on the Feedback Engine to provide feedback on how the user is doing based on his her input The Feedback Engine in turn retrieves data from the database and processes this data to provide the requested feedback We will go into more details about the feedback engine later in the chapter The content we used to provide the feedback to the users can be found in appendix Appendix 4 2 2 Google Health client The Google Health client allows our application to communicate with Google Health for more information on Google Health please refer to section 2 7 to store user input as wellness data In this application we record wellness data in the form of weight readings calorific intake and time spent exercising This wellness data is then stored on the user s Google Health profile which is a Google account This allows the user to access their health information wherever they are and share it with their doctors and physicians 59 Page As the user fires up the application for the first time our application prompts the user to select a Google account to associate the application with and a Google Health profile If no profile exists then the appli
16. Graph Outputs 1233 q 12 16 Weight Over Time Chart T Acitivity Over Time Chart Lessel Nutrition Over Time Chart ed User Interface Polish 11 24 Up 11 25 Home Screen 0 Reminders Screens 0 Weight Screens H Activity Screens H Food Screens H Profile Screens H Progress Screens H SQL Database Implementation ee Focus Groups January February March April 12 19 146 123 180 26 243 220 227 36 343 320 327 43 40 47 4 C Term Conclusions 113 Ween 3 4 Paper Tm a Sprint 4 113 Gre 1 27 Feedback Engine T Information Library n Sprint 4 31 Uess 3 2 UI Polishing Ce Bug fixes Ta Presentation Poster H Interviews Presentation Appendix C User Manual Mom O Meter A self help pregnancy Android app 3 14 2011 Brendan Harris Michael Ng Ken Miyauchi Thomas Jenkins Evan Duderewicz 1 Setting up MOM O Meter recaeron noiai aataid anina iaaa osada aAA EA aaa Ta Naana re i ai C 2 Creating aiProtiles meinen hace cxtesah ooh ass edel Aa is sos se A i ete C 2 Zi The Home SCSI BEE C 3 NAVIGATION EE C 3 e SDK eege dg CA INAVIB AU EE CA 4 Creating a New Reminder asniensis Ree Ch Editing an Existing Reminder arriten a Kerg d et ENEE AER Z ede Ch Removing an Existing Reminder aonni neiaa neesan eea eadar aa aea aaa aiara eanit a aa niusi aelana Ch 5 Hehe let Eternal saad eege A EE CEET de EEEa A AR e EES C 6 Overview tee EE e SEENEN te Dag vedo Eet ee EEN C 6 NAVI
17. Screen 83 Figure 5 4 First attempt at input screen 83 Figure 5 5 Iteration 3 HOME Screen 84 Figure 5 6 Iteration 2 Input Screen 84 Figure 5 7 OldiDetails E EE 85 Figure 5 8 NeW Details Gra piise ss sscsisctecd geet S EE ee 85 xi Page List of Tables Table 2 1 Examples of iPhone Applications by Major Pharmaceutical Companies Byrne 2010 7 Table 2 2 Sample Recommended Pregnancy Diet MyPyramid gov 20101 11 Table 2 3 Key Nutrients for You and Your Baby During Pregnancy American College of Obstetricians and Gynecologists 2010 EE 12 Table 2 4 2009 IOM Gestational Weight Gain Guidelines IOM NRC 2009 p 2 15 Table 2 5 Applications Available Pertaining to Pregnancy uquery Androlib AppWorld 2010 20 Table 2 6 Applications Available Pertaining to Pregnancy Weight Gain uquery Androlib AppWorld SC Lu E 22 Table 3 1 Criteria for selecting a methodology Dennis Wixom Roth 2006 31 Table 5 1 Survey participants cellphone usage EE 78 xii Page 1 Introduction Healthcare is one of the most pressing concerns facing the United States and the rest of the world in the 21 century As healthcare costs soar ever higher Dick et al 1997 industry professionals have been looking for ways to keep these costs at bay One such method has been the use of technology Technology has been a core player in helping improve healthcare by reducing costs improving patient safety and
18. They also fall under overlapping categories For example there are Healthcare amp Fitness and Medical categories under the Apple App Store This is because of the wide variety of uses for mobile devices in these particular areas As a result there is a lot of room for development in this sector of mobile software 4 Page There is also potential for applications that are extremely full featured and can transcend individual categories Utilities 10906 4 Travel 9922 4 Weather 851 0 Sports 6370 2 Social Networking 4997 2 Reference 12049 5 Productivity 7712 3 Photography 5664 2 News 8382 3 Navigation 8715 3 Music 10417 4 Medical 3282 1 Lifestyle 19838 8 Healthcare amp Fitness 7886 3 Figure 2 1 Distribution of Available Applications on the Apple AppStore for iOS by Category Source uquery AppStore Search Engine Oct 2010 Business 12303 5 Finance 4197 2 Travel 3906 5 Communications 2479 3 Demo 895 1 Sports 3513 4 Software Libraries 356 0 Shopping 1234 1 Finance 1684 2 Social Networking 2063 Reference Health 1852 2 2 6 d Lifestyle 5517 6 Productivity 2923 3 News amp Weather 2624 3 Multimedia 5123 6 Figure 2 2 Distribution of Available Applications on the Android Market for Android OS by Category Androlib Android Market Search Oc
19. able 79 Page to customize the application specific to their preferences The things the participant would like to customize in the application specific to their particular use are e The participants wanted the ability to select their own color schemes including being able to change the font type and color The participants also provided the following feedback regarding what color schemes to offer o Boy Girl theme colors o Neutral theme suggested yellow green for those women who do not know or do not want to know what their baby s gender is Other images that symbolize a baby child a suggestion was a rubber ducky Model the color schemes and themes after those typically used to decorate baby rooms The yellow bar used to display messages was disliked a different color would be preferred e The participants all liked being able to view graphs of their progress however some preferred different types of graphs e g bar graph vs line graph Thus they requested the ability to customize which type of graph showed their pregnancy e The participants differed in opinion on the proposed smiley face in the center of the application home screen The purpose of the smiley is it would change how big of a smile was visible based upon the participants progress Some women did not want to have this additional form of feedback on the home screen while others thought it was fine Regarding alternatives the participants suggested being able to
20. activity coefficient PA 1 00 if PAL is less than 30 minutes PA 1 14 if PAL is 30 to 60 minutes PA 1 27 if PAL is 60 minutes or more If age gt 14 and lt 18 Energy need calories 135 3 30 8 x age y PA x 10 0 x weight kg 934 x height m 25 addition for P B Where PA is the physical activity coefficient PA 1 00 if activity is less than 30 minutes PA 1 16 if PAL is 30 to 60 minutes PA 1 31 if PAL is 60 minutes or more Addition for P B equation Trimester Addition for P B Lt trimester 0 kcal 24 trimester 340 kcal 3rd trimester 452 kcal F 1 Page F 2 GWG Guidelines Pre pregnancy 1990 IOM GWG Guidelines 2009 IOM GWG Guidelines BMI Category Pre pregnancy Total GWG Trajectory Pre pregnancy Total GWG Trajectory 1990 gt 2009 BMI kg m GWG BMI kg m GWG tri 2 amp 3 mean and range Ib wk Low weight gt lt 19 8 28 40 Ibs 5 lb 2 3 kg first tri lt 18 5 28 40 Ibs 1 1 4 4 Ibs 0 5 2 kg first Underweight 1 07 0 49 kg wk tri 2 amp 3 tri 1 1 1 3 lbs wk tri 2 amp 3 Normal weight 19 8 26 0 25 35 Ibs 3 5 Ib 1 6 kg first tri 18 5 24 9 25 35 Ibs 1 1 4 4 Ibs 0 5 2 kg first gt Normal 0 97 Ib 0 44 kg wk tri 2 amp 3 tri weight 1 0 8 1 lbs wk tri 2 amp 3 High weight gt 26 1 29 0 15 25 Ibs 2 lb 0 9 kg first tri 25 0 29 9 15 25 lbs 1 1 4 4 Ibs 0 5 2 kg first Overweight 0 67 Ib 0 5 0 75 Ib or 0 3
21. an Android developer As a result we had to learn all of the many facets of this kind of development Integrating the various parts 88 Page of the application from Google Health to the various modules of the application meant that everyone had to have a clear understanding of the project and the systems in use This is a major achievement especially when it comes to the timeframe One of the most important of these challenges was to create a system that was not only functional and aligned with our goals but also to design a system that was easy for another group to continue development on Early on we realized that this application had great potential and that it had the possibility to be extremely valuable to both the woman using it and her doctor We took particular care in adhering to as many best practices as possible as well as carefully documenting the development We know that if someone cannot readily understand what we did there is not much opportunity to improve on it and turn it into an even more valuable tool The major implication of this kind of application is that it is adding to the changing paradigm of reactive medicine to proactive medicine This application not only empowers the user to improve her health thus improving the health of her child but also increases communication between her and her health care provider in a positive way While the application is not a replacement for a doctor it is a helpful supplem
22. are cholesterol free Processed meats such as ham sausage frankfurters and luncheon or deli meats have added sodium Check the ingredient and Nutrition Facts label to help limit sodium intake Fresh chicken turkey and pork that have been enhanced with a salt containing solution also have added sodium Check the product label for statements such as self basting or contains up to _ of which mean that a sodium containing solution has been added to the product Sunflower seeds almonds and hazelnuts filberts are the richest sources of vitamin E in this food group To help meet vitamin E recommendations make these your nut and seed choices more often Dry beans and peas Dry beans and peas are the mature forms of legumes such as kidney beans pinto beans lima beans black eyed peas and lentils These foods are excellent sources of plant protein and also provide F 15 Page other nutrients such as iron and zinc They are similar to meats poultry and fish in their contribution of these nutrients Many people consider dry beans and peas as vegetarian alternatives for meat However they are also excellent sources of dietary fiber and nutrients such as folate that are low in diets of many Americans These nutrients are found in plant foods like vegetables Because of their high nutrient content consuming dry beans and peas is recommended for everyone including people who also eat meat poultry and fish regularly The Foo
23. be able to go back and say so and so said what It s just to keep everything anonymous so that you feel very comfortable talking and saying whatever you want to say Also because we are researching There is a consent form which is what we gave you There s the one that is stamped Original on the top of the blue signature if you could read through that It basically says that you should know this is research you don t need to participate and this is purely voluntary whether or not you do participate or no matter what you say It will not affect your healthcare in any way shape or form your doctors don t know you re here If at any point in time you don t want to answer a question you ve just had enough of this you just want to get up and leave you can do that One you need to sign and we put it on file The other you should keep in case at the end of this you want to read it more carefully or you have a question about anything or you want to contact us there s information in here Additionally for human comforts there s food at the back of the room if you d like anything and there s also several bathrooms on this floor At the end of D 19 Page this you will receive a 30 gift card and we ll make sure your parking is taken care of l Il give you all a moment to read through this if you haven t already and l Il just do a quick recap There is also what we call a demographics survey that has a coupl
24. com app answers detail a_id 946 the impact of mobile technology on medical education Lieberman Henry Paterno Fabio amp Wulf Volker 2006 End user development human computer interaction series Netherlands Springer Leyva D 2009 10 13 2010 Welcome http www myhealthtechblog com Livingston A 2004 Smartphones and other mobile devices the swiss army knives of the 21st century Educase Quarterly EQ 27 2 MayoClinic 2009a Fetal Development The First Trimester http www mayoclinic com health prenatal care PROO112 MayoClinic 2009b Fetal Development The Second Trimester http www mayoclinic com health fetal development PRO0113 MayoClinic 2009c Fetal Development The Third Trimester http www mayoclinic com health fetal development PROO114 MayoClinic 2009d Symptoms of pregnancy What happens right away http www mayoclinic com health symptoms of pregnancy PROO102 96 Page Medicine N R C a I o 2007 Influence of Pregnancy Weight on Maternal and Child Health Workshop Report Washington DC Committee on the Impact of Pregnancy Weight on Maternal and Child Health Board on Children Youth and Families Division of Behavioral and Social Sciences and Education and Food and Nutrition Board Institute of Medicine Microsoft Model View Controller 2011 http msdn microsoft com en us library ff649643 aspx MyPyramid 2010 MyPyramid Plan for Moms http www mypyramid gov
25. d have to just change it C like deselect it Jenkins You d go through the reminders again and just deselect or change the time Rosal That would be a helpful feature to have someone may think they want a reminder and then they want to change it C may think may want to be told 5 times a day need to eat a piece of fruit and then suddenly realize A Are you going to have a part that includes instructions Jenkins That s part of the info but we re trying to figure out what actually people want to have in there A How to easy delete how to change stuff you should make the background customizable Like if you re having a girl you can pick from like purple and pinks and a boy you can pick different colors So it s more customized to you Have different wallpapers instead of just a sun and yellow Jenkins Speaking of the appearance of it what other color schemes like you were saying boy or girl you could pick a different theme A You could do different hues of purple or how people do polka dots for girls Rosal stripes for boys A Yeah different room ideas Something that makes it fun that makes you want to use it that s helpful too Jenkins What other colors would you guys like to see B Pink for girls D Blue for boys Jenkins How about the default theme that would show up because you wouldn t know at the beginning of your pregnancy What kind of colors would you like to see A Light colors light
26. details tab there will be a graph showing your overall time and the input tab is where you actually input it The activity weight and food tracking have these three main tabs Also at the bottom there is a feedback help and info button We won t be going over those too much today though Well be focusing on the input screen specifically because this is where you ll be interacting with the application We want more feedback on them For the weight input this is the simplest of them you ll just input your weight into that box and click submit and it will record it The more complicated one we ll go to next the activity input but l II let you play with the weight input first quick and you can try adding your weight or just look at it and get a feel for how you actually type things into the application B Does this thing slide A Yeah turn it and push up B To the side Oh I ve got it Moore Then how do they input Jenkins You click on the box and a keyboard will pop up A Or you can slide it open Jenkins Or you can slide it and then you can type there as well not all Android phones have the sliding keyboard so we didn t really focus on that too much Moore So a keyboard that they can touch the numbers and also the letters Jenkins yep A It s missing a thing Jenkins Like was saying this is kind of the most basic input Brendan could you go to the activity So activity same overview as before The input this time i
27. diameter 1 corn tortilla 6 diameter 1 large tortilla 12 diameter 4 ounce equivalents WG whole grains RG refined grains This is shown when products are available both in whole grain and refined grain forms What foods are in the vegetable group Any vegetable or 100 vegetable juice counts as a member of the vegetable group Vegetables may be raw or cooked fresh frozen canned or dried dehydrated and may be whole cut up or mashed Vegetables are organized into 5 subgroups based on their nutrient content Some commonly eaten vegetables in each subgroup are Dark green vegetables Starchy vegetables bok choy corn broccoli green peas collard greens lima beans green dark green leafy lettuce potatoes kale mesclun Other vegetables mustard greens artichokes romaine lettuce asparagus spinach bean sprouts turnip greens beets watercress Brussels sprouts cabbage Orange vegetables cauliflower acorn squash celery butternut squash cucumbers carrots eggplant hubbard squash green beans pumpkin green or red peppers sweet potatoes iceberg head lettuce mushrooms Dry beans and peas okra black beans onions black eyed peas parsnips garbanzo beans chickpeas tomatoes kidney beans tomato juice lentils vegetable juice lima beans mature turnips navy beans wax beans pinto beans zucchini soy beans split peas tofu bean curd made from soybeans white beans What counts as a cup
28. easily available The content of the application was also something the participants felt was useful and valuable While the general consensus was that the application included a lot of relevant information there was room for improvement and expansion of the content especially as it pertained to the food and exercise library As a part of these interviews we sought to learn what could be further improved as far as the user interface The more prominent of these improvements is increased or the ability to increase font size in the application There were also additions to the food input outside of overall content that 86 Page some of the participants wanted to see The first is the ability to add custom foods readily from the input screen Another is that the food selection screen does not save the foods selected or prompt the user to submit changes when the back button is pressed There were also some bugs that were discovered The most important of these is the food servings input screen in which the keyboard blocks the text box for inputting the number of servings This proved slightly confusing for all of the participants In addition to the discussion on the interface and the application as a whole there was discussion on possible future development Aside from the expansion of the content the participants wanted more customization This pertains to customizing the colors the ability to add custom foods and the ability to add cus
29. edE 63 Figure 4 5 Entity Relationship diagram ccccccccccccssssssssesececeeecessesseaesececeesceesesaeaeseeeeseessesesaeeeseeeenseeeses 64 Figure 4 6 Weight feedback algorithm cccccsccccccececsesssseeeeecececsesesseaeseseceesceesesaeaeseeeeseesseseeaeeeeeesenseeeses 65 Figure 4 7 Nutrition feedback algorithm vicesseacnavesccsccaspasceesithvadanuinsannasd Eege eege eege Eegen 66 Figure 4 8 Activity feedback algorithm cccccssscccececessesenseseeeceeeessseeseaeseceesesseesssaeaeeeeeeseeseesseaeaeseeseneeesee 67 Figure 4 9 Use case diagram tees asst reales seeds ace athe a EEEE nasal COSE EKA EEA EAEE EEA iaaa aden 68 Figure 4 10 E e E ode TTT 69 Figure AE SELUL ET 70 Figure 4 12 Setup activity EE 70 Figure 4 13 Home activity E 71 Figure 4 14 Weight tracking activity iiscacevsasseanctans eege SNE EEGENEN SIE EEGEN 72 Figure 4 15 Weight overview activity cccccccssscccccececsessseseceeeescesseseeseeeceeeesceesesaeaeseeeeseessesseaeeeeeseeeseeeses 72 x Page Figure 4 16 Weight deta ils aGtivity 3 2 20ccc sdeneesv sseacestcascessscendassSeagees da ENTREE Eed Eed 73 Figure 4 17 Weight NPUtaCtivity cs 2s cccccscsoseacsadececescaacesdsss2ateciea cess sagusshacte ceadss NEES ENEE 73 Figure 5 1 Initial Home Screen UI Design ccccccccccceecssssssecececeeecsesesseaececeeeeecsesesaeseseeeeseessesssaseeeeesesseeee 76 Figure 5 2 Initial Overview Screen UI Desen 76 Figure 5 3 Iteration 2 HOME
30. enables pregnant women to monitor their weight gain nutrition and activity levels throughout their pregnancy To enable these women to fully utilize the application a comprehensive reminder system was created to ensure continued use for the duration of the pregnancy By using the information provided by the user we generate graphs to chart the progress of the pregnancy and provide relevant feedback in order to keep the women on track for a healthy delivery This data can be shared with the patients doctor through the integrated Google Health profile providing the doctors with an in depth look into the patients pregnancy This application is a bold step in the world of mobile and patient driven healthcare and we endorse using our application as the framework for a comprehensive pregnancy application For future developers we recommend expanding the overall feature set by integrating the application with providers information systems and making it more customizable The nutritional component of the application could be improved as well by tracking additional nutrients and eating habits We also advocate running further focus groups and clinical trials to test the effectiveness of the application By following these recommendations a comprehensive mobile pregnancy application can be produced 93 Page 7 Bibliography ACOG The American Congress of Obstetricians and Gynecologists 2010 Nutrition During Pregnancy Washington D
31. for the day or the week or whatever That would be really helpful because carry this bottle of water around all the time but I m still probably not getting enough A And then for people who can t drink milk cause can t a way to get those vitamins Moore This is a very specific question if you had to think about your friends and family you know maybe other pregnant women you know What would you say how many or what percent of them have cellphones D 36 Page All All of them Moore How many text All All of them Moore How about the phones that can do this type of thing that allow you to have applications How many would you say Cellphones are pretty common but call them the fancy phones the fancy phones are less so A A lot of them Moore So not a 100 C No I d probably put it at like 30 of the people know have smartphones Moore Anyone else a guess C Especially right now know a lot of people who had smartphones and got rid of them because they were too expensive Right now people are not too attached to their smartphone Moore With the texting piece do you feel like most people have unlimited texting or a pay per text A It depends had another phone that was 25 month for just 300 minutes but everything else was unlimited So they re doing a lot more unlimited text and web Moore There s a lot of variety Jenkins As far as texts vs email would you want both in this s
32. forms of foods in each food group you would make the best nutrient buys Depending on the foods you choose you may be able to spend more calories than the amount required to meet your nutrient needs These calories are the extras that can be used on luxuries like solid fats added sugars and alcohol or on more food from any food group They are your discretionary calories Each person has an allowance for some discretionary calories But many people have used up this allowance before lunch time Most discretionary calorie allowances are very small between 100 and 300 calories especially for those who are not physically active For many people the discretionary calorie allowance is totally used by the foods they choose in each food group such as higher fat meats cheeses whole milk or sweetened bakery products You can use your discretionary calorie allowance to e Eat more foods from any food group than the food guide recommends F 21 Page e Eat higher calorie forms of foods those that contain solid fats or added sugars Examples are whole milk cheese sausage biscuits sweetened cereal and sweetened yogurt e Add fats or sweeteners to foods Examples are sauces salad dressings sugar syrup and butter e Eat or drink items that are mostly fats caloric sweeteners and or alcohol such as candy soda wine and beer For example assume your calorie budget is 2 000 calories per day Of these calories
33. grain products F 4 Page What counts as an ounce equivalent of grains In general 1 slice of bread 1 cup of ready to eat cereal or cup of cooked rice cooked pasta or cooked cereal can be considered as 1 ounce equivalent from the grains group The chart lists specific amounts that count as 1 ounce equivalent of grains towards your daily recommended intake In some cases the number of ounce equivalents for common portions are also shown G whole wheat RG plain egg G 100 Whole heat RG white wheat French sourdough Cornbread RG English muffins G whole wheat RG plain raisin WG F 5 Page Amount that counts as 1 ounce equivalent of grains 1 mini bagel 1 regular slice 1 small slice French 4 snack size slices rye bread 1 small piece 2 1 2 x 1 1 14 14 muffin AG cup cooked 1 packet instant 1 ounce dry regular or quick Common portions and ounce equivalents 1 large bagel 4 ounce equivalents 2 regular slices 2 ounce equivalents 1 medium piece 2 x 2 1 2 1 2 ounce equivalents 1 muffin 2 ounce equivalents 3 cups popped 1 microwave bag popped 4 ounce equivalents G brown wild AG cup cooked RG enriched white 1 ounce dry olished 1 cup cooked 2 ounce equivalents Tortillas G whole wheat hole grain corn RG Flour corn 1 small flour tortilla 6
34. greens like neutral like if you go to a baby store and you wanna be the person who doesn t know what you re having What colors you d pick neutral Rosal Going back to the text messages vs emails how many of you text Rosal All of you text What type of plan do you have All unlimited D 29 Page Rosal You don t get any additional charges for the text messages you receive Jenkins So you guys all use cellphones all the time B Is it possible to have a forum that other pregnant women that are using this can have discussion without them knowing your phone number and other person Rosal So like a chat room Jenkins Like a social network C Maybe not necessarily on the phone but because again the phone is not the center of my world the computer is So if there was something linked if you had a forum online or a webpage attached to the app Jenkins Well the app uploads this data to Google Health Google Health is a free service anyone with an Android phone it links to their Gmail account So all of your information is up there and you can actually share that with your doctor or something like that or you want to share your progress So it is on the computer but it doesn t have that social networking aspect Jenkins Welcome Rosal Maybe we can bring you up to speed as to what we re doing Jenkins So basically you re here because you re part of our demographic for this application as a pregnant wo
35. has used a cell phone for communication or information gathering with 19 of Americans are using mobile devices to access the internet every day Horrigan 2009 Another study done between April 2009 and May 2010 has shown that 54 of American adults have sent someone a photo or video from a cell phone Hemmenginger 2010 The progression of technology has facilitated this increased use of mobile devices Many improvements namely faster processors and better battery life have enabled notebooks and smartphones to become powerful devices giving us the ability to completely change the way we work The evolution of the smartphone especially has changed the face of business It is now possible with our data infrastructure and powerful mobile devices for many people to do most of their work outside the office Livingston 2004 With the emergence of the smartphones of today namely Apple iPhone Android and Blackberry products people can work almost anywhere Operating systems on many of these smartphones have the ability to run many business applications such as the ever popular Microsoft Office The explosion of software that has been developed especially on the major smartphone platforms covers a variety of categories Figure 2 1 Figure 2 2 and Figure 2 3 illustrate the distribution of applications available by category on the main three platforms Health applications account for a relatively small percentage of the overall applications available
36. have 280 working hours as in A term we deem it economically feasible to deliver the functionality outlined in the requirements section within the given time frame A 6 Page The standard application developer rate is 27 hr so the total cost of development in B term will be 6345 3 According to our project timeline during C term we will spend approximately 259 hours writing the final research paper conducting the pilot and training programs and performing the final presentation These tasks are broken down into the following components Final Paper 200 hrs Pilot Program 25 hrs Training 30 hrs Presentation 4 hrs Total 259 hrs Given that the standard IT consulting rate is 22 76 hr the total cost of consulting in C term will be 5894 84 From the above information we calculate that the total cost of the project over the three terms will be 18453 32 f Staffing Plan Our team consists of members with strong business and technical background with experience in various aspects of the information technology industry Some of the skills we possess are e Project Management e Microsoft Office proficiency e Database systems e Knowledge of various programming languages SQL Java Visual Basic e Software Engineering Principles e CASE Tools A 7 Page e User Interface Design e Graphical Design g Communication Our team s major strength is the strong communication skills each
37. having heavy user involvement to garner feedback on the user experience and satisfaction Constantine and Lockwood 1999 thus tailoring the application to the target group The backbone of such design is user testing on iterations of prototypes On a higher level there are two major aspects of motivation in this application The first is the usability of the application itself The second is the content and value of the application If either of these are lacking no woman is going to want to use the application especially for the entire duration of pregnancy Our goal then is to instill confidence in the user in both her ability to use it as well as her perceived value of the application and information provided The first step in this process is to understand our user group For this specific application we are looking at pregnant women as the target user group Even though we have narrowed our focus there are still a variety of user types that need to be taken into account Beyond cultural financial and age differences there are tech savvy expert smartphone users and complete novices that will be potentially using this application The goal for design in this regard is to focus design on the least proficient users Potential users who do not have much if any experience with using a mobile application or the phones themselves will immediately lose interest in using it This is independent of the perceived value as most 23 Page users
38. is not doing so and encourages the user to exercise more It also provides a list of exercise activities that the user could try out Exercise Time gt 30 mins Exercise Time lt 30 mins You are doing You should try great Keep it up exercising more Figure 4 8 Activity feedback algorithm 67 Page 4 6 Use case diagrams In this section we look at how the user interacts with the application Since this application is a smartphone application there is only one user interacting with the system therefore we assume that the user interacts with all the use cases in the diagram Figure 4 9 shows the main front end components with which the users interact and the different functions of each component weighttracking et GWG Input weight erview feedb User Get detailed GWG feedback Get recommendations informationlib Get screen help Figure 4 9 Use case diagram 68 Page 4 7 Logical flow diagrams In this section we look at how the application logic flows Each figure represents an individual activity in the application Figure 4 10 shows the logic behind the main activity that is the first activity that is launched when the application starts When the application starts it checks to see if the database has been set up If not the activity goes ahead and sets up the database by creating and populating the required tables Next it checks to see if the user s Google Health profile is setup If not
39. m really clicking on stuff So maybe it could pop up and got a little bigger Jenkins Like when you click on it it moves or something Rosal Have you used applications before Your opinion is very important because this is supposed to be for everybody Many people that don t have that experience 4 Yeah don t have anything to compare it to so don t know much about it Jenkins Ok lets say you just started off with an idea of what this application would do how would you like to have it look right from the start What kind of menu would you like to see What differences 4 Its nice because its all labeled and there are pictures that show what they do 2 It seems straightforward really Cuz had a phone where everything was really small and it was hard to use and see There were so many different options didn t know what was doing and actually returned it It was too complicated 1 This one tells you what you are clicking on and it seems easy 4 Maybe have the option to pick graphs or charts where you can customize it 1 Yeah like if you don t like the line graph you can choose a different way Rosal So you want to have the option to choice 2 Yeah to be able to customize it how you want it Jenkins how would you want it 2 like it just like this it makes sense Jenkins As far as graphs maybe 2 would like a line graph 3 Some phones Ive had before had other stuff like when you click on act
40. much o Calories burned during activities particularly non exercise specific ones such as cleaning There is a desire to see the calories consumed compared to calories expended in activity e Progress related information o Pictures of baby development o General information about development of the baby such as what body parts are developing that week o Apregnancy tracker countdown to delivery e The participants wanted a tip of the day that would either appear on the main screen of the application or appear as a pop up when they entered the application They noted the following information for inclusion in the tip of the day o Managing symptoms of pregnancy such as back pain or nausea o For healthier eating o Tip of the day related to the risks of excessive weight gain high blood pressure gestational and how to prevent the excessive gain e Food related information o The participants wanted information about alternatives to meals when they were dining out e g compare options at McDonalds to subway o An example a participant gave was if she were craving pizza she needs to know how much of her desired pizza she can eat essentially what is the size of a serving of that pizza c Customization of the Look Feel of the Application The participants also expressed a high level of interest in customizing the look of the application They made suggestions for how we could change the application and for how they would like to be
41. mypyramidmoms pyramidmoms_plan aspx News C 2010 Number of Cell Phones Worldwide Hits 4 6B Retrieved from CBSNEWS BUSINESS Nielsen J 1994b Heuristic evaluation In Nielsen J and Mack R L Eds Usability Inspection Methods John Wiley amp Sons New York NY Centers for Disease Control and Prevention 2009 Body Mass Index http www cdc gov healthyweight assessing bmi Raskin Jef 2000 The humane interface new directions for designing interactive systems United States Addison Wesley Rasmussen K M amp Yaktine A L 2009 Weight Gain During Pregnancy Reexamining the Guidelines Institute of Medicine http www iom edu Reports 2009 Weight Gain During Pregnancy Reexamining the Guidelines aspx Richard S Dick E B S Don E Detmers 1997a The Computer Based Patient Record Revised An Essential Technology for Health Care ed National Academy Press Stotland NE Haas JS Brawarsky P Jackson RA Fuentes Afflick E Escobar GJ Body mass index provider advice and target gestational weight gain American College of Obstetricians and Gynecologists 2005 105 633 8 97 Page APPENDICES Appendix A System Request Project Name Pregnancy Smartphone Application Project Sponsors Name Tiffany A Moore Simas MD MPH MEd FACOG Department Director Research Division Dept Ob Gyn Associate Director Residency Program Dept Ob Gyn Assistant Professor of Ob Gyn and Pediatrics Organization Umass Med
42. o Do you own a cell phone Model o If you have a phone what do you use it for o Have you used an application on a mobile device o Did your doctor s ever talk to you about the amount of weight that would be healthy for you to gain in pregnancy 45 Page o Have you used any sort of program to help monitor your weight diet or physical activity o Do you know your ideal weight When not pregnant o Do you have a scale to weigh yourself at home o If you are pregnant what week are you on o Is this your first pregnancy We sought to not only collect information on the participants use of mobile technology but also their understanding of their health We included the question about use of a program to monitor health as a way to connect pregnancy and mobile technology allowing us to understand how these women track their health if at all The following questions were those we used as prompts for discussion These questions were targeted at individual aspects of the application interface with specific focus on the input functionality of the application and overall look and feel We put added emphasis on this aspect of the interface because it is the major contributing part of the application that will influence the user s adoption and continued use of the application If it is confusing or hard to use there will be little or no user base for the application These questions also gave us insight into the factors that go into usi
43. of the components we are looking to develop such as the activity tracker 29 Page might have already been developed by someone else By reusing this code we are able drastically save development time e Third the Android Market place is open to all developers Anyone who develops an Android application can then upload it to the App Market and share it with other people This is a huge advantage given the time constraints of our project because we plan to develop and distribute the application in less than 9 months On the other hand if we develop an iPhone application it has to go through Apple and Apple has to approve of it before it becomes available in the iTunes store 2 9 Summary With more people than ever connected to the internet wherever they go with the many smartphones and other mobile devices on the market it makes sense to develop solutions for tasks that were previously cumbersome While the healthcare industry has widely accepted mobile technology this project falls into a niche Pregnancy applications and websites have provided a multitude of tools and a wealth of information but there has yet to be a gestational weight gain specific solution Because weight gain during pregnancy can greatly affect both the child and the mother the value of such a tool that eliminates many of the challenges of previous solutions is great As previously stated our goal is to design and implement a smartphone self help application based o
44. on designing the focus group protocols 43 Page Focus Groups Design In order to further the analysis of different user interface Ul designs we conducted two focus groups of women These focus groups have critical meaning to the usability of the application and the evolution of the interface as we continued development because of the feedback gleaned The people who were included in the focus groups were pregnant women who have varying degrees of experience with smartphones from a non user to a power user between the ages of 18 and 35 The purpose of this was to gather feedback on the usability of our application by allowing the participants to interact with our application running on an actual smartphone The focus group started with an introduction of the project gestational weight gain and smartphone applications We then distributed phones and demonstrated a walk through of the important sections we were focusing on specifically the input screens Below are the areas of the application that we covered o Application UI o Weight tracking o Activity tracking o Nutrition tracking o Reminders Notification The subjects were then encouraged to discuss with each other during and after they have the opportunity to interact with the application This helped generate discussion between non smartphone and smartphone users that yielded valuable feedback on not only our current design but also how they expected the application to look an
45. satisfaction saving time and effort for both patients and clinics alike and reducing potential errors Leyva 2009 This shift in paradigm is in part due to the fact that technology can help automate a lot of manual processes and procedures involved in healthcare practices In recent years mobile technology in particular has greatly evolved and become a mature platform and according to CBS News 2010 there are around 4 6 billion mobile phones worldwide Because of this many health organizations such as the World Health Organization and experts from across the healthcare industry are looking to tap into the potential of mobile technology to revolutionize healthcare management and delivery Carucci 2009 It is in this regard that we look to employ mobile technology to help pregnant women more effectively manage and keep track of their weight gain during their pregnancy Weight gain during prenatal stages also known as Gestational Weight Gain GWG is a factor that can significantly affect the immediate and long term health of both the mother and child Moore Rosal et al 2010 Studies have shown that women should gain a recommended amount of weight determined by their body mass index BMI during prenatal stages However many women in their prenatal stages still gain weight outside of specific recommended ranges According to Stotland et al 2005 24 1 of overweight women gain weight above the Institute of Medicine IOM recommended g
46. screen and say your baby this week would want to look at instead of going to Barnes and Noble and buying a huge book Rosal So you prefer having it in the phone as opposed to the book or the internet Cause you are using the internet how would it compare to having it in the phone vs the internet What might you use more B The phone you can just check it anywhere It s just gonna be a summary instead of a whole chapter A have an app on Facebook that every week it sends a little picture of what your baby looks like this week It tells you what the baby is doing and if you click on it it will bring you to a website and it will tell about you what the mom should be feeling Rosal So very similar to what you re describing in a different program but both programs are pretty much the same Jenkins What are they called B babycenter com Jenkins That s a good point too you said it gets sent in email how would you like that shown in this application for instance Would you like it to be like a text message on the main screen of your phone or would you want to go into the application and find it somewhere in there B A text message reminder would be nice that would direct you to the application A Maybe it could even be the background you could have it so it updates right Jenkins That s another thing we re going to look at to the reminder feature For all of these you can set custom reminders for when you w
47. seizure e hypoglycemia e polycythemia e hyperbilirubinemia e meconium aspiration syndrome e obesity at age 3 One study noted that although some conflicting or unclear results exist the overwhelming majority of studies indicate that GWG consistent with BMI specific IOM recommended ranges are associated with better maternal and infant outcomes Moore Rosal and Waring 2010 p 2 Since there are a numerous amount of health risks that are caused by gaining more than the recommended amount of weight during pregnancy and gestational weight gain is a controllable factor for most women there is an opportunity for an intervention to help women gain the right amount of weight during their pregnancy and significantly reduce their health risks during and after the pregnancy 2 4 Pregnancy Resources Because of readily available access to information that the internet provides women now have many options for finding information pertaining to pregnancy There are a variety of websites social networks and standalone applications that allow women to do everything from find nutrition information to track their own pregnancy with a customized profile both free and paid 2 4 1 Websites The first type of pregnancy resources are extensions of general health or information websites Websites such as WebMB com MedicineNet com BabyCenter and Everyday Health have pregnancy 17 Page portals that allow users to access a variety of articles an
48. sizes is listed in the application Rosal Where would you like to see it 3 Well I think was doing it when I was selecting the food Harris Like when you select the food you would like to know how many servings there are or 3 Yeah like if you were putting in you know you ate such and such a food just to know how much it is A lot of people don t know Rosal You are absolutely right where the food shows you would want to know what a serving of that food is is that what you would like to see 3 Yeah something like that Rosal Ok that s a great idea 3 You know you could be putting in you meatballs and you might just say one serving but you might have had like 4 Rosal Right exactly And not know it but if you have it right there you would easily be able to know What other things related to the food or recording the food might be helpful 3 So does it it comes up in food groups right 2 So would there be an option to enter your own food Like if it is not in the list D 6 Page Rosal So you would find that helpful to be able to enter your own foods into the application Great idea Jenkins Right away when you click here 2 Yeah you could put in your foods Rosal Rather than going through your categories of food Moore Simas Maybe it can kind of create a list of favorite for you Jenkins That is what it shows under each specific meal The first page that comes up is your favorite foods fr
49. sponsors on a regular basis and gathered feedback throughout the entire length of the project Scheduling everything from our meetings to milestones far in advance allowed us to stay on track and mitigate any unforeseen setbacks For example the Institutional Review Board IRB between WPI and UMass Medical School operate significantly differently A review of our proposed focus groups and interviews takes 1 2 weeks at WPI as opposed to UMass Medical School s 2 3 weeks as there is additional deliberation for at risk populations which include pregnant women We took this into account when we had to file for a review for interviews toward the end of the project Because we needed to design the interviews far in advance we were able to adequately prepare for them by properly finishing and testing the application before we gave it users we interviewed in the time it took to get approval Scheduling meetings with our sponsors was also very important because they both have very busy and different schedules We could not have developed this application without the regular meetings with them especially as a result of the special considerations we needed to take into account with our target demographic Obviously the implementation of the application was one of the major challenges necessary to overcome to call this project a success While we all possess various degrees of programming knowledge none of our group was a pure software developer let alone
50. tedious Jenkins Can you think of a better way to organize that information besides the gallery of pictures we have 3 Instead of the more button maybe you could search for a food and as you type it finds it Like everything is alphabetized Rosal So instead of scrolling just typing in the name of a food and having it search for you am going to ask you because you haven t used applications before what would make the use of an application like this appealing for women like you who have not had all the exposure to all of these phones 4 am very interested in using something like this to stay educated and on top of things Rosal So you would use the baby information 4 Right Jenkins Is there anything else you guys want to add Any last comments or anything else you would like to see 3 If you are talking about personalizing it maybe you could have a place where you could put in a picture Like you got a baby picture taken and you upload it and have it as the background D 18 Page Jenkins We talked about that a little bit ago about customizing the themes and colors what other ways would you like to personalize or customize the application 1 Maybe there could be templates you could download and use with different colors Rosal What color schemes do you think would be appealing 1 More like baby colors like don t know like kid stuff like rubber duckies Jenkins So besides baby blue and pink what other col
51. their health records from a variety of sources such as doctor s records prescription history and test results 26 Page User focus Google Health provides a clean and easy to use interface for patients to easily manage their health information In making this an easy and straightforward process the average user who doesn t necessarily know much about technology can also create and manage their own Google Health profiles Google Health provides an Application Programming Interface API that allows third party developers like our team to develop applications that can interface with and make use of the Google Health services Currently there are no 3 party applications that help pregnant women optimize their weight gain during pregnancy 2 8 Android Recently Android has been gaining popularity and its market share in the mobile operating system market is rapidly increasing According to a research from Gartner 2010 Android is poised to become number 2 worldwide mobile operating system by the end of 2010 This accelerated growth has been driven by the widespread adoption of the Android operating system by a number of smart phone manufacturers such as Samsung HTC Motorola among others Gartner 2010 In our efforts to develop a robust mobile application to help pregnant women optimize their gestational weight gain we decided to leverage the Android platform Android is a software platform designed by Google for mobile devi
52. tri kg wk tri 2 amp 3 0 6 0 5 0 7 Ibs wk tri 2 amp 3 Obese gt gt 29 0 At least gt 30 0 11 20 Ibs 1 1 4 4 Ibs 0 5 2 kg first Obese 15 Ibs tri 0 5 0 4 0 6 Ibs wk tri 2 amp 3 BMI categories as per Metropolitan Life Insurance tables cutoff points for BMI categories BMI categories as per World Health Organization WHO cutoff points for BMI categories first trimester based on Siega Riz et al 1994 Abrams et al 1995 Carmichael et al 1997 F 2 Page F 3 MyPyramid Food Information What foods are in the grain group Any food made from wheat rice oats cornmeal barley or another cereal grain is a grain product Bread pasta oatmeal breakfast cereals tortillas and grits are examples of grain products Grains are divided into 2 subgroups whole grains andrefined grains Whole grains contain the entire grain kernel the bran germ and endosperm Examples include e whole wheat flour e bulgur cracked wheat e oatmeal e whole cornmeal e brown rice Refined grains have been milled a process that removes the bran and germ This is done to give grains a finer texture and improve their shelf life but it also removes dietary fiber iron and many B vitamins Some examples of refined grain products are e white flour e degermed cornmeal e white bread e white rice Most refined grains are enriched This means certain B vitamins thiamin riboflavin niacin folic
53. upload their own picture e g an ultrasound of their baby or they would prefer a picture of a developing baby ideally the picture of the baby would represent where the woman is in her pregnancy e The participants also wished to be able to set a picture that would be the entire background of the application d The Application should Generate Suggestions This theme linked closely with the participants desire for a high volume of information they want the application to make suggestions on how to make changes to their habits what is allowed what they need to do and more An example of this desire for suggestions was highlighted by one participant who said if the application does not make specific suggestions e g it just said she was consuming too many calories she would probably not use the application e Anexample of a desired suggestion was that the application suggests the user get some exercise if they re gaining too much weight Additionally the participant would be amenable to other 80 Page alternatives e g eating a healthier food option vs their current option They specifically noted they do not want to be told they re gaining too much weight o Related to the exercise component the participants wanted the application to make recommendations for particular exercises that appropriate and low impact Another desired suggestion was what particular foods vitamins and minerals the participant should eat that they are c
54. user instructions to perform changes in the application Each activity must implement the base class Activity and must be started by passing an Intent object to Context startActivity Figure 4 2 shows the events in the activity lifecycle Once an activity is started it can run on the background until it is terminated allowing other activities to be started as well The developer can override all these events and implement their custom logic in any of them Most of the screen setup and variable initialization occurs during the onCreate event onCreate User navigates back to the activi The activity comes to the foreground Another activity comes in front of the activit The activity Other applications comes to the e Ee The activity is no longer visible Figure 4 2 Android Activity Lifecycle Android Developer 2011 57 Page 4 1 4 Other Android components The Android software stack is a complete set of libraries that provide a number of components that applications utilize for their day to day activities and tasks The activities mentioned the previous sections were the main components we utilized Aside from activities we also employed the following components d Notification manager The notification manager is a component from the Android operating system that servers to alert notify the user about events that happen These notifications are sent to the notification bar also known as the la
55. was part of the development team and worked on most of the user interface aspects of the application to make sure that the application s look and feel is well designed Michael Ng was part of the development team He designed the system architecture and coded all of the application s back end components Michael also wrote the executive summary introduction system architecture chapters and much of the methodology chapter vi Page Table of Contents l PRS E i ll Executive Summar yasinan tuena a E aa a a aaa a a E aaa ii Ill Acknowledeementz v IV Authorship Ree de Te vi NNEN 1 2 Literat re REVIEW sivecccsseciedcceieec ceive eege ER ee ENEE 4 2 1 1 Mobile Technologies in Healthcare ccccccccccccecssssssnsececeeeesceesesseseseceesesssesesseeeeeesesseesensnaeeas 4 2 2 PROBMANCY ie sssncsaseeccnuecvannssutaseadaaxtondseabeeseseveaendsuauveruec a i aa a aaa iaaa aaiae 9 KK Ee D UE 10 2 2 2 Physical CHILE 13 2 3 Gestational Weight Gain o misiissisincitenin ee E NRE E ES 14 2 4 Pregnancy Resources 17 241 Websites cienie aa aa E E a E EE ER EEE 17 2 4 2 SOCIAL INCOM ORIG eerste eegene Ee NEEE AKE ENTERON aaa K K Eak 19 2 4 3 PP NCARIG EN 19 2 5 Existing Smart Phone Applications for Pregnancy cssccccesssscececeesseeecseseeeeceeseneeceeseaueeeeneesneees 20 2 6 User Centered De Sigcccissiscesssssdecsssscvecsssiesenssce idsecsiavviesnaiddeeesia aves sees aeecevsaaveessuadienseadedesvaraadeaeennev
56. who are intimidated by technology generally shy away from using such devices Lieberman Paterno amp Wulf 2006 The more technology savvy users will not give up nearly as quickly especially since they have experience with particular devices but that does not mean the application should be unnecessarily complex or obtuse The next step is to design the displays as intuitively as possible To achieve this we utilized display design heuristics and significant user input on our design throughout the process There has been much study into user interface UI design and there are many points of view but there are some agreed upon guidelines Some of the pioneers in this field Larry Constantine and Lucy Lockwood have devised a set of principles for UI design that have been widely accepted Constantine and Lockwood 1999 These are more overarching suggestions than standards The principles are structure simplicity visibility feedback tolerance and reuse principles These principles are generally intuitive and logical The structure principle states that the overall interface should be clear and consistent The simplicity principle says that the information and interface design should communicate easily to the user with relation to the task at hand The visibility principle is concerned with having all options available to the user This also means not to include extraneous information that may bewilder the user The tolerance principle relates
57. with a dip or dressing Try low fat yogurt or pudding as a dip for fruits like strawberries or melons Make a fruit smoothie by blending fat free or low fat milk or yogurt with fresh or frozen fruit Try bananas peaches strawberries or other berries Try applesauce as a fat free substitute for some of the oil when baking cakes Try different textures of fruits For example apples are crunchy bananas are smooth and creamy and oranges are juicy For fresh fruit salads mix apples bananas or pears with acidic fruits like oranges pineapple or lemon juice to keep them from turning brown Tips to help eat more vegetables In general Buy fresh vegetables in season They cost less and are likely to be at their peak flavor Stock up on frozen vegetables for quick and easy cooking in the microwave Buy vegetables that are easy to prepare Pick up pre washed bags of salad greens and add baby carrots or grape tomatoes for a salad in minutes Buy packages of veggies such as baby carrots or celery sticks for quick snacks Use a microwave to quickly zap vegetables White or sweet potatoes can be baked quickly this way Vary your veggie choices to keep meals interesting Try crunchy vegetables raw or lightly steamed E 3 Page At meals Plan some meals around a vegetable main dish such as a vegetable stir fry or soup Then add other foods to complement it Try a main dish salad for lunch Go light on the salad dressing Include
58. would be helpful to have in the reminder and how it shows on the screen C Can you connect it to your email am very bad with cellphones leave them in the other room leave them in the car things like that and don t always have it on me Or go to the library a lot or go to places where you need to be quiet Rosal Not everybody uses their cellphone as much C I m on the computer all the time all day So if had it in my email then that would be better than having to cart my phone with me everywhere Rosal So a text message can also be set by choice to an email C If could choose to send it to me email instead of my phone or choose both that would be more helpful A What are the reminders for Jenkins For inputting this data so it will remind you to put in your weight for that week It will remind you to put in foods for breakfast lunch Let s say you set it for the evening and then you do all your meals or you set it for after lunch A What if it was the day you go up a week So that you get your reminder and get your weekly update so you do everything at once Cause some people don t check it so if you re reminded Jenkins So an all encompassing reminder that just says do all of it A Yes Some people won t remember so if you reminded to check your weekly update on the baby and you You can just do it all at once C Can you delete a reminder D 28 Page Jenkins Yes but you
59. would you like that shown or told to you Or you haven t walked or done any exercise in a week Maybe negative things is there a way that you d want to have that told to you so that you wouldn t be discouraged but you would still want to D 34 Page A We know B A little pop up icon Jenkins okay A Those are just things we don t want to acknowledge but we know deep down we haven t exercised or eaten fruits and vegetables Jenkins So you would want it to remind you C think if you have a reminder to do your walking you already have the reminders programmed in Jenkins Right to input the information but let s say you haven t input the information in a while Would you want it to tell you that you haven t done that for a while C suppose it could don t know what good it would do quite honestly it s very easy to ignore those things A You should definitely have other activities that women do like cleaning Walking is obviously exercise but not everyone does that for exercise It s not like you don t exercise when you re cleaning especially with all the extra weight it s twice as hard to do anything Jenkins Based on what you guys have seen of the application would you be interested in using it Would it be something you would find useful A would probably download it if it was free don t really pay for any apps Moore That s good to know that s important for us to k
60. you are after your first trimester you should avoid exercises on your back You should avoid brisk exercise in hot and humid weather as well as if you have a fever Wear comfortable clothing that will help you remain cool while exercising Wear a bra that fits well and gives lots of support to help protect your breasts Be sure to drink plenty of water to keep you from dehydrating and overheating If you exercised regularly before your pregnancy then running some racquet sports and strength training if done in moderation may be appropriate for you to continue Consult your doctor before participating in one of these more advanced sports Sources http www acog org publications patient_education bp119 cfm Your Pregnancy and Childbirth Month to Month 5th edition The American College of Obstetricians and Gynecologists 2010 E 7 Page Appendix F Nutrition GWG Guidelines Food Information F 1 MyPyramid Gov Nutrition Equations Equations to determine energy needs in pregnancy and breastfeeding Age in years weight in kg and height in meters are calculated from user input PA coefficient is assigned from user input and addition for P B is determined by trimester The necessary Kcal to add for trimester is determined from the Addition for P B equation If age gt 19 and lt 50 Energy need calories 387 7 31 x age y PA x 10 9 x weight kg 660 7 x height m addition for P B Where PA is the physical
61. you need to spend at least 1 735 calories for essential nutrients if you choose foods without added fat and sugar Then you have 265 discretionary calories left You may use these on luxury versions of the foods in each group such as higher fat meat or sweetened cereal Or you can spend them on sweets sauces or beverages Many people overspend their discretionary calorie allowance choosing more added fats sugars and alcohol than their budget allows F 22 Page
62. 100 orange or grapefruit juice Or try a fruit mixed with low fat or fat free yogurt At lunch pack a tangerine banana or grapes to eat or choose fruits from a salad bar Individual containers of fruits like peaches or applesauce are easy and convenient At dinner add crushed pineapple to coleslaw or include mandarin oranges or grapes in a tossed salad Make a Waldorf salad with apples celery walnuts and dressing Try meat dishes that incorporate fruit such as chicken with apricots or mango chutney Add fruit like pineapple or peaches to kabobs as part of a barbecue meal For dessert have baked apples pears or a fruit salad At snacks Cut up fruit makes a great snack Either cut them yourself or buy pre cut packages of fruit pieces like pineapples or melons Or try whole fresh berries or grapes Dried fruits also make a great snack They are easy to carry and store well Because they are dried cup is equivalent to cup of other fruits Keep a package of dried fruit in your desk or bag Some fruits that are available dried include apricots apples pineapple bananas cherries figs dates cranberries blueberries prunes dried plums and raisins dried grapes E 2 Page As a snack spread peanut butter on apple slices or top frozen yogurt with berries or slices of kiwi fruit Frozen juice bars 100 juice make healthy alternatives to high fat snacks Tips to make fruit more appealing Many fruits taste great
63. 3 The New Methodology http www martinfowler com articles newMethodology html France R Rumpe B amp Turk D 2003 Assumptions Underlying Agile Software Development Processes Journal of Database Management http www cs colostate edu france publications AgileSE draft pdf Gould John 1995 How to design usable systems San Francisco Morgan Kaufmann Publishers Inc Hardy K 2009 WebMD deploys mobile medical application for physicians 2010 http www healthcareitnews com news webmd deploys mobile medical application physicians Women s Health 2010 Healthy Pregnancy Dos and Don ts 95 Page http www womenshealth gov pregnancy mom to be tools pregnancy dos donts pdf HealthMango 2010 Fetal Growth from 8 to 40 Weeks http www healthmango com second trimester of pregnancy html Hemmenginger M 2010 Market overview 2010 the state of the smartphone revolution Digital Media Test Kitchen hosted by the University of Colorado http testkitchen colorado edu projects reports smartphone smartphone market Horrigan J 2009 Wireless internet use Pew Research Center s Internet amp American Life Project http www pewinternet org Reports 2009 12 Wireless Internet Use aspx Kay R 2002 QuickStudy System Development Life Cycle http www dbcominc com web WhitePapers SDLC pdf Keane J amp Rege O 2009 The impact of mobile technology on medical education CustomerThink http crmguru custhelp
64. Android application We will also employ some outside libraries such as gData to connect to Google Health to store and retrieve information 28 Page APPLICATIONS Home Contacts Phone APPLICATION FRAMEWORK Window Content View vity Manager vity G Manager Providers System Telephony Resource Location Notification Manager Manager Manager Manager Package Manager LIBRARIES ANDROID RUNTIME Media Framework Core Libraries Freelype WebKit LINUX KERNEL Display ena Flash ry Binder IPC Driver Camera Driver Driver Keypad Driver WiFi Driver Figure 2 5 Android Software Stack Source Android Developer 2011 Google provides an Android Software Development Kit SDK which contains the tools code libraries necessary for developing applications that run on Android powered mobile devices using the Java programming language The reasons for choosing this programming platform in lieu of other platforms such as the iPhone s iOS are the following e First and foremost is our experience with the Java programming language Android is based on Java and because the project team is familiar with this programming language we are able to easily ride the learning curve as opposed to having to learn the iOS programming language e Second Android provides an open source environment which allows us to look at existing pieces of code that can deliver some of the functionality we are trying to achieve That is some
65. C Alliance A 2010 The Twelve Principles of Agile Software http www agilealliance org the alliance the agile manifesto the twelve principles of agile software American College of Obstetricians and Gynecologists 2010 Your pregnancy and childbirth month to month Sth ed Washington DC Android Developer 2011 What is Android http www android com about Android Market Search Engine 2010 Androlib http www androlib com AppStore Search Engine 2010 uquery http www uquery com Beaulieu M 2002 Wireless Internet Applications and Archeticture Boston Addison Wesley Beck K Beedle M amp van Bennekum A 2001 The Agile Manifesto http agilemanifesto org Beck K amp Cunningham W 2001 Principles Behind the Agile Manifesto http agilemanifesto org principles html Beck Kent amp Cunningham Ward 2001 Manifesto for agile software development http www agilealliance org the alliance the agile manifesto BlackBerry AppWorld Search Engine 2010 Blackberry app world http us blackberry com apps software appworld Brown J E 2006 What to Eat Before During and after Pregnancy McGraw Hill Professional Publishing Byrne J 2010 Healthcare Apps Exploding in Mobile Are You Ready http www v fluence com blog 459 healthcare apps exploding in mobile are you ready Carucci D D J 2009 World Health Day Mobile Technology Revolutionizes Healthcare Delivery In Develo
66. Cases ss Database Model UI Design Use Scenarios Physical Architecture n Logical Architecture Physical Design kens Logical Design ed Data Storage ee Program Prototype 5 Ey 10 14 Development Environment gy Install SDK m Hello World Program kel Familiarize with API Make Google Account for Phone Smartphone Component Feedback Component UI Component Reminder Component Google Health Component Weight Component Exercise Component Food Component B Term Implementation Sprint User Interface Screen Layout XML Markup Home Screen Reminders Screens Weight Screens Activity Screens Food Screens Profile Screens Progress Screens Screen Display Code Android Activity Declarations Tab Helper Dialog Handler Google Health Sprint H User Inputs Weight Input Activity Input Food Input Reminder Input Data Storage Weight Reading Activity Reading Nutrition Reading B 3 Page 38 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 12 days 8 25 days 8 25 days 8 days 8 days 8 days 1 25 days 1 day 1 day 1 day 1 day Tue 10 2610 Thu 126 10 150 27 hrs Tue 10 26 10 Wed 11 10 10 32 hrs Tue 10 2640 Wed 111040 26 hrs Tue 10 2610 Wed 11 10 10 18 hrs Tue 10 2640 Wed 114040 2 hrs Tue 10 2640 Wed 114040 2 hrs Tue 10 2610 Wed 114040 2 hrs
67. December 14 Sprint backlog Weight tracking Nutrition tracking Activity tracking components In the third and final sprint the development team incorporated the feedback on the weight nutrition and activity tracking components from the customers in order to have a functional prototype for the focus groups During this sprint the team carried out the focus group sessions on December 1 and December 3 2011 and gathered qualitative information on the usage of the application These focus groups were conducted in the UMass Medical school campus and each session had 4 6 participants Food and refreshments were provided for the participants as well 48 Page From this feedback the team analyzed the feasibility of incorporating the required changes and chose the ones that were feasible to implement given the time constraints This is detailed in Chapter 5 The team met with the customers on the following dates December 8 the team presented the summary of the focus group feedback to the customers The team also asked the customers for additional guidance on building the feedback component of the application c C term During this term the development team focused on polishing the Ul coding the rest of the application and writing up the documentation of the application These tasks were split up into three more sprints The research team focused on building the information library and writing the term paper For this we perform
68. GATION EE C 6 el ett et Geer E Eeer tale matte C 7 le UE C 8 Inputting a Weight Reading o cccessccccecececessesssecececeeecsessaeseseceescessesseseseseeseussesesaeaeseesessueseeaaeeeeeeeees C 8 6 The Activity TT WEE c 9 COVENVIGW ase A E A ee ee C 9 NAVIB ATION EE C 9 NEIE E C 10 Changing the Time EEafpg eeh C 10 INPUTS ChE E C 11 Inputtingsan Activity Re aging ssc cc2isv2ceccicscsecdssaedede teases savevsceateaceed sa sodseeetiadesessvosduasieniaedeaveusiavsniaeiaveets C 11 Fi IME NUtition Screen seee a anaE a a VR E EE ENES ah aA aE a E Aa N EEE R AEE C 12 OVONRVICW edd EE ES ee C 12 NAVIGATION EE EE C 13 RE C 13 Changing the Time Frame ccccccccccccccssssssseeeceesesssessaesececeeeceeseseeseeeeeeeeessesesaeseeeeseseessnseaeeeeeesesseeees C 14 ll ef e C 14 Inputting a Nutrition REACING ccccccccccccesssssssecececeeeceesseaesecececsseesesaeeeeeceesceeseeeaeeeeeesesssessaeseeeeeens C 14 Be Ihe Profile SRS E C 16 C 1 Page 1 Setting up Mom o Meter Please enter the following information Current week in pregnancy Gei Select a week Your Height Pregnancy Week Menu Butto Feet Box Your Weight Weight Box Sp W kg OK Button Inches Box Pounds Kilograms Toggle The account set up screen is what you will see the first time that you launch Mom O Meter The application will ask you information regarding your pregnancy After filling in the fields press the OK butto
69. How would you like it to tell you that D 31 Page D like the frown or the smiley face because it lets you know you are doing bad It s better to have someone or something tells you The facial expression would be good for me Rosal How do others feel about that type of feedback up front B don t think people would know much about it They would just think it s a picture but for you you would know what it was C Yeah if you open it up and it s smiling yeah it s just an icon and the sun is frowning A That s why it should be customizable because some people want it and some don t Rosal How about for you your suggestion is good cause the women can pick and choose A would like to just have a background that would have to do with the baby Cause you have the bars in all the other sections Jenkins So leave the feedback in the other sections and not on the main screen A Yeah think you should have that option E don t like the smiley face think you should have a picture of the ultrasound not a smiley face B So that means you should provide a way to customize it based on what the person wants Jenkins You guys have said you have used some applications that show you pictures What that be something you want to see on the main screen or elsewhere in the application C Can input my own graphics If have an ultrasound picture and want to put it there will be able to do that Jenk
70. MQP BXT 1002 WPI Mom O Meter A self help pregnancy Android app A Major Qualifying Project Submitted to the Faculty of the WORCESTER POLYTECHNIC INSTITUTE In partial fulfillment of the requirements for the Degree of Bachelor of Science by Evan Duderewicz MIS Brendan Harris MIS Thomas Jenkins MIS Ken Miyauchi MIS Michael Ng MIS 3 14 2011 Sponsored by Dr Tiffany A Moore UMass Medical School Dr Milagros Rosal UMass Medical School Approved by Professor Bengisu Tulu Advisor Professor Emmanuel Agu Advisor I Abstract The goal of this project was to develop a self help Android application to aid pregnant women in achieving healthy weight gain during pregnancy Using Scrum an agile software development approach the team gathered requirements designed and implemented a smartphone application utilizing the Android and Google Health platforms This application empowers women to take their health into their own hands and has the potential of reducing short term and long term health risks associated with gestational weight gain for both mother and child This application is an example of continued advancement of mobile technologies in healthcare which drives the shift from a reactionary to preventative treatment paradigm page II Executive Summary Healthcare has been and continues to be one of the most pressing concerns facing the United States and the rest of the world in the 21 cent
71. Page 5 2 Interview Summary As part of the final feedback gathering aspect of this project we designed and conducted key informative interviews KIF The goal of these interviews was to generate some discussion with potential users to help us understand the clarity appeal and feasibility of a Smartphone application which proposes to inform women about gestational weight gain guidelines and motivate them to use and adhere to such recommendations To accomplish this we allowed potential patients to use the application following some guidance as to what parts of the application to cover Later the participant was asked a series of questions as to her opinions of the application as a whole as well as specific areas of the application food input etc The results from the three key informative interviews were positive The participants had a moderate degree of technology savvy and did not express much frustration in using the application during the time allotted All of the participants were open to the application and expressed interest in using a final version and recommending it to a friend There was a general acceptance of the design of the user interface and navigation of the application with one participant noting It s just easy you know Everything is right there on the screen The participants were especially excited about the fact that they did not have to manually write and keep track of all of this information and that it was
72. a green salad with your dinner every night Shred carrots or zucchini into meatloaf casseroles quick breads and muffins Include chopped vegetables in pasta sauce or lasagna Order a veggie pizza with toppings like mushrooms green peppers and onions and ask for extra veggies Use pureed cooked vegetables such as potatoes to thicken stews soups and gravies These add flavor nutrients and texture Grill vegetable kabobs as part of a barbecue meal Try tomatoes mushrooms green peppers and onions Make vegetables more appealing Many vegetables taste great with a dip or dressing Try a low fat salad dressing with raw broccoli red and green peppers celery sticks or cauliflower Add color to salads by adding baby carrots shredded red cabbage or spinach leaves Include in season vegetables for variety through the year Include cooked dry beans or peas in flavorful mixed dishes such as chili or minestrone soup Decorate plates or serving dishes with vegetable slices Keep a bowl of cut up vegetables in a see through container in the refrigerator Carrot and celery sticks are traditional but consider broccoli florettes cucumber slices or red or green pepper strips E 4 Page Sources http www mypyramid gov pyramid fruits_tips html http www mypyramid gov pyramid vegetables_tips htm Exercise Feedback If no exercise is inputted display a message saying Exercise during pregnancy offers many health benefits including
73. acid and iron are added back after processing Fiber is not added back to enriched grains Check the ingredient list on refined grain products to make sure that the word enriched is included in the grain name Some food products are made from mixtures of whole grains and refined grains F 3 Page Whole grains brown rice buckwheat bulgur cracked wheat oatmeal popcorn Ready to eat breakfast cereals whole wheat cereal flakes muesli whole grain barley whole grain cornmeal whole rye whole wheat bread whole wheat crackers whole wheat pasta whole wheat sandwich buns and rolls whole wheat tortillas wild rice Less common whole grains amaranth millet quinoa sorghum triticale Refined grains cornbread corn tortillas couscous crackers flour tortillas grits noodles Pasta spaghetti macaroni pitas pretzels Ready to eat breakfast cereals corn flakes white bread white sandwich buns and rolls white rice Most of these products are made from refined grains Some are made from whole grains Check the ingredient list for the words whole grain or whole wheat to decide if they are made from a whole grain Some foods are made from a mixture of whole and refined grains Some grain products contain significant amounts of bran Bran provides fiber which is important for health However products with added bran or bran alone e g oat bran are not necessarily whole
74. alf of the screen and there seems to be blank space on the bottom half of the screen Is that on purpose Are there going to be more graphs Jenkins There s going to be some more text feedback in that top bar So there s a fact there now like your baby s fingers and toes are now present but most of the feedback will be on that feedback button Harris What kind of information would you like to see on that screen D 25 Page A Is there a way to take a picture and get measurements of your stomach don t know if you could scale it down but like every week you re supposed to gain a centimeter you could take a picture and see if you re where you re at Seeing that you have the updates on the baby or even what the mom s going through that week know on some websites they have what your baby s doing and then what you should be going through and stuff like that Rosal So some feedback about the mother that could be measurements or perhaps weight Would you want to see there measured waist circumference A Or maybe daily tips like put your feet up to get rid of swelling or something like that Something helpful B also think if they put some of the things that they have in the pregnancy book about like your baby s lungs are developing this week stuff like that That will make me appreciate this because won t have to carry that huge book around because can just look it up on my phone Rosal Where would you li
75. and 72 Page constructs a Google Charts URL which will be used to generate a webview chart from the Google Charts services This chart is then displayed to the user 5 3 Weight Details Activity Figure 4 16 Weight details activity Figure 4 17 shows how the weight input activity works The user inputs her current weight in either pounds or kilograms The activity will store this data in the SQLite Database and will pass it to the Google Health Client so that it stores the data in the user s Google Health profile The activity will then notify the user that the data has been stored and will navigate back to the weight overview screen 5 4 Weight Input Activity 5 4 1 User inputs 5 4 2 Display confirmation weight in kg or Ibs message to user lt lt datastore gt gt SQLite Database Figure 4 17 Weight input activity 73 Page 4 8 Summary This chapter outlines the architecture of the system we built as well as the implementation of the general logic and flow of the application thus providing enough details and documentation for any other group to pick up our project and be able to recreate it or expand upon our final product without having to spend too much time looking through our source code and trying to understand it 74 Page 5 Results The goal of this project was to create a system that would serve as a self help health tool for pregnant women to better care for themselves and maintain a higher level o
76. and has a number of special considerations and changes This is the period of time during much of the initial development of the fetus occurs During this time the baby will start to develop many parts of its anatomy including the skin circulatory system bladder head toes neck fingernails and genitals Mayo clinic 2010 This is also the part of the pregnancy when the mother goes through the most hormonal changes which can lead to a number of unpleasant symptoms including morning sickness or nausea swollen breasts food aversions or cravings fatigue headaches constipation mood swings and dizziness Mayo clinic 2010 The second trimester covers week 13 through week 28 During this time the baby starts to take a more definite form Over the course of this trimester the baby develops many more parts of its core 9 Page anatomy including bones and fat As a result of this growth the baby develops more definite human characteristics such as hair fingernails and fingerprints In addition to these developments the gender of the baby can be determined usually around the 14 week of pregnancy and by the 18 week the baby is capable of forming facial expressions and hearing Mayo clinic 2010 The third trimester lasts from week 28 until the child is born This last stage of pregnancy is when many intense changes occur The fetus continues to develop physically and during this trimester the baby will develop eyelids and eyelashes an
77. ant it to remind you to put in your weight or record foods or your activities Here s the reminders page it has 3 tabs like before but those 3 tabs are now for the specific things you re going to be recording For weight for example you click add reminder and it will ask you what days you want it to remind you to put in your weight A It s babygaga com If you want to take a look at it this is what it looks like Jenkins this is on Facebook A yeah D have an app on my iPod it s called Pregnancy Facts Every week it gives you updates on what you should eat what you should do what the baby is doing what you re doing Rosal Very much like the others one D 27 Page D Yes Rosal So what is the name of that one D Baby Center Pregnancy and my baby light com That one s the one basically use more It tells you how far along you are how many weeks you have left and the sign of the baby like if it s a Scorpio Just little facts Jenkins Back to the reminders feature you can set the times for all these different things and it will actually show up on the home screen of phone There s a reminders part of the phone so it will show up when you turn on your phone and you ll see that there will be a reminder there You do that for weight activity and nutrition Is there any way you would like to see this different How you actually set up reminders or how the reminders are given to you Rosal What kind of things
78. are individuals and interactions working software customer collaboration and responding to change Beck amp Cunningham 2001 The main idea behind agile development is that it is to be flexible and efficient to deliver the most value 33 Page Beyond the main values the Agile Manifesto lists there are some basic principles that have been agreed upon for successful use of the agile method These principles stress flexibility delivering working software on a regular basis close collaboration division of labor regular meetings regular pace within development attention to detail and constant improvement in order to produce the best final product Beck amp Cunningham 2001 Agile development breaks down a project into individual modules of the final project over iterations Cockburn amp Williams 2003 Each iteration requires the full system development process thus allowing working software to be available after each iteration Agile development is best suited for smaller teams where many tasks can be shared Cockburn amp Highsmith 2001 It is a highly collaborative environment that does not take into account the corporate level of the team members This kind of teamwork allows for more creative thinking in effectively creating simple solutions to problems The key to success with this methodology is constant communication which is easier to accomplish with a smaller group In the end it is the team s goal to appropriately translat
79. at foods are in the fruit group Any fruit or 100 fruit juice counts as part of the fruit group Fruits may be fresh canned frozen or dried and may be whole cut up or pureed Some commonly eaten fruits are Apples Apricots Avocado Bananas Berries strawberries blueberries raspberries Cherries Grapefruit Grapes Kiwi fruit Lemons Limes Mangoes Melons cantaloupe F 9 Page Mixed fruits fruit cocktail Nectarines Oranges Peaches Pears Papaya Pineapple Plums Prunes Raisins Tangerines 100 Fruit juice orange apple grape grapefruit honeydew watermelon What counts as a cup of fruit In general 1 cup of fruit or 100 fruit juice or cup of dried fruit can be considered as 1 cup from the fruit group The following specific amounts count as 1 cup of fruit in some cases equivalents for AG cup are also shown towards your daily recommended intake Amount that counts as Amount that counts as 1 cup of fruit cup of fruit Apple AG large 3 25 diameter 1 small 2 5 diameter 1 cup sliced or chopped raw or cooked cup sliced or chopped raw lor cooked Applesauce bh cup Dn snack container 4 0z Banana 1 cup sliced 1 small less than 6 long 1 large 8 to 9 long Cantaloupe 1 cup diced or melon balls 1 medium wedge 1 8 ofa med melon Grapes 1 cup whole or cut up 32 seedless grapes 16 seedless grapes Grapefruit 1 medium 4 diameter 1 medium LAT diam
80. ated Initially all of our data was graphed using a local algorithm to generate a single graph However after hearing that different women would like to see different kinds of graphs we discovered the Google Charts API This 84 Page open source addition to the project enabled much cleaner looking graphs and enabled a greater variety of graphs to be generated The different graphs are illustrated in Figure 5 7 and Figure 5 8 Mom o Meters VEN Overview Details our weight gain detailed view Weight by Week Weight 190 Figure 5 7 Old Details Graph Figure 5 8 New Details Graph 5 1 3 Scoring and Personal Goal Management Due to the development constraints surrounding our project we had to remove a scoring component and personal goal tracking in order to deliver a high quality application on time Initially we wanted to provide each user with a single progress score which could be compared with other users in a social network After meeting with doctors we realized that this feature was not feasible Since each patient responds to different activities and diets in such a unique way finding a way to quantify that data in a non arbitrary way was not easy In order to adjust for this we outlined a way for users to set specific goals for weight gain activity level and nutrition However due to time restrictions this new feature was never implemented and has been moved to future work see Chapter 6 85
81. ay to get you back down to your starting weight Rosal That is a possibility Moore Simas Would you like to see the graph go this way and then back down again 2 l Il be on the treadmill watching it Rosal What other types of food messages would you like to receive 1 If there is a food like a vegetable you don t like maybe it can give suggestions for an alternative or a recipe that would be good or something Or maybe even a hint to try that food 3 Maybe information on the benefits to the mom and baby for breastfeeding Getting people into the precontemplation stage of starting to think about what your plan is going to be when you get toa specific week Maybe some of the benefits for not just the baby but for the mom too D 12 Page Rosal Basically preparing the mother to be a mom Jenkins How would like you like to see this on the screens 3 Like if you put in the foods and it would kind of break down the meal Maybe it would track vitamins and nutrients specific to pregnancy like folic acid and fiber and things of that nature Moore Simas lve heard a lot about wanting feedback on a variety of things How about if we made it that making up and example here maybe you had ice cream 6 nights in a row and it came back and said maybe this wasn t the best decision Would you look at this as a turn off or a turn on 2 Maybe have it try and get you to switch those foods for other healthier alternatives Moore Simas Like
82. body use protein fat and carbohydrates Beef liver pork ham whole grain cereals bananas Vitamin B12 2 6 micrograms Maintains nervous system Needed to form red blood cells Liver meat fish poultry milk found only in animal foods vegetarians who do not eat any animal foods should take a supplement In addition to eating a healthy diet maintaining proper nutrient level it is important to avoid exposing the developing baby to certain chemicals such as alcohol and tobacco Use of tobacco products exposes the child to carcinogens and leads to increased risk of stillbirth or premature birth 12 Page NIH 2010 Consuming alcohol regularly or excessively is also advised against and can lead to various complications most notably fetal alcohol syndrome NIH 2010 Illicit drug use can also lead to birth defects including underweight deliveries and withdrawal symptoms after delivery NIH 2010 By avoiding exposure to these chemicals women can lower the risk of birth defects 2 2 2 Physical Activity The American College of Obstetricians and Gynecologists in Your Pregnancy and Childbirth American College of Obstetricians and Gynecologists 2010 p 25 state general activity and time specifically spent exercising are shown to have several benefits These benefits include being healthier reduction of physical and mental stress and an overall boost in energy levels Regular activity and exercise duri
83. bout 8 ounces 1 piece 2 2 x234 x 1 about 4 ounces Starchy Vegetables Corn yellow or white 1 cup 1 large ear 8 to 9 long 1 small ear about 6 ong Green peas fi cup White potatoes 1 cup diced mashed 1 medium boiled or baked potato 2 1 to 3 diameter French fried 20 medium to long strips 2 1 2 to 4 long Contains discretionary calories a Amount that counts as 1 cup of vegetables Other Vegetables Bean sprouts h cup cooked Cabbage green 1 cup chopped or shredded raw or Amount that counts as L cup of vegetables cooked Cauliflower bn cup pieces or florets raw or cooked Celery bn cup diced or sliced raw or cooked F 8 Page Cucumbers Green or wax beans Green or red peppers Lettuce iceberg or head 2 large stalks 11 to 12 long 1 large stalk 11 to 12 long bn cup raw sliced or chopped ji cup cooked 1 cup chopped raw or cooked 1 large pepper 3 diameter 3 34 long 2 cups raw shredded or chopped H cup raw shredded or equivalent to 1 cup of vegetables chopped equivalent to AG cup of vegetables 1 small pepper Mushrooms ji cup raw or cooked Onions ji cup chopped raw or cooked Tomatoes 1 large raw whole 3 1 small raw whole 2 1 4 1 cup chopped or sliced raw canned DEEN canned or cooked Tomato or mixed vegetable juice bn cup IY cup Summer squash or zucchini ji cup cooked sliced or diced Wh
84. cals Inc iChemoDiary 10 14 2009 Merck amp Co Inc Medical GoMeals 11 4 2009 Sanofi Aventis U S LLC Healthcare amp Fitness Biotherapie 11 28 2009 Wyeth une societe du groupe Medical Pfizer Eye Health 12 1 2009 Bausch amp Lomb Inc Healthcare amp Fitness iManage Migraine 12 18 2009 Merck amp Co Inc Medical INTUNIV Guanfacine 12 21 2009 Shire US Inc Medical Dosing Calculator One of the best examples of a recent innovation for mobile medical technologies is the WebMD Health application This cross platform smartphone application is geared toward physicians providing information on the go Hardy 2009 The application called Medscape Mobile provides information on medications tools medical news and other educational information The application relies on WebMD Health Network consisting of WebMD health MedicineNet eMedicine Medscape and other health resources Hardy 2009 The application allows doctors to reference vital information whenever they need it providing a higher level of treatment 7 Page Mobile technologies have also allowed for better education in medical schools The training of physicians is an extremely important task So much so that many medical schools are utilizing new mobile technologies to facilitate a better educational experience The major issue facing schools is the tracking of the performance of the students These new innovations have also provided better communicati
85. cation creates a default one For the Google Health client we utilized the org apache http libraries to create HTTP GET requests to the Google Health service which are comprised of the URL with an appropriate header The Google Health service then returns an HTTP response containing the data we requested or posted our application processes that data Store Data wn FLU U U i Get Feedback 1 1 I Get Feedback lt lt yuse gt gt Store Data Figure 4 3 System Architecture 60 Page 4 2 3 Database component In order to persist user data and configuration settings we have used the following components the shared preferences and the SQLite database a Shared Preferences The shared preferences component provides a framework for saving and retrieving persistent key value pairs of primitive data types This allows us to store based configuration information without the need to create database tables Data stored in shared preferences are persisted across sessions so even if the application is closed or the phone is rebooted this data will remain intact The application uses shared preferences to store the following information e Starting pregnancy week the week into the pregnancy when user first started using the application e Starting weight the weight of the user when he she started using the application e Starting height the height of the user when he she started using t
86. ce we the developers were not the intended audience this question would help us determine if our intended audience was able to easily navigate the different screens of the application By asking what did not work as expected we hoped they could tell us where navigation did not function logically from a user s perspective e What made this application intuitive What worked as you expected o This question sought to confirm what navigation and functionality worked as the user would expect e What did you like most about the application o This question could potentially help us identify future expansion or development if there was a particular feature that was well liked e What did you like least about the application o This question was designed to help us find difficult to use parts of the application bugs and just general features that were not desired e What did you think of the appearance of the application o The colors of the screens o The icons o The font used All of these appearance questions were designed to make sure the application was both visually appealing and easy to read The question about the icons was designed to make sure the icons and buttons implied to the users what we selected them to represent This is the second set of questions and relates to each specific task we asked the volunteers to complete We went through each section of the aforementioned tasks asking these questions Each section was 52 Page
87. cececeeeceesessaececeeeesceesssaeaeeeceescssseseeseeeeeeeeeseesesaeaeeeesesseeees 62 4 32 lt Package diagrams eessen a EA 62 4 4 Database Model scsiivccscrcisraisycniesdsacsousinsaua van sasnnnsn auna ea Aa EEA E ARE ECTS 63 dr Eeegdbackengtng ugangen deg E E E a EE ETE E E a 63 4 5 1 W ight Gain Feedback arnee aa aaa aaa aaa aa a aa Eege e 65 45 22 N trition Feedback EE 66 4 5 3 Fitness Activity Feed back c 2cc scieci ccd Eden baie das ea A Teh 67 467 USE CaSO di aSFAMIS e n E Medea EA esas 68 ATs MOI CAL TOW CIA BAIN EE 69 ABe SUIMIMALY EE 74 EE 75 5s User Intertace Designs cc ii TEE O AIL EE ee be EE G 75 SLL FOGUS GrOUPS SUMMA ee Ee EN ed a daaa a anaana ioraa aaa Coagecdai So ecduade 76 5 1 2 Data Storage amp Graphing ccccccsccccececessessnsecececeeeceeseeaeeeceeeeesnesesaeaeeeesesesesesnsaeeeseeseseeeenes 84 5 1 3 Scoring and Personal Goal Management 85 5 202 Interview SUMIMAPY neresidir ndn a de copes M e Net deefe deisde ebe eg daad cede 86 E Re Ee TEE 87 5 3 1 Implications Takeaways and Achievements s ssssessseesessssesererressssssrerrresessssesrrereessessssene 87 Ke GC IMI AtIONS erste sce nna aa a aE a EAE 89 Conclusions and Recommendations scutes stucudervyttitanim sch teduduta cn sied eRe tiasestlyadytoulelavennadsaeetianmacrtents 91 let le elei 94 viii Page Append YA lt SVSteM R ngegtsiegdtergde rege ee Ee eebe dech A 1 Appendix B Project Timeline B 1 Appendix U
88. ces that includes an operating system middleware and key applications Android Developer 2011 The Android Software Platform also known as the Android Software Stack is illustrated in Figure 2 5 and consists of the following components Applications layer contains the core set of applications that are delivered with the Android operating system such as the email client calendar maps SMS program and others 27 Page Application framework layer provides a set of Application Programming Interfaces APIs used by the core applications which can also be used by developers to develop their own applications Libraries layer provides a set of C C libraries used by the various components of the Android system Developers can access this library for more advanced development features such as 2D and 3D graphics engines and media support Android runtime layer includes a set of core libraries that provides most of the functionality available in the core Java source files This layer also includes the Dalvik virtual machine which creates instances of virtual machines for Java based applications to run on Linux Kernel the abstraction layer between the hardware and the rest of the software stack provides core system services such as security memory management networking drivers etc For our application we will mostly be utilizing the Application Framework and Libraries components from the Android Software Stack to develop our
89. ched count any additional dry beans or peas eaten as part of the dry beans and peas subgroup in the vegetable group What counts as an ounce equivalent in the protein foods group In general 1 ounce of meat poultry or fish cup cooked dry beans 1 egg 1 tablespoon of peanut butter or ounce of nuts or seeds can be considered as 1 ounce equivalent from the protein foods group The chart lists specific amounts that count as 1 ounce equivalent in the protein foods group towards your daily recommended intake Amount that counts as 1 ounce Common portions and ounce equivalent in the protein foods equivalents group Meats 1 ounce cooked lean beef 1 small steak eye of round filet 3 to 4 ounce equivalents 1 ounce cooked lean pork or ham small lean hamburger 2 to 3 ounce equivalents Poultry Fae cooked chicken or turkey 1 small chicken breast half ithout skin 3 ounce equivalents F 17 Page Fish 1 ounce cooked fish or shell fish 1 can of tuna drained 3 to 4 ounce equivalents 1 salmon steak 4 to 6 ounce equivalents 1 small trout 3 ounce equivalents Nuts and 2 ounce of nuts 12 almonds 24 1 ounce of nuts or seeds 2 oz seeds istachios 7 walnut halves eq A ounce of seeds pumpkin Sunflower or squash seeds hulled roasted 1 Tablespoon of peanut butter or almond butter What are oils Oils are fats that are liquid at room temperature like the vegetable oils used in cooki
90. cial decision is taking supplements which contain 400 800 micrograms of folic acid during pregnancy which has been shown to reduce birth defects Office on Women s Health 2010 By following dietary recommendations and taking supplements the child is ensured the vital nutrients necessary to develop Table 2 3 details the recommended levels of nutrients and what foods provide them Table 2 3 Key Nutrients for You and Your Baby During Pregnancy American College of Obstetricians and Gynecologists 2010 Nutrient Dietary Reference Intake DRI Why You and Your Baby Need It Best Sources Calcium 1 000 milligrams Helps build strong bones and teeth Milk cheese yogurt sardines Iron 27 milligrams Helps red blood cells deliver oxygen to your baby Lean red meat dried beans and peas iron fortified cereals prune juice Vitamin A 770 micrograms Forms healthy skin and helps eyesight Helps with bone growth Carrots dark leafy greens sweet potatoes Vitamin C 85 milligrams Promotes healthy gums teeth and bones Helps your body absorb iron Citrus fruit broccoli tomatoes strawberries Vitamin D 200 international units some experts recommend 400 international units during pregnancy Helps build your baby s bones and teeth Sunlight exposure vitamin D fortified milk fatty fish such as salmon Vitamin B6 1 9 milligrams Helps form red blood cells Helps
91. ck and continue to use the application 2 7 Google Health One of our goals is to allow patients to capture their own health information and record it in a centralized repository that they can access online from any mobile device or computer and share it with their physicians and hospitals regardless of where they are Therefore we will be leveraging the Google Health platform to empower users to collect store and manage their own medical records online Patients can create their own Google Health profiles online and manage their medical information According to Google Google Health offers the following features Portability by establishing an online presence Google Health allows its users to access and manage their health data from anywhere Patients can import data from one medical facility and conveniently share this data with other facilities thus decreasing the time it takes to transfer this information This provides the user with flexibility in handling their own medical records and in choosing who they would like to share these records with Privacy and Security Google Health counts with privacy policies and practices developed by the Google Health Advisory Council that help protect the privacy of its users sensitive health information Platform Google embraces a platform strategy which means that the Google Health platform is built to allow interoperability with third party services and tools so that users can import
92. ctually be able to click through and follow along with us a little bit too This will maybe get you a better idea of how the application is going to work Rosal If we are doing things too fast or whatever feel free to stop us ok Jenkins Especially because it is a smaller group tonight we can actually go through a lot more D 1 Page Moore Any comment is helpful so feel free to you know interrupt Jenkins Try to speak kind of loudly know it is just us here but I m not sure how the microphone will work for us Also underneath this packet there is a little thing about vocabulary and a page showing you kind of what the main buttons are on our application know you guys probably aren t familiar with this specific kind of phone but on the bottom there are four soft key buttons It will say on your screen you know back menu home and search Those will work within the application like the back button will take you back one screen Basically the main menu there are 6 buttons there That s the different functionalities we are going to go through will show you how each of those works too And then there is the feedback home and help button We will kind of go through that too I m just trying to get you familiar with it Ok so the application overview As Tiffany kind of said there are guidelines for pregnancy weight gain We are not doctors and we didn t come up with these gui
93. cy tracking much like the previous applications mentioned as well as a day by day checklist and multimedia pictures and video Pregnancy Toolbar is a toolbar embedded in a web browser It has the ability to give access to a customized pregnancy calendar and other pregnancy information at all times with the ability to set the home page to a woman s related pregnancy information Overall these applications are fairly outdated as they do not offer as regular updates or as great of a feature set as the web based alternatives available 2 5 Existing Smart Phone Applications for Pregnancy There are a variety of pregnancy applications available for most smart phone operating systems namely on the iPhone BlackBerry and Android platforms We looked at a variety of alternatives currently available so that we can focus our efforts on features that are not fully developed or are more promising for this application It is important to understand what exists on each platform with special consideration for Android is the platform we have chosen to develop on Table 2 5 highlights the pregnancy applications currently available on each of the most popular smartphone platforms The data for these charts was based on searches of the respective application marketplaces based on a query of pregnancy Table 2 5 Applications Available Pertaining to Pregnancy uquery Androlib AppWorld 2010 Platform Total Applications Pregnancy Applications
94. d Guide includes dry beans and peas as a subgroup of the vegetable group and encourages their frequent consumption several cups a week as a vegetable selection But the Guide also indicates that dry beans and peas may be counted as part of the protein foods group How to count dry peas and beans in the Food Guide Dry beans and peas can be counted either as vegetables dry beans and peas subgroup or in the protein foods group Generally individuals who regularly eat meat poultry and fish would count dry beans and peas in the vegetable group Individuals who seldom eat meat poultry or fish vegetarians would count some of the dry beans and peas they eat protein foods group Here s how Count the number of ounce equivalents of all meat poultry fish eggs nuts and seeds eaten 1 Ifthe total is equal to or more than the suggested intake from the protein foods group which ranges from 2 ounce equivalents at 1000 calories to 7 ounce equivalents at 2800 calories and above then count any dry beans or peas eaten as part of the dry beans and peas subgroup in the vegetable group F 16 Page OR 2 Ifthe total is less than the suggested intake from the protein foods group then count any dry beans and peas eaten toward the suggested intake level until it is reached One fourth cup of cooked dry beans or peas counts as 1 ounce equivalent in the protein foods group After the suggested intake level in the protein foods group is rea
95. d and is equal or greater to 30 minutes most days Exercise during pregnancy offers many health benefits and you have done a great job meeting or exceeding the recommended minimum amount of exercise Keep it up Definition of Moderate intensity exercise Moderately intense exercises are those that increase your heart rate while you can still have a conversation If you measure your physical exertion on a 1 10 scale moderately intense exercise would bea 4 6 Tips Suggestions E 6 Page 30 minutes of moderate exercise on most days of the week is the recommended amount of exercise but you don t have to do all 30 minutes in one session For example you could go for 3 walks that are each 10 minutes long Be sure to follow your doctor s recommendations If you re just starting an exercise program be sure to start slowly and add 5 minutes per week until you re able to exercise for 30 minutes in a day You should be careful to avoid activities such as contact sports and scuba diving because they put your baby at an increased risk of harm You should also avoid gymnastics water and downhill skiing and horseback riding because they put you at an increased risk of falling Exercising should begin with a 5 10 minute warm up such as slow walking that includes stretching At the conclusion of your workout you should do a 5 10 minute cool down such as slow walking again Stretching after your workout will help you avoid sore muscles If
96. d feel We were able to use this to adjust our interface to accommodate both the experienced user as well as the novice user based on responses and criticisms as well as establish areas for future work We recorded these discussions to make sure we get every 44 Page comment from the participants and can relate those to the entry survey responses taking care to maintain anonymity of the participants Questions As a part of these focus groups we conducted an intake survey with the participants for basic demographic information The questions we asked in the surveys were brief and gave us an opportunity to understand the participants background which stuck to the essential points of our research We paid close attention the thinking involved by the participants as the discussion evolves throughout the course of the focus group allowing us to quantify the attributes they considered to be most important and arrive at themes of discussion we prioritized to continue development The intake survey included the following questions to gain basic demographic information We also included questions on cell phone ownership and use The last set of questions pertains to the participants health and standing as it is related to gestational weight gain and pregnancy These questions are important for us to understand who participated in the focus group which will influence how they perceive the application o Age o Race Ethnicity o Employment
97. d finish developing bones and sexual organs In addition to these developments the baby will prepare for life after birth by practicing breathing kicking grasping and even constricting the pupils in its eyes to react to changes in light After these final developments occur the baby will begin to rapidly gain weight and change its orientation for delivery Mayo clinic 2010 Fetal Growth From 8 to 40 Weeks Embryo Fetus at 8 at 12 Weeks Weeks Figure 2 4 Fetal Growth Health Mango 2010 Second Trimester of Pregnancy Health Mango 2010 2 2 1 Nutrition The key to a healthy pregnancy is proper nutrition By eating healthy and maintaining an active lifestyle a number of complications varying in intensity from anemia to miscarriage and stillbirth can be avoided American College of Obstetricians and Gynecologists 2010 p 241 While there are certain general dietary guidelines for the entire pregnancy each trimester has certain dietary recommendations 10 Page to help the baby develop properly The mypyramid gov site provides recommended dietary plans based on a woman s height pre pregnancy weight and exercise habits These factors helps create a plan to provide enough nutrition for a healthy pregnancy without resulting in excessive weight gain Your Pregnancy and Childbirth points out that while a pregnant woman is technically eating for two she should not be eating twice as much food American College of Obstetricians and Gy
98. d the foods you d want to add to your list Right now we don t have pictures in there yet but there will be a gallery of pictures of the different foods so you click on the food you want to select So it will give you calories fat just pretty basic information Rosal What are your thoughts about the information that is in there right now C am assuming you guys are just putting in random foods for things Jenkins The initial library is very small C So when I hit fruit get pizza that s what s supposed to happen The other thing is keep hitting submit on this screen and it s not going anywhere Is that supposed to happen Jenkins No not really What kind of confirmation what you like to see Would you like to see a confirmation that says this has been added to the list C Yeah I m not very computer savvy and need to be told with a popup that I ve done something right Rosal Because you re not very computer savvy we want your feedback What is it like when you go through it C Cause it says add foods below and press submit and hit submit and then nothing changes so don t know if it s gone through or not A You should have a spot just to be able to type in like chips or something so you don t have to go through all this stuff to be able to Jenkins Like a search A Yeah or a custom input because then you don t have to sit there and take the time to go through all the differe
99. d to the Internet at all times Hence the goal of our project is to design and develop a smartphone application that will help pregnant women during their prenatal stages to optimize their Gestational Weight Gain in order to promote improved health for both mother and child More specifically this application will help women keep track of their weight gain loss their level of physical activity and their nutrition all of which are factors that might influence their GWG The application will also provide them with feedback on whether they are gaining losing too much weight so that they can adjust their diet physical activity etc to get back on track In addition the application will be storing this information in an online repository 2 Page Google Health so that the users will always have this information readily available to them for personal use or to share with their physicians These features can significantly simplify the efforts of pregnant women to optimize their GWG as they will empower the users with the ability to better manage their own health Healthcare providers would be able to drastically reduce their costs and hospitals and clinics would be able to better allocate their time and other resources because part of the healthcare process would be delegated to the patient s self care through the use of mobile technology As mobile technology specifically smartphones becomes more widespread we believe that many of our da
100. d tools for free The most common areas covered by these websites are information about getting pregnant basic pregnancy information and labor birth information Most of this information is broken down into first second and third trimesters These portals also include photo slideshows newsletters fitness nutrition information and other health related information These resources also offer various tools women can use These include due date calculators ovulation calculators and pregnancy calendars Of these types of websites WebMD appears to be the most up to date and complete even offering expert blogs and a social community larger than most available The important aspect of these sites is that they are part of a larger commercial health company As a result of this the sites advertise very heavily While this may not affect the quality of information provided it does leave some question as to the slant the site is taking These sites do offer very credible information with content by real doctors The next type of pregnancy resources are websites that the government and organizations have put up in order to provide similar information as the name brand health resources Some of the most popular are pregnancy org womenshealth gov and americanpregnancy org The important difference between the mainstream name brand websites and these smaller organizations is funding Many of the pregnancy portals found on other sites advertise much m
101. delines but this application is supposed to help the patient to kind of you know manage weight better and keep track of different areas So there is the weight tracking which is the main goal of the application And there is food and activity tracking too This is supposed to help you its not supposed to replace your doctor obviously You are still supposed to go and establish goals although not necessarily for all pregnancies Alright this user interface we are trying to streamline a little bit just to make it easier for someone to use ideally on a daily basis because this sort of application you would go in and set reminders for yourself to you know input your food this certain time Brendan do you want to start the presentation Ok so the main menu screen here as you guys can see on the phone has 6 little pieces to this There is the weight food and activity tracking which are the buttons here Those are the things you actually input you know things into Your profile allows you to set up your profile like basically your age weight when you started and that sort of thing Progress will give you sort of idea of how well you are doing with a graph of your weight within the ranges Basically on this main screen it will show the overview with this smiley face This is very general but if you are within the ranges it will show a happy face right And if you are not within the ranges it will be like a little unhappy so it kind of gives
102. died research topic in the medical community of the process which has led to many guidelines to follow for a healthy pregnancy Findings of the research produced guidelines to achieve a healthy pregnancy One of the areas in which the medical community agrees upon certain guidelines is gestational weight gain GWG over the course of pregnancy The Institute of Medicine an independent non profit organization originally established under the National Academy of Sciences provides guidelines for health care providers on gestational weight gain which serves to recommend how much weight a woman should gain during her pregnancy The guidelines updated by the Institute of Medicine in 2009 are designed for health care providers working with their patients to help women avoid many potential birth defects and unhealthy pregnancies due to inappropriate weight gain and are based on evidence on relationships between weight gain patterns before during and after pregnancy and maternal and child health outcomes IOM NRC 2009 p 2 The Institute of Medicine guidelines provide a range of weights suitable for pregnant women to gain based on their pre pregnancy Body Mass Index BMI BMI is a number derived from a person s height and weight the Centers for Disease Control and Prevention say BMI is a reliable indicator of body fatness for most people Centers for Disease Control 2011 The IOM notes that a positive outcome can be 14 Page achieved over a
103. e S7 99 Blackberry 12 198 993 Free S69 99 Of those available these applications are primarily pregnancy information resources exercise tracking and nutritional tracking By looking at applications that offer each of these different functionalities we can compare them and take various ideas into consideration for the design of our application Table 2 7 highlights the top applications currently available on the Android Market in each of those three criteria pertaining to weight gain management during pregnancy based on the best reviewed and downloaded applications available at this time 21 Page Table 2 7 Table of Basic Information for Top Rated and Downloaded Alternative Applications Androlib 2010 Title Developer Date Published Price Downloads Estimated Functionality Pregnancy Assitant Dzieciowo mi 2010 Free 50 000 250 000 e Fetal development tracking e Information about stages of pregnancy with photos e Average weight and height of baby with descriptions of development e Countdown to due date CardioTrainer WorkSmart Labs Inc 2010 Free 3 460 014 e GPA Tracking e Pedometer e Voice Notifications e Music Integration e Recording Feature e Social Networking Calorie Counter MyFitnessPal 2009 Free 676 506 e Mobile version of MyFitnessPal com e Social networking e Food and exercise tracking e Progress Tracking e Access to large
104. e are all on facebook but it would be cool to look and see these kind of tips to keep you coming back daily You want to kow what it says D 11 Page Rosal What other type of health information would you want to see or would be helpful 1 Maybe what types of foods are bad to eat know you aren t supposed to eat some things like certain fish or cheeses or something like that Jenkins Not just good foods but also the bad foods 2 Yeah like foods you should avoid Rosal What else about foods would you want to know 3 think a good thing to add would be beverages and to be able to track that type of thing Suggary caffeinated things that aren t too good for pregnancy Something like that so if you are putting in too many bad drinks it will be able to tell you Maybe even make recommendations to try different things A lot of websites say stuff like try a water and throw an orange slice in there Smoothies and that sort of thing too Rosal So specific recommendations about healthy diet including beverages to make it healthier 1 Or even substitutes Rosal Oh yes great ideas 1 Then what happens when you get to the 40 week of pregnancy then what happens with this application Jenkins So all this information will be uploaded to Google Health which is online and you can share that with your doctor Basically you will be able to see overall how you did What would you like to see after 2 Does the app have a w
105. e baby grows information like that Jenkins This focus group is specifically focuses on the user interface but that is definitely part of it Like you can see there is the little week 6 the baby is developing something That is going to show up in the reminders as well so like it would pop up week 7 your baby is growing bones but they are not hardened yet you should eat some more broccoli you haven t had that many vegetables this week That sort of thing liked your comment about the looking ahead in pregnancy Rosal Other comments Jenkins What do you guys think of the overall navigation or how you go through the pages of the application Does that seem straightforward 3 Yeah seems pretty straightforward Jenkins Anything you didn t like about it really Rosal What would you like to see differently 2 I m wondering when you do the weight is there a way when you go to input it and there are pounds and kilograms is there a way for just the numbers to come up versus the full keyboard You click on this and you don t even get the numbers you get the full keyboard instead don t know if that s possible Jenkins Let s go back to the main menu so that we can take a look at it again As far as the actual appearance of the screens like the icons for instance does the design explain how it works Is there any better way you think we could do it Rosal What do you interpret How do you interpret those bu
106. e design of the User Interface UI design of the application There were two groups conducted at UMass Memorial Medical Center 76 Page One group on 12 6 10 from 6 00pm 7 30pm One group on 12 8 10 from 3 00pm 4 30pm The participants for the groups were recruited to be pregnant women and English speaking The focus group discussions lasted approximately 90 minutes see appendix Appendix D for the full transcripts of the focus groups Participants were asked to complete an entry survey for demographic information The initial discussion covered general background of weight gain guidelines during pregnancy and an introduction to smartphone applications and key vocabulary that would be used during the discussion Participants were given demo phones with the application on it and were asked to follow along to a presentation of the application that was focused on particular aspects of the UI Both groups were shown the same material Summary of Focus Group Demographics The two focus groups consisted of a total of 9 pregnant women ranging in age from 19 31 The women were in their 11th 38th week of pregnancy The following races were represented black 1 white 7 and Asian 1 One participant did not report her race and another reported white and Asian Two participants identified themselves as being Hispanic Latina five identified themselves as not Hispanic Latina and the remaining two participants did not respond All participants report
107. e of questions for you to answer if you feel comfortable with answering them If you have any questions medically related or otherwise please feel free to talk to me and or your doctor There will be one other person joining us her name is Milagros Rosal Jenkins In the packet of information we will give you a phone to play with the application So here is kind of a quick explanation of what buttons are We will go through a presentation when we get started Moore We ve loaded the program up on the phone so you can click through and play with it during the focus group A are these the Droid s Jenkins They are the original Droid guess we ll get started fire alarm A Can you find this on the Android Market Jenkins No we re just developing it Eventually we hope it will be up Moore We re in the pre beta phase A Are you planning on having it free Or charge for it Jenkins We have no idea yet this is a UMASS thing We will see what happens when we finish the app think we can start now that the fire alarm is finally done My name is Tom Jenkins this is my group we are working on this project We are not doctors but we are working with Tiffany and Milagros to develop this application We just want to reiterate that this is being recorded so try and keep your voices up when you talk just so we get everything Also anything you have to say we want to hear anything good or bad you re not going to hurt ou
108. e that You should probably go ahead and eat some more So that s kind of why we are tracking these things And now we are going to look at the food input screens now This is a little more complicated and it requires a little more effort but we are trying to streamline this a little bit more This screen is split up into meals You would click the select meal type button right there and when you click that it will open up a dialog box that will say breakfast lunch dinner or snack Then you pick one of those and then click continue It will open up a dialog box with your most popular foods you have had for that specific meal If none of those are there you can select additional food types by clicking more We have split it up into different categories so within each category let s say we pick potato We don t have pictures up yet but then there would be pictures of the food you would pick so you would click the picture and it would give you information like caloric intake that sort of thing You would add that to your list of foods and then at the end on that main screen of the food input there will be a list of the selected foods So when you are done with the list of foods for that specific meal you would click submit Obviously there are fair amount of things to add to this over time so we have developed a reminders part of this which will allow you to set times where it will remind you when to input food information when to input you weig
109. e the need into a solution that produces the most value Agile development has evolved into different methods over time including Extreme Programming XP Scrum Agile Unified Process and Agile Modeling France Rumpe amp Turk 2003 While all of these different methodologies share the basic tenets of the Agile Manifesto they all differ in some logistical ways It is important to understand that the performance measurement of the project is primarily based on a working final product While the overall agile development plan is very flexible it is not without a plan Cockburn amp Highsmith 2001 The reason for this flexibility is to allow the team to adapt to potential problems or changes in requirements of the project Among the various agile development methodologies we have decided to choose scrum and the next section explains our reasons for doing so 34 Page 3 3 1 Scrum Scrum development is a form of agile development that splits up the final product into incremental pieces Using this method each module of the final application is split up into short sprints of development Each sprint lasts from 1 4 weeks depending on the project timeline A scrum project consists of 3 roles 3 main artifacts and 3 main meetings We will go over each of these in the following sections a Roles The three roles that come into play at a scrum project are the product owner the scrum master and the team The product owner r
110. ed having graduated high school or attained a GED Five participants reported graduating college while three reported they had either attended or were attending some college Five Participants reported their employment status as unemployed but looking for work three of these participants also reported being students Three participants reported being employed two full time and one part time The remaining participant reported their employment status as being a housewife All participants reported owning a 77 Page cell phone that included phones manufactured by LG Samsung RIM Blackberry and Apple iPhone Seven of the participants reported having used an application on a mobile device such as a cell phone or an iPod while two did not Table 5 1 presents the reported cellphone usage among participants Table 5 1 Survey participants cellphone usage Cell Phone Uses Participants Making Phone Calls 9 Text Messaging Applications Scheduling Calendar Browsing the Internet Send Receiving Email Multimedia such as watching videos or listening to music WAI NIN a oO Eight of the participants reported their doctor had talked to them about the amount of weight that would be healthy for them to gain Seven of the participants reported that they had never used a program to help monitor their weight diet or physical activity Seven of the participants reported that they knew their ideal weight when n
111. ed to searching for them by picture f Preferred Methods of Receiving Reminders and Information The participants expressed a desire to receive reminders and updates outside of the application but would like to be able to customize if they were email or text message reminders Some examples of what the participants would like to receive a message updating them on their weight gain whether they are on track and a message announcing they have reached a milestone such as the end of the first trimester g General Suggestions e On the weight input screen when the onscreen keyboard appears it should only provide numbers not letters e Does the application adjust if the user is carrying multiples e One participant wants feedback from the application when something is submitted e g the user enters a meal for the day and submits it she wants a dialog saying the information was submitted e Include a notes section where the user could enter whatever she desired A sample use of this would be so the information could later be shared with the doctor e g noting what days the user got sick e One participant would like for the application connect to a forum or chat room to be able to talk to other pregnant women The Information button should contain the following information e How to easily delete inputs an example use is if the user entered too many items for a meal e How to modify an input an example use is if the user accidentall
112. ed two more sprints The team also decided to carry out a number of interviews to gather more qualitative data on the usability of the application The interviews were conducted on February 23 2011 Our goal was to finish building the product by February 18 so that we could have a finalized version to use during the user interviews While waiting for IRB approval for the interviews the team focused on writing the documentation and the rest of the term paper Sprint 4 January 17 January 28 Sprint backlog Feedback component Google Health component Information library 49 Page The team met with the customers to obtain more information and guidelines on providing feedback on nutrition based on calorific intake and the type of food The team developed flowcharts to describe how we envisioned the feedback engine to work and presented them to the customers for feedback The customers then provided us with more information and guidelines as to how the feedback engine should work The development team then used this information to build the feedback engine The research team started compiling the information library and drafting the first three chapters of the term paper Sprint 5 January 29 February 18 Sprint backlog Feedback component Information library During this sprint the team finished developing the feedback component and focused on finishing the information library and polishing the application UI We also cond
113. elopment of very complex and highly structured software systems Rapid application development RAD methodologies focus on developing some part of the system quickly and delivering it to the customer for more timely feedback This allows analysts to interact more with the customer and better understand and anticipate the customer s needs However RAD methodologies still need some level of modeling diagramming and documentation in order to get development started but the development speed for software systems is higher than structured methodologies Agile development methodologies eliminate much of the SDLC overhead by removing the modeling and documentation tasks and focus on simple iterative application development That is the project is split into several small incremental iterations that will add up to the final product After each iteration the customer and the analysts get together to determine where the project currently stands and whether modifications need to be made These methodologies therefore are more flexible in allowing the customer to add change modify the requirements of the system and in allowing the developers and analysts to adjust the project to accommodate these changes Because development 32 Page starts in the early stages of the project the project can be completed a lot faster than if the team were employing structured or RAD methodologies 3 2 Methodology Selection In determining the methodolog
114. ements oh got my bank statement and then don t open it for 3 days But I m just lazy that s just me Jenkins a lot of you use online things You use that Facebook thing that sends you weekly information Does that seem like something you would want in this as well A Maybe a countdown to your due date know there is a website called am Pregnant You put in your due date and it comes up with what week you are what your trimester you are how many weeks until next trimester and how many days until your due date Then it has a picture of the baby for that month Like it will have the blocks of the week and the picture of the baby Jenkins What kind of tips or things would you want to get out of this application You were talking about the baby book and having that information What kind of things would you want to know C suppose if you have something telling you what vitamins you ve been good at taking say if I m not eating enough iron It gives a suggestion that eat spinach with dinner that night Not telling me what to eat a suggestion that might want to think about a leafy green with my chicken A You can think about it C Something like that if you do start tracking vitamins and minerals that it tells you re overdoing on calcium but you re not getting enough vitamin D A The vitamins that are hard to get Prenatal vitamins make a lot of people sick so a lot of people don t take them know a
115. en To return to the Home Screen press the Home button at the bottom right of the screen C 4 Page 4 Creating a New Reminder 1 Press the Add Reminder button Add Reminder 2 Select days by pressing the corresponding check box 3 Press Select Time button Select Time 4 Select a Time with the and AM PM buttons 5 Press Set button 6 Press Ok button Ok 7 New Reminder Appears in list Editing an Existing Reminder 1 Press and hold a reminder on the list Reminders Mon Wed Fri 2 Select Modify Reminder from the menu 2 Select days by pressing the corresponding check box Sunday Monday E vJ 3 Press Select Time button A Select Time 4 Select a Time with the and AM PM buttons 5 Press Set button 6 Press Ok button 7 Changes appear in list Removing an Existing Reminder 1 Press and hold a reminder on the list Reminders Mon Wed Fri 2 Select Delete Reminder from the menu C 5 Page 5 The Weight Screen Overview Screen Description Bar Weight Tab Quick Overview Recommended Minimum Weigh Toggle Baby Facts Screen Information Button Feedback Button BM e 6 27 pm Details Tab Input Tab Your Status Indicator Recommended Maximum We
116. ent that will lead to better healthcare in the future 5 3 2 Limitations Like any tool our application is only as good as the person using it Although our application is based around the idea of enhancing patient centered healthcare it requires accurate information to do so If users fail to provide accurate information or do not provide enough information then the application will be unable to provide meaningful feedback and may actually provide feedback or advice that is wrong 89 Page The purpose of our application is meant to guide pregnant women in making healthy decisions during their pregnancy regarding their weight gain nutrition and physical fitness However it is not meant to serve as a replacement or substitute for visits with doctors or other medical personnel Each patient is a unique case with a unique medical record that needs to be considered when medical decisions are made Due to the confidential and complex nature of these medical records it is impractical to import them into the application which makes it extremely difficult for the application to make a wholly informed medical decision Our information and feedback is based on facts which are accepted by the medical community however anything that our application recommends should also be discussed with the patients doctor It is also important to note that the information that is stored in the application is only valid for a single fetus pregnancy since multiple fe
117. epresents the customer s interests and is responsible for communicating these interests to the team in the form of product requirements The product owner is also responsible for maintaining this list of requirements which often changes and making sure the team is aware of changes to the product backlog The scrum master is responsible for managing the scrum process meaning that the scrum master makes sure that the team remains focused and does not fall behind in its development endeavors by measuring the progress and removing impediments The scrum master helps the product owner and the team to negotiate the sprint backlog for each sprint The scrum master also leads team meetings acting as a liaison between the product owner and the development team and works on the product as well The team is responsible for completing the tasks in the product backlog The team usually consists of 7 9 cross functional members including software engineers programmers QA experts 35 Page testers Ul designers and architects The team is also responsible for managing themselves and determining how it will accomplish its tasks b Artifacts The three main artifacts in a scrum project are the product backlog the sprint backlog and the sprint burn down chart The product backlog is a dynamic list of high level requirements ordered by priority Items with the highest priority are completed first The list usually changes as items are added o
118. erview Tab Please input your meal Select Meal Type Breakfast Meal Menu Button Continue Continue Button Toggle Baby Facts ext Baby Fact Screen Information Button Screen Help Button Feedback Button Home Button The activity input screen is where you can input a new activity reading In addition to inputting activity readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Inputting a Nutrition Reading 1 Press the meal menu Select Meal Type 2 Select the meal from the menu 3 Press Continue button Continue 4 Press the Add Food button C 14 Page 5 Select the category of the food from the menu Vegetables Fruits Dairy Meats Poultry 6 Select the food that best resembles your food from the gallery 7 Enter the number of Servings Number of Servings 8 Press OK 9 Repeat Steps 4 8 until all foods have been selected To delete an entry press and hold it 10 Press the submit button Submit 11 A confirmation message will display C 15 Page 8 The Profile Screen Screen Description Bar Information Tab Toggle Baby Facts Screen Info
119. ess 23 27 Google Klee eege Ee 26 2 8 PAM E 27 29 SUMMA iniaa evadenstecetaie cae accwandennceectoetens bate begesh cveouberdbage a SE AERE e EO E aaa OAE EA AEAEE Aaa 30 DN age e TE EN 3 1 Software Development Life EE iuestesiue gg e e keete Eege 31 3 2 Methodology Selection EE 33 3 3 Agile Development Methodologie 33 ES DN ME Tu peveaieaed ladedeisndon redid E E 35 332 BEIER peausagetaemiesctas sbeuauunea deer 37 E SUMMA Y isein aeaiaioe aa a nade cdsabangtc ne aaa aa ao aia cane ddsavenwugeateadcede 54 4 System architecture and implementation EE 55 4 1 Android development environment cccccesssececessseececseaaececssueeeceeseneeceeseaaeeeeseaeeeeeeseneeeeesenaes 55 4 1 1 Model View Controller Pattern sssssssesssssssesssrrssreessssressserrrsstrssrenstenstensetessernssresstensereseensnte 55 vii Page 6 7 41 2 ele RE 56 Ge Android ACUVINES EE 57 ALA Other Android components 2 ciiesi essai sisi ee EES 58 AD System ASSIS Nre annn aa laecouaeyaderases a weld dase a a abarscevedesesuzstendeeeidgedeleleseat 59 ADT FECADACK CNEING eors eirete nane n aiea EEE a AEE T TE EA E O E IREN 59 4 2 2 Google Health CEN ste ege See E e a ahaa so va bs a A Gees eege ee Eaa aNs 59 42 34 Database componenten EE EE 61 4 2 4 Weight tracking Activity tracking and Nutrition tracking components 62 4 25 Reminders component onnaa aa a a a a a a a A a 62 4 2 6 Information library ccccccccccccessesse
120. eter 1 cup sections Mixed fruit fruit cocktail 1 cup diced or sliced raw or canned 1 snack container 4 oz drained drained 3 8 cup Orange 1 large 3 1 16 diameter 1 small 2 3 8 diameter 1 cup sections Orange mandarin bh cup canned drained Peach 1 large 2 34 diameter 1 small 2 diameter 1 cup sliced or diced raw cooked or 1 snack container 4 oz canned drained drained 3 8 cup 2 halves canned F 10 Page Pear 1 medium pear 2 5 per lb 1 snack container 4 oz drained 3 8 cup 1 cup sliced or diced raw cooked or canned drained 1 cup sliced raw or cooked 3 medium or 2 large plums 1 large plum Watermelon 1 small wedge 1 thick 6 melon balls 1 cup diced or balls 100 fruit juice orange 1 cup 14 cup apple grape grapefruit etc What foods are included in the dairy group All fluid milk products and many foods made from milk are considered part of this food group Foods made from milk that retain their calcium content are part of the group while foods made from milk that have little to no calcium such as cream cheese cream and butter are not Most dairy group choices should be fat free or low fat Some commonly eaten choices in the dairy group are Milk Cheese All fluid milk Hard natural cheeses fat free skim cheddar low fat 1 mozzarella reduced fat 2 Swiss F 11 Page whole milk flavored milks chocolate st
121. ews display information on the screen and is comprised of all the user interface UI elements The controllers respond to user inputs and actions and instruct the model or the view to change their states or properties accordingly Figure 4 1 depicts the structural relationship between the three layers Figure 4 1 MVC Pattern Source Microsoft 2011 4 1 2 Android MVC In Android the programming model is similar to MVC Android application development is centered on views and activities The model or the application domain is represented through Java classes These classes maintain information about our business or application entities such as a Food Category The views represent the user interface layer which displays information for the user and allows the user to interact with the application Views in Android are implemented as layouts which are XML files that define the different UI elements in the view and their properties such as height and width Activities are the equivalent of controllers from the MVC pattern An activity contains logic that displays the views and reacts to user input or actions that change the model or the view Each activity is given a window which it can fill with a view Because activities are the main components in Android we will go over them in a little more detail in the next section 56 Page 4 1 3 Android Activities As mentioned before the activity is the component that listens to
122. f health for them and their children Through close support and collaboration with Dr Tiffany Moore Simas and Dr Milagros Rosal of UMass Medical School we were able to design develop and implement the Mom O Meter smartphone application Because of the timeframe of this project we were forced to limit our scope to include essential functionality and content specific to gestational weight gain Throughout development we concluded there is significant future development that would take this application from a gestational weight gain specific tool to a full featured pregnancy application This section summarizes the changes that we have implemented based the feedback we received based on the focus group sessions and interviews This chapter also serves to summarize the results of the various other aspects of the project such as discussion of results bugs and limitations of the application implications and overall recommendations 5 1 User Interface Design The Graphical User Interface GUI of our application went through a number of revisions before the final layout was accepted Our first version illustrated in Figure 5 1 and Figure 5 2 was our initial proof of concept and our first attempt at making a UI utilizing Android technology Our purpose with this design was to break down the application into manageable segments and establish menu hierarchy One of the major things we decided on in this phase was to implement the six button home sc
123. feedback on Basically on the input for activity here you are going to pick your standing or your sedentary activities We are trying to balance those two So you would go ahead and pick standing for instance and then you click select activities and there are list of activities If you click select activity a dialog box will pop up and you can select the activity and then when you submit it adds it to your thing The different screens have kind of similar input screens If we can go back we can see the weight input screen The weight input screen is basically the same idea you have a box that you add the weight to and submit that Rosal Do you know what inputs are Do you know what input screens are Jenkins Yeah these are things that you are going to give the application You are going to tell it you know these specific types of information Rosal You are going to type it in Jenkins Yeah you are actually going to type in the box The rest of this application will show you things So let s go back to the Rosal Are you going to talk about what types of things are in the application Jenkins Yes so the weight input is the most basic type of input You just put your weight at a certain time and submit that and it will sync The activity input is a little more complicated Like said before you have to pick what type of activity standing or sitting activities your active times and your sedentary times When you click on those l
124. ft Getting Information To get more information about reminders press the info button at the bottom of the screen Getting Help In order to get help with creating editing or removing a reminder press the help button on the bottom bar Returning to the Home Screen To return to the Home Screen press the Home button at the bottom right of the screen Details BM G 5 08 pm Screen Description Bar Mom o Meter Details Tab Input Tab Overview Tab Overview Calories ime Frame Menu Button Average Daily Consumption by Week Calorie Reading Week of Pregnancy Toggle Baby Facts Screen Information Button Screen Help Button Feedback Button Home Button The Activity Details screen is where you can see a detailed graph of your activity break down over time A color key is located to the right of the graph In addition to graphing your activity readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished C 13 Page Changing the Time Frame 1 Press the Time Frame Menu Button Time Frame ee 2 Select the desired time frame from the menu All Weeks Week 1 Week 2 Input Screen Description Bar Details Tab Input Tab Ov
125. ge A Less invasive Jenkins The sun in the middle is not really scoring how you do on this but it s very loose are you within your boundaries A So if we re doing bad it s going to have a sad face Jenkins It will have a little bit of an unhappy face not a sad face Rosal What would you like to see C maybe wouldn t want that on the opening screen A It would make me feel bad C wouldn t want that yelling at me A wouldn t want to open it Rosal Maybe not as up front C Maybe a little farther into it so if someone picks up my phone and says oh what s this oh I m doing terribly don t really need my mom to see that Rosal So a matter of privacy Jenkins How would you like to see how you re doing C Your graphs that are on the activity and food page seem to be Jenkins There s a line graph too on the details page that we didn t go over C You already have that measurement within the app I m not sure need an icon on the front to tell me how Um doing Harris Is there anything you d like to see in place of that Jenkins Or in general C If you want to keep the smiley face sun and not have it change that would be fine D like the smiley face if I m doing bad want it to tell me I m doing bad Not a lot of people tell me if I m overweight or So if open the phone and it has a sad face it will let me know I should be walking or eating less Jenkins
126. gnancy is no exception As previously mentioned many of the pregnancy sites online today have social networking in their repertoire of features Some are larger than others and differ in content but they allow women to ask questions and support each other Many of these pregnancy websites are also connected to more mainstream social networking sites such as Facebook and Twitter mostly for content updates The real difference between the pregnancy social networks is the size of the community and the contributors themselves For example WebMD s community has expert contributors in addition to the rest of the community participating in discussions Smaller sites may not have the ability to have medical professionals regularly posting or even as large of a user base in general 2 4 3 Applications There are also a variety of standalone software applications available for women These applications have been overshadowed by online resources especially as most if not all of the tools are available without installing any additional software and in many cases without charge A majority of 19 Page the applications available are pregnancy counters calendars such as Pregnancy Count pregnancycount com Free and Pregnancy Calculator www onelife2care com 18 Other applications offer an extended feature set such as Pregnancy Planner www pregnacy org uk Free and Pregnancy Toolbar www pregnancytoolbar com Free Pregnancy Planner offers pregnan
127. he application e Database setup whether the database for the application has been setup e Starting date the date the user first started to use the application e Google Health account the Google account and the Google Health profile associated with the application b SQLite Database In order to store more complex data in the application we made use of SQLite database With the power of SQL we were able to perform complex queries and calculations with the data we obtained from the user Later in the chapter we will go over the database model we designed for the application which will list all the tables their properties primary keys and relationships 61 Page 4 2 4 Weight tracking Activity tracking and Nutrition tracking components These components are used to record input data such as weight physical activity and food intake data from the user and store this data in the database The weigh component also retrieves data from the database and passes this data to the feedback engine to generate feedback for the user 4 2 5 Reminders component The reminders component allows the user to create and manage reminders and notifications to record their wellness data For example the user can set up a weekly reminder to record her weight so that the application can keep track of her Gestational Weight Gain and provide feedback on whether the amount of weight is appropriate As mentioned before the reminders make use of broadca
128. he oils I eat The chart gives a quick guide to the amount of oils in some common foods Amount Amount of Calories from Total calories of food oil oil Teaspoons Approximate Approximate rams calories calories S Vegetable oils such as 1Tbsp 3tsp 14g 120 120 canola corn cottonseed olive peanut safflower soybean and sunflower Margarine soft trans fat free i Tbsp 2 tsp 11 We S g Mayonnaise type salad i Tbsp itsp 5 g Hs ig Thousand Island dressing P Tbsp 2 tsp 11 f i 8 Avocado Il med 3 tsp 15 g EI 160 Peanuts dry roasted 1 OZ E tsp 14 120 1165 Cashews dry roasted 1 OZ E tsp 13 g RE 1165 Hazelnuts Dos l4tsp 18g 160 185 Avocados are part of the fruit group nuts and seeds are part of the protein foods group F 20 Page What are discretionary calories You need a certain number of calories to keep your body functioning and provide energy for physical activities Think of the calories you need for energy like money you have to spend Each person has a total calorie budget This budget can be divided into essentials and extras With a financial budget the essentials are items like rent and food The extras are things like movies and vacations In a calorie budget the essentials are the minimum calories required to meet your nutrient needs By selecting the lowest fat and no sugar added
129. he team The scrum master also acted as a liaison between the product owners and the team organized the items from the product backlog into the sprint backlogs for each sprint and assessed the team s development work through weekly reports Team members Given that our team consisted of only five people each of the team members assumed 1 or more development roles Application development team The application development team was in charge of coding the application and its core components as well as writing out unit tests to test out the individual components Ken Miyauchi software engineer QA engineer Michael Ng architect software engineer Brendan Harris tester QA engineer UI design and content management The user interface design team was in charge of laying out all the user interface elements of the application and designing the look and feel of each individual screen and generating all the feedback content for the application through research 38 Page Evan Duderewicz UI designer content manager Thomas Jenkins Ul designer content manager Artifacts Next we look at the product backlog for the project These components were designed to deliver the functionality we agreed upon with the customer For details on the system request and specifications please refer to appendix Appendix A 1 Android Application UI component This component consists of all the screens and UI elements that the u
130. ht that sort of thing This screen is split up into 3 tabs for the 3 different things we are tracking so like for weight we will see the reminders that you want 12am Monday Tuesday etc to remind you to enter your weight Or you click on the activity tab and it would have reminders for that Basically they all work the same as far as adding the times as well as the days you want to be reminded for that specific thing You check the boxes and then you would select the times on those days you would want to have it to ask you to input things Do you guys have any questions on the input screens know this is kind of a lot but we are trying to get you more familiar with it Feel free to ask us anything Rosal What questions do you have so far Or what comments Jenkins Anything like it is maybe overwhelming 1 think this is a good idea Ive always gone to babygaga com to find out things like how much weight to gain think this is a good idea Jenkins Yes this is also more customizable Rosal So what do you like about where you go 1 Um like that it tells you like how much weight the baby gains and like how or what your eating does for the baby stuff like that Rosal So you would like baby weight information in addition to your weight information Would that be helpful 1 Yeah D 4 Page Rosal Anything else that you think would be valuable to add to what you have seen so far 1 Maybe like more information about how th
131. ht gain on a graph Rosal How would you like to see it D 7 Page Jenkins What would be easier for you look at and understand 3 think what would almost be a good idea based on my experience is almost when you are inputting your data to begin with and you ask what your ideal weight is its almost like a graph that would show you under or over so that you have a comparison to know because mean you might see a steady incline but is it too rapid of an incline or are you falling off at the beginning Things like that Rosal So you would like the see the comparison You would like to see the data and then the comparison 3 Yeah Moore Simas You know some people like graphs and others do not so you know are there other ways other people might want to see that Are there other ways of representing that better or more to you Rosal What type of graphs would you like 2 Like a line graph or a bar graph 1 A line graph would be easy to look at Jenkins If you were to click on weight for instance would you like the first screen to be the line graph 1 wouldn t because know that would be gaining too much so don t know how would want that Moore Simas That s a good point part of this is about getting feedback right So if you are gaining the right amount your phone would say something like Oh great you are going a great job But what if you were not following the ranges and gaining too much how would yo
132. ical Center Email TiffanyA MooreSimas umassmemorial org Name Milagros C Rosal Ph D Department of Medicine Associate Professor Division of Preventive and Behavioral Medicine Organization Umass Medical Center Email Milagros Rosal umassmed edu Business Need To empower patients with the ability to better and more effectively manage their gestational weight gain Functionality Record daily physical activity data A 1 Page Record daily diet information Record weight Daily Reminders Alerts Feedback on weight gain exercise levels and diet Personal goal tracking and management Interface with Google Health Provide information about pregnancy Utilize Android platform Expected Value By allowing patients to take matters into their own hands and better manage their gestational weight gain both patients and hospitals save time and resources since the patients make fewer trips to the hospital Moreover patients could attain a higher quality of life as the application will help them with dietary recommendations reminders to exercise and to weigh themselves and ubiquitous access to information about having a healthy pregnancy in general This would also lead to lower insurance premiums for the patients and further improve their living conditions for themselves and their children Clients get portable access to information about Pregnancy Higher quality of life Dietary recommendations Reminders to keep active Improved treatment op
133. ight ext Baby Fact Screen Help Button Home Button The overview screen provides a brief summary of your current weight and weight gain goals This is expressed through the combination of the quick overview bar and your status indicator Your status indicator will be closer to the green end if you are doing well at following your goals and closer to the red if you are having difficulty In addition to displaying your weight gain overview at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Navigation Changing Tabs In order to access other tabs press the desired tab Getting Feedback In order to access feedback on your reminders press the feedback button on the bottom left Getting Information To get more information about reminders press the info button at the bottom of the screen Getting Help In order to get help with creating editing or removing a reminder press the help button on the bottom bar C 6 Page Returning to the Home Screen To return to the Home Screen press the Home button at the bottom right of the screen Details Screen Description Bar Weight Tab Weight Display Box Weight Toggle Baby Facts Screen Information Button Feedback But
134. ily activities will be performed through interactions with our smartphones This is also true of self care Many healthcare providers will jump onto the mobile bandwagon to realize the potential savings and efficiencies by having users take matters into their own hands through the use of their smartphones As we move forward into the next decade mobile technology will play an essential role in revolutionizing the healthcare industry The next chapter will provide background information on various topics of importance to our project Chapter three will explain how we approached both the research and software development aspects of the project by flushing out the details about the methodologies we employed Chapter four will go over the details of the system architecture and the implementation of the application Chapter five will present our findings and results regarding how the system can help women optimize their GWG and explain in detail the features and functionalities of the software system we developed Finally Chapter six will provide our conclusions and recommendations 3 Page 2 Literature Review 2 1 1 Mobile Technologies in Healthcare Mobile devices have become ubiquitous in today s society Projections in 2002 speculated that more people were expected to access the internet from a mobile device more than from traditional desktop computers Beaulieu 2002 According to more recent studies in 2009 32 of the American population
135. ins We re open to suggestions give us anything you ve got C didn t know how that difficult would be Moore Pretend this is all the easiest thing this is pie in the sky so easy they could do it by snapping their fingers What would you want it to look like What would you want it to be different C want to be able to find an icon or a background that like and be able to input it from my computer Like the way do on my own phone the picture I have on it is something downloaded from the web It s not part of the phone if could do that with that Rosal One of the things we discussed is how you would want reminders sent to you Reminders related to entering information reminders to look at where your baby is at whatever the reminder might be was wondering what you feel or whether you have used any internet websites related to the baby or the pregnant woman Not every woman uses websites D 32 Page E use baby center online Jenkins What information do you use or like from it E The weekly updates A It s basically the same thing showed you Jenkins Little overview A E Yes Rosal Sounds like most of you find that very helpful the weekly updates Do you text E Yes would probably want a text message sent to remind me Rosal What type of plan do you have for texting Are you able to text unlimitly E Yes Jenkins As far as the overall appearance do you have any color schemes or anything
136. ion Focus Groups C Term Conclusions Paper Sprint 4 Feedback Engine Information Library Sprint 5 Ul Polishing Bug fixes Presentation Poster Interviews Presentation B 4 Page 16 75 days 14 days 14 days 14 days 14 days 1 day 1 day 1 day 1 day 1 day 1 day 1 day 1 day 14 days 2 days 37 days 37 days 11 days 11 days 11 days 23 days 23 days 23 days 1 day 1 day 37 days Wed 11 2410 Mon 11 29 10 Mon 11 2940 Mon 11 2940 Mon 11 2940 Wed 11 2410 Wed 11 2410 Wed 11 2410 Wed 11 2440 Wed 11 2410 Wed 11 2410 Wed 11 2410 Wed 11 2410 Mon 11 2940 Fri 124040 Thu 1 13 11 Thu 1 43 11 Thu 1 13 41 Thu 143411 Thu 113414 Mon 1 31 11 Mon 1 31 11 Mon 1 31 14 Mon 2 28 14 Wed 2 23 11 Thu 1 43 11 Thu 12 1610 Thu 12 4610 Thu 124640 Thu 124640 Thu 124640 Thu 11 2510 Thu 11 2540 Thu 11 2510 Thu 11 2540 Thu 11 2510 Thu 11 2510 Thu 11 2540 Thu 11 25 10 Thu 124640 Mon 12 4340 Fri 3 4 11 Fri 3 4 11 Thu 1 27 11 Thu 1 27 14 Thu 1 27 14 Wed 3 2 11 Wed 3 2 11 Wed 3 2 11 Mon 2 28 11 Wed 2 2311 Fri 3 4 14 62 67 hrs 26 67 hrs 10 hrs S hrs S hrs 16 hrs 2hrs 2hrs 2 hrs 2hrs 2 hrs 2 hrs 2hrs 10 hrs 6 hrs 180 hrs 100 hrs 30 hrs 20 hrs 10 hrs 25 hrs 20 hrs Shrs 10 hrs 9hrs 6 hrs Sprint ill 11 2 12 16
137. iples Would there be a difference Rosal Yes there would be a difference The recommendations for multiples are much different Moore Simas Presumably you are pregnant the second time and think what you are saying is D 9 Page 2 Like the weight gain is always different Moore Simas Yeah it is always different but if there is recommendations for a certain amount of weight regardless of your past history Harris So one of our concerns going forward is getting this message on your phone like what are you telling me to do and they are going to throw it against the wall and not listen to it anymore So is there anything we should definitely not do 4 If you are going to use it you know what you are looking for and you know what it is going to turn out to be so it should get irritated if you choose to use it 3 Yeah as long as the sun doesn t turn into a little devil with horns you know spitting fire at you Rosal What types of things would make someone want to use this type of information 4 Stay healthy Rosal Anything else 1 Well I m on my phone daily so it would help me out because would be looking at it all day Rosal So just seeing it all the time would help you 1 Yeah like where my house computer isn t with me my phone is so can just look at it Moore Simas Several of you mentioned getting on a computer based program to sort of help you throughtout pregnancy What is it about those that yo
138. ittle radio buttons click select activity it will come up with a list of things that are active things like walking swimming you know that sort of thing And if you pick sedentary it would be like you know watching TV sleeping that sort of thing Then you just pick a duration and submit that Oh yeah go ahead and try it You guys can go ahead and give it a try will catch her up really quick 1 Can you jump ahead till how many weeks pregnant Jenkins It knows when you start it so it keeps track of how long you have been pregnant This just happens to say I think week 7 or week 5 It will keep track and give you facts based on what time and how long you have been pregnant 1 always like to look ahead and see what s coming Jenkins Oh ok See this is the kind of comments we are trying to get things we wouldn t have thought about so go ahead and feel free to make any comment 2 So what does it track once you put in your activity Then what Jenkins The overarching thing is that it saves these all in a database essentially and this is accessed online through Google Health as well but once you save all these things it keeps track of it all and it will D 3 Page give you a progress report type of thing Maybe there will be feedback on how you didn t walk really much this week and you should go out for a 20 minute walk now or something like that Or you haven t eaten you know this many vegetables or something lik
139. ivalent to cup milk Cheese choose low fat cheeses most often 1 ounces hard cheese cheddar mozzarella Swiss parmesan 1 3 cup shredded cheese 2 ounces processed cheese 1 slice of processed cheese is American equivalent to 1 3 cup milk cup ricotta cheese 2 cups cottage cheese A cup cottage cheese is equivalent to cup milk What foods are in the protein foods group All foods made from meat poultry fish dry beans or peas eggs nuts and seeds are considered part of the protein foods group Dry beans and peas are part of this group as well as the vegetable group For more information on dry beans and peas click here Most meat and poultry choices should be lean or low fat Fish nuts and seeds contain healthy oils so choose these foods frequently instead of meat or poultry See Why is it important to include fish F 13 Page nuts and seeds Some commonly eaten choices in the protein foods group with selection tips are Meats Lean cuts of beef ham lamb pork veal Game meats bison rabbit venison Lean ground meats beef pork lamb Lean luncheon meats Organ meats liver giblets Poultry chicken duck goose turkey ground chicken and turkey Eggs chicken eggs duck eggs Selection Tips F 14 Page Dry beans and peas black beans black eyed peas chickpeas garbanzo beans falafel kidney beans lentils lima beans mature navy beans
140. ivity or something it would be a pedometer If there were different options for how data is inputted like if you were just carrying your phone with you it could track something like that D 17 Page Jenkins Based on all that you have seen and said today is this an application you would like to use potentially or recommend to friends If not then how could we improve it 1 would its easier than going through the internet and stuff Rosal So that is one thing that would make you want to use it yourself Is there anything else Any other reason why someone would want to use this application as opposed to the internet or nothing 2 Well you click on one thing and it all comes up for you Instead of searching online for a certain food you want to lose weight or gain weight or whatever at a certain week you aren t looking up each thing it s all kind of right there Rosal What are some reasons why someone would not use it What are some things that would not make you want to use it as well 3 It may be a little bit time consuming if you are putting in everything all of the time If you forget to each day even though there is a reminder there Rosal So entering the information could be challenging or take time Jenkins How would you like to see it made maybe a bit easier 3 don t know don t think the activity and weight take that long because in the food thing there are so many foods to scroll through That could be
141. ke to see that on this screen Is that something you d like to see on the top middle or the bottom Can you take a look at this screen and see what s in there right now what it tells you B You mean on the main screen Rosal On that screen Jenkins For instance this is the food screen Rosal Oh I m sorry are you saying you might want to see it on the main screen B Yeah if you have a button for it your baby this week or something then you can just hit on that from the main screen and it will tell you you are 6 weeks in maybe your baby s lungs are developing A Maybe it will give me more motivation to remember to actually use the app cause if it s just telling us you re just eating too many calories we re not going to want to use it But if it s telling us you re baby doing this we ll want to go and look and see what our baby is doing Rosal Does that mean adding another button there that says Your baby s Development B Your baby this week Rosal Or your baby this week B Since you put your date due in let s say every week it s gonna tell you what the baby is doing and it can have a reminder pop up signed up for this on babycenter com and every week they send me an email telling me what s developing in the baby and what s normal for me to go through and what s not D 26 Page normal and what you should contact your doctor about So if have something pop up on the
142. library of foods Pregnancy Ticker Bitcab 2010 Free 50 000 250 000 e Tracks days to go trimesters days passed and other pregnancy stats e Illustrations of baby s development e Fact database None of these applications fall into our specific niche but rather each focuses on part of the functionality of our proposed solution These applications also vary greatly in usability For example the Pregnancy Ticker application has a very simple interface with a plain color scheme Other applications such as Calorie Counter and CardioTrainer offer a deeper feature set that includes a social networking aspect 22 Pag e 2 6 User Centered Design The computer is an extension of a person a tool that he or she can use As such it has been extremely important for designers and programmers to develop the physical device and the software that is on said device in order to efficiently complete tasks There has been a lot of research into Human Computer Interaction HCI in order to come up with a better way to interact with machines people use every day The goal is to eventually be able to design computers and other devices that are so intuitive that someone who has never used such devices can pick one up and effectively utilize it For the success of this project it is necessary we motivate the user to want to start and continue to use this application User centered design is focused on
143. llo World Program Familiarize with API Make Google Account for Phone Smartphone Component Feedback Component Ul Component Reminder Component Google Health Component Weight Component Exercise Component Food Component B 2 Page 19 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 22 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 7 days 10 days 10 days 10 days 10 days Wed 9110 Wed 94110 Wed 9410 Wed 9410 Thu 9 9410 Thu 9 910 Thu 9 9 10 Thu 9 9 10 Fri 94710 Fri 97 0 Fri 97 0 Wed 9 15 10 Wed 9 15 10 Wed 94540 Wed 94540 Wed 94540 Wed 94540 Thu 9 2340 Thu 9 23 10 Thu 9 23 10 Thu 9 23 10 Fri 10 1 10 Frid 040 Fri 10440 Fri 10440 Mon 9 27 10 Thu 9 9 10 Thu 9 9 10 Thu 9 9 10 Fri 9 47 10 Fri 94710 Fri 94710 Fri 94710 Mon 9 27 10 Mon 9 27 10 Mon 9 2710 Thu 10 410 Thu 9 2310 Thu 9 23 10 Thu 9 23 10 Thu 9 23 10 Thu 9 23 10 Fri 10 4 10 Fri 1040 Fri 1040 Fri 1040 Thu 10 410 Thu 10 14 10 Thu 10 14 10 Thu 10 14 10 132 hrs Shrs 8 hrs 8 hrs 32 hrs 8 hrs 8 hrs 8 hrs 8 hrs 44 hrs 8 hrs 80 hrs 32 hrs 8 hrs 8 hrs 8 hrs 8 hrs 24hrs 8 hrs 8 hrs 8 hrs 24hrs 8 hrs 8 hrs 8 hrs Program Analysis amp Design SST Logical Flow Diagrams Less Use
144. lly show that too 1 Yeah it shows the baby s development inside Moore Simas So it gives you some text about the baby and it shows the picture of it going from the tadpole shape to a baby Rosal What other things might be fun to see on your phone Jenkins What will keep you coming back to use this application Besides the obvious health benefit Is there anything you want to add to it Rosal What are some things about your own health mean like you mentioned being healthy but what types of things about your own health do you want to find out in the phone 2 How much activity is good and healthy and you don t overexert yourself Rosal So how much is good for you ok 2 My question is am working too hard Should walk that long Rosal So not only about the activity but also about the intensity You were saying about walking faster 3 So depending on what trimester you are on it will be different for you Rosal So specific messages related to your activity and how much is safe 3 Well on of the main things for me is managing different symptoms or you know back pain or you know nausea Anything you know How to stay hydrated when you are on the go all day just little tips Could be tips of the day based on the week you are on Rosal Because as you pointed out the beginning of pregnancy or the middle or the end So the message of the day could realte to where you are at in the pgrenancy would be helpful 2 Sadly w
145. log and the sprint backlogs for each sprint which we will talk about when we cover the sprints later in the chapter We decided not to create a scrum burn down chart because the scrum master had to focus more on the development tasks and therefore had no time to assess the progress daily Additionally our product backlog did not evolve much during the development cycle The required changes identified during the meetings were small and relatively easy to implement b Meetings Our team did not have daily standup meetings but rather weekly meetings for the same reason we decided to omit the scrum burn down chart Additionally our development team was fully invested in the project and was clear on the goals of each sprint Progress tracking was a matter of calling up a team member to ask him about his tasks and then updating the project timeline document The team however did have sprint planning meetings before the start of each sprint in order to go over the 40 Page product backlog and organize the sprint backlog for that particular sprint Sprint review meetings were also conducted at the end of each sprint to review the completed work with the customers and make sure that the product is coming along as they had envisioned it As for the sprint retrospective meetings we decided to skip this part of the scrum process due to our time constraints Aside from these meetings we met weekly with our customers to go over the product backlog and o
146. lot of my friends couldn t take cause they would just get really sick So maybe a way to supplement that Jenkins You guys talked about things you track before you were saying you track omega 3s C track folic acid especially folic acid calcium iron vitamin A D and E always read the nutrition labels to track that also try to track that I m not eating too much sodium or Trans fats things like that D 38 Page Moore My sense of the room is that we re coming to close to an end on what we can sort of tease out of you A would say a lot of meal suggestions Jenkins Like recipe suggestions A Maybe you can input your favorite food and you can go from there Like healthy suggestions because don t know about you guys but haven t had any weird cravings had one and it was the worst idea ever and never went for another one C actually have had this weird aversion to bananas A Hot dogs C can t stand the smell but you get a lot of potassium from bananas If could put in can t eat bananas have an allergy to shrimp can t eat shrimp What s an alternative to bananas that I can eat since can t get anywhere near bananas can t even have it in my house right now Something like that If you could put in carrots Jenkins Like a list of favorites and a list of not so favorites C Well not so much know what my favorite foods are and what don t like used to eat bana
147. lt for this project Our project would not have been possible without their commitment involvement and support We would also like to express our sincerest gratitude to our project advisors Professors Bengisu Tulu and Emmanuel Agu for their continued support and guidance throughout the project Their feedback and advice have helped us accomplish the goals we set forth with this project v Page IV Authorship and Contributions This project represents the works of all the project team members The team worked together on the Abstract Planning Design Implementation Conclusion Focus Groups and Interviews The following are the tasks that each team member worked on individually Evan Duderewicz was part of the research team and wrote on most of the background chapter as well as the content information for the application Evan and Thomas designed the focus group and interview protocols Evan also evaluated and wrote up the analysis of the focus groups Brendan Harris was part of the research team and development team Brendan wrote part of the background and results chapters as well as the user manual and worked on the application s user interface design Thomas Jenkins was part of the research team and wrote part of the background chapter methodology chapter and results chapter Thomas also led the focus group discussions and interviews to gather qualitative feedback on the usability of the application Ken Miyauchi
148. man This application we re not doctors but this is supposed to be a self help tool to allow you to maintain your weight gain during pregnancy and stay within guidelines To do that we are tracking three major things your weight your food intake and your activities This is the main screen of the application and these buttons correspond to the different parts of the application that you d be using Theres the profile you d put in your due date your age your initial weight After that you d be tracking on a regular basis your weight activity and food Within there there s different input screens that we kind of looked at Then you d set reminders for when you d actually want to put this information in and then you it would give you progress and feedback as well So we re trying to figure out just basically any input you d have on how we can make this better what information you d want to see any appearance things So we were talking about the appearance How do you want to see the main screen layout What do you like or not like about this A You could do like a grid or a block like you have different options on your phone Some people just like to read it and click on it instead of seeing pictures C I m not too fond of the yellow bar would like a different color Rosal What would you like to see there C Maybe if the color was blended with the blue background Not so red it looks like a yield sign D 30 Pa
149. maybe it would see you weren t eating enough vegatables this week and it would give you a tip to up vegatables Would this be taken favorably do you think 3 think it would be 4 want to know what would be good for me and the baby 2 Yeah if it gave you suggestions Moore Simas But more concrete suggestions like you are not doing this and you should try and do this 4 Maybe it could have something for when you are craving something you can type in pizza for example and it would tell you how much to eat 3 You were talking about recipes maybe instead of going out it could tell tell you to make something at home Like if you look up Papa Ginos it would give you a hint to eat something homemade Quick tips for how to do it and customize it Rosal So it is kind of like tailoring your cravings and your weight Not necessarily to not eat a certain food 2 know when I m told not to eat something kind of overdo it Rosal Well that would not be productive so maybe offering suggestions 3 Maybe it could even tailor to different times of the year Like if it around Christmas how with holidays can you there could be tips for this kind of thing Kind of how to piece it all together with what s going on now in the present Rosal Yes that would be good especially as there are big differences in what is available in the summer vs the winter And for you you feel the positive messages are important heard you say that earlie
150. maybe like every week you would get a summary or something showing how much weight you should have gained and your progress something like that Maybe update your app with a summary to make sure you are on track 3 Or maybe even something when you reach like your third trimester and it would give you a longer summary with more key points D 15 Page Rosal That sort of mark the major times in the pregnancy Jenkins Like milestones cool Mike Is there any specific brand s of foods that you prefer or you think is healthier 3 Well it depends on the type of food there is pasta and you know yogurt it could be anything But if you were to do it you could maybe start with what s most popular or whatever 1 know downstairs in the women s center they have a poster on the walls that compares if you were to get this sandwich at McDonald s vs another place you can see which one is healthier It is basically a breakdown comparing if you get this lunch from Subway or some other place can t think of exactly what was on it Rosal And how would you apply that to this what would you like to see Some people find these comparisons very helpful so I m just curious as to what you would like 1 Like when you are putting in a food it can give you an option Or if you are eating ice cream for a whole week like we said maybe it can tell you to do something If you are getting a BigMac everyday it will tell you to get something else
151. member has We have routine meeting times where we discuss progress address new issues share information and collaborate toward a finished product Outside of these regular meeting times we rely heavily on email and phone communications h Team Members Tom Jenkins has experience in various aspects of information systems from hardware implementation to business analytics His previous experience lies in IT consulting for various companies from purse makers to financial institutions such as Merrill Lynch to make sure each business has access to the technology and services that allow them to compete in the digital world This experience will allow him to properly identify the business needs by communicating with the customer and come to the best possible solution the delivers the most value His experience with rational databases object oriented design hardware program project management and business intelligence will make sure the project aligns with the customer needs Michael Ng has experience in the software engineering and systems analytics field He has experience coding in both Net and Java and the overall infrastructure that support both development environments Michael has worked as an IT consultant developing Net solutions for the past couple of years and as an application developer at Travelers Insurance This experience will allow him to better understand and anticipate the needs of the customer and deliver the most cost effec
152. men to keep track of their GWG and some other factors that might affect their GWG In our efforts to design and implement the Android application we adopted the Scrum Agile methodology due to the short time frame of the project and we modified it to suit our project need This approach provided us with the flexibility to adapt to potential problems or changes in the ii Page requirements of the project and to separate the project into smaller tasks in order to optimize the development process We maintained a product backlog with the application s requirements and functionalities and divided the development process into 6 two week sprints We came up with a fully functionally application at the end of the eh sprint Over the course of the project we met with our sponsors Drs Rosal and Moore to determine the required functionality of the application since they were currently performing these pregnancy interventions to optimize GWG via a paper book solution Additionally we organized focus groups and interview sessions to allow the participants to try out our application and provide us with feedback regarding the usability intuitiveness user friendliness and additional functionality they would like to see in the application After gathering the requirements for the project we designed the application using a modular approach by splitting up the system into a number of smaller components This allowed us to divide up the different co
153. mething Moore Give you a bye for that time C Congratulations have a chocolate bar Jenkins So like alternatives to different foods A Like a day to splurge or something like that If it s seeing that you ve been keeping track and staying on your calories and eating healthy Not everyone wants to eat healthy all the time Jenkins As far as eating healthy let s say you put in a bunch of foods that aren t good would you want it to tell you alternatives to foods Or other things you should eat A Yeah maybe even how they have the regular food and the all natural Maybe you could suggest that vs the other one to lower the calories Jenkins So you want it to go both ways if you re doing well you want it to give you some foods to have fun with and then if you re not doing well you want it to give you some alternatives A Yeah some alternatives either way guess And then the time of the day that you eat maybe it could suggest meals that will fill you up at night so you re not eating in the middle of the night and gaining those calories cause you re just sleeping and not doing anything So meals that will fill you up more later like for dinner and then lighter ones in the afternoon or for snacks or something C You know what else would be good Instead of just food your liquid intake cause you have to stay so hydrated all the time So knowing how many ounces of water or juice or milk that you ve been tracking
154. mponents of the application among the various developers in order to optimize the development process We documented the system architecture and the implementation process so that any other group would be able to pick up our project and recreate it or expand upon our final product without having to spend too much time looking through our source code and trying to understand it The final product we developed which we named Mom O Meter consisted of the following features motivational notifications to remind the users to record their wellness data a feedback engine to review this wellness data and compare it to a set of rules or guidelines to provide feedback to the user as to how well she is doing a library component with general information about nutrition and gestational weight gain and a user friendly and intuitive user interface to allow the users to experience a seamless interaction with the application iii Page Towards the end of the project we conducted a final usability test using interviews to validate the design of our application in order to make sure that the user experience is as smooth as it can be From the focus groups and interview sessions that we conducted we learned that most participants were very receptive to the idea of managing their GWG through our smartphone application and most of the feedback was positive There were also a number of requests for enhanced functionality and adding new features to the application Thi
155. ms The sprint retrospective meeting occurs after the sprint has finalized In this meeting all team members meet and reflect on their work during the past sprint to determine what was done well and what needs to be improved in the current way they are doing things This will allow the team to do a better job in the next sprint The daily scrum meetings are 15 minute meetings that occur every day During these meetings the scrum master marks the progress of the team s work and makes sure that it is in line with the project schedule and that the team will be able to finish the tasks in the sprint backlog by the end of the sprint 3 3 2 Our Scrum For our project we decided to implement our own flavor of scrum that is we followed parts of the scrum process and modified some parts to suit our project In the following sections we describe how we implemented the scrum process and why we chose to implement it the way we did a Roles First of all we will identify the players in the scrum team and their roles 37 Page Product owner Thomas Jenkins his role was to communicate the vision of the end product and its features through requirements Thomas acted as the liaison between the customers Milagros and Tiffany Rosal and the development team This is where our project deviated from the original scrum process Scrum Master Michael Ng the scrum master was in charge of organizing and communicating the development goals to t
156. n eem Wa G 6 26 pm Add Reminder Reminders Weck 4 null EH LE Mon Wed Fri Go 7 Ff Activity Tab Nutrition Tab Reminder Days Next Baby Fact Screen Help Button Home Button The Reminder Screen is where you can add modify or remove any of your reminders These reminders will go off at specific times on the days of the week that you specify The screen displays all of the reminders of a specific type ie weight in a list in the middle of the screen The time at which the reminder will alert you is on the left side and the day s of the week is located on the right side In addition to displaying reminders at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Navigation Switching Reminder Types In order to switch reminder types press and release the tab of the desired type Getting Feedback In order to access feedback on your reminders press the feedback button on the bottom left Getting Information To get more information about reminders press the info button at the bottom of the screen Getting Help In order to get help with creating editing or removing a reminder press the help button on the bottom bar Returning to the Home Scre
157. n Additionally Brendan will bring the interpersonal skills necessary for him to explain the interface to new users and to gather information about the interface in order to make appropriate design decisions for the end users While Brendan might have prior UI and coding experience they are far from his strong suit and will be a challenge for him In addition to working with the coders and end users to identify interface improvements Brendan will also work as a writer for the final report A 9 Page Appendix B A Term Planning Analysis Design Project Plan Gantt Chart System Request Project Requirements Feasiblity study Technical Economic work plan Task identification Time estimation staffing plan project charter CASE tool Standards list Risk Assessment Paper Introduction Background Motivation Problem Statement Literature Review Methodology Proposed Solution B 1 Page Duration Project Timeline Start i 32 days Wed 9140 15 days Wed 94110 5 days Wed 94410 10 days Wed 94 0 6 days Tue 9740 6 days Tue 91410 6 days Tue 941440 6 days Tue 94410 6 days Tue 9 740 6 days Tue 9740 6 days Tue 9 7410 6 days Tue 9740 6 days Tue 9740 6 days Tue 9740 6 days Tue 9 740 6 days Tue 970 30 days Wed 91110 5 days Wed 94410 5 days Wed 94140 16 days Tue 94440 6 days Tue 9710 30 days Wed 9440 16 days Tue 94440 16 days Tue 94440 Finish e Thu 10 44 10 Tue 9 21 10 Tue S710 Tue 94410
158. n at the bottom of the screen Getting Help In order to get help with creating editing or removing a reminder press the help button on the bottom bar C 9 Page Returning to the Home Screen To return to the Home Screen press the Home button at the bottom right of the screen Details Screen Description Bar Details Tab Input Tab Weight Tab Overview Your activity Weight Display Box Please choose a time frame All Weeks Time Frame of Graph Overall Fitness Activity Summary Color Key DW Active ER Sedentary Exercise Toggle Baby Facts Screen Help Button Screen Information Button Feedback Button Home Button The Activity Details screen is where you can see a detailed graph of your activity break down over time A color key is located to the right of the graph In addition to graphing your activity readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Changing the Time Frame 1 Press the Time Frame Menu Button Time Frame 2 Select the desired time frame from the menu All Weeks Week 1 Week 2 C 10 Page Input Screen Screen Description Bar Weight Tab Cancel Button elect a duration
159. n the Android platform to aid expecting mothers maintain better health While this application does not replace a physician it does have the potential to be an effective supplement in empowering patients to take better care of themselves This development process will require many special considerations as a result of the target demographic of pregnant women 30 Page 3 Methodology 3 1 Software Development Life Cycle In our efforts to design and implement the Android application we adopted a software development life cycle methodology to guide our development endeavors The Software Development Life Cycle SDLC is a highly structured approach to developing software that development teams employ to build software systems Brown DeHayes Hoffer Martin amp Perkins 2009 It provides a set of guidelines that help architects analysts developers and project managers to work together to build a software system Over the years a number of different SDLC methodologies have surfaced structured rapid application development RAD and agile Each methodology suits a different type of development environment and selecting a proper SDLC methodology depends on the type of software project in question and the goals objectives and requirements of said project Table 3 1 shows an overview of some of the different methodologies Table 3 1 Criteria for selecting a methodology Dennis Wixom Roth 2006 Usefulness in
160. n to go to the home screen Creating a Profile 1 Press the Pregnancy Week Menu Button Select a week L e 2 Select your current week in pregnancy use the scroll bar on the left side to see more options Week 1 Week 2 Week 3 Week 4 Week 5 3 Press the feet and inches boxes and type your current height Your Height 4 Press the OK button Ok C 2 Page 2 The Home Screen Screen Description Bar Weight Button Food Button Daily Checklist Button Mom o meter Welcome Reminders Button Activity Button Profile Button Progress Button Information Button Help Button The Home screen is what you will be greeted with after setting up an account From this main menu you can access your reminder settings your weight nutrition and activity tracking screens and view your progress or profile At the bottom of the screens there are buttons which you can use to check your Daily To Dos and get information or help on the current screen from the program Navigation To get to another screen press and release the button of the desired screen In order to return to the home screen at any time press the Home Button in the bottom right corner C 3 Page 3 The Reminder Screen Screen Description Bar Weight Tab Add Reminder Button Reminder Time Toggle Baby Facts Screen Information Button Feedback Butto
161. n we have chosen to develop our application Next we will go into the details of our system design with the class diagrams and the database model Then we will look at how our feedback engine works to provide informative feedback for the users Finally we will look at some more detailed documentation on the implementation of the system through use case diagrams and logical flow diagrams 4 1 Android development environment Android applications are written using the Java programming language which is an object oriented programming language Using this high level language we were able to develop our application using a fairly modular approach The software development pattern in the Android environment is very similar to the Model View Controller MVC used in other software development environments 4 1 1 Model View Controller Pattern The model view controller pattern is a software development pattern that separates the modeling of the domain business entities the presentation user interface and the logic of the application Microsoft 2011 This allowed more modularity since we split the application into three separate independent layers Doing so also allowed us to test each individual layer independently so that we could divide up the work among the several developers The model represents the data of the application domain and responds to requests for information about it state and requests to change its state 55 Page The vi
162. nal Weight Gain Underweight lt 18 5 28 40 Ibs Normal Weight 18 5 24 9 25 35 Ibs Overweight 25 0 29 9 15 25 Ibs Obese 2 30 0 11 20 Ibs In addition to the basic guidelines provided in Table 2 4 the IOM provides gestational weight gain ranges for each BMI category on a weekly basis which can be found in Appendix A The combination of the guidelines for weekly gestational weight gain dietary intake weekly exercise and the potential 15 Page need for an intervention implies that some form of individualized continuous real time feedback could be beneficial to pregnant women Moore Rosal and Waring summarized a set of studies that identify risk profiles associated with non adherence to ranges and rates of gain during pregnancy Moore Rosal and Waring 2010 p 2 They found the following risks in under and over gainers Under gainers are at increased risk of e Small for gestational age SGA and low birth weight infants e Preterm labor delivery Over gainers are at increased risk for e preeclampsia e gestational diabetes e induced labor e failed induction e lacerations e preterm delivery e cesarean delivery e large for gestational age infants or macrosomia e postpartum infection e early termination of breast feeding e postpartum weight retention e maternal obesity 16 Page They also found that the neonates of over gainers are additionally at increased risk of e low 5 minute APGAR scores
163. nancy it will know how you are going along 1 So it will be able to show me my whole pregnancy on there Jenkins Yes it will have all of that information and show you your weight and where it is within that range within pregnancy 1 Does it work with your age and weight Or what 2 Like how was it going to be for us Like how would it track mine Moore Simas So you input your weight your pre pregnancy weight that is the weight you were before the pregnancy And you input your height and your due date so it knows how much you weigh and also how much you should gain throughout the pregnancy and the day you input it also tells it where you are in your pregnancy And there are recommendations on if you are on track or not on track based on these ranges 2 But you know every pregnancy is different For my son he s 11 months old I m 7 months pregnant but I m not gaining as much as did for him because still have some weight on So how would it track it Moore Simas It s a little black and white meaning it takes your information and makes a recommendation and you know of course there should be discussions with your physician about how you are going Especially if you get a message saying you are gaining too little or too much There are tips to help you Jenkins This is obviously not going to replace your doctor but it will help you 2 Im just curious as to how it is going to track it 3 What if you are carrying mult
164. nas on my cereal everything morning but suddenly one day tried and had to run to the bathroom I m not getting the nutrients that used to get every morning If you could put in I m never eating this for the rest of my pregnancy what can eat instead Jenkins You wouldn t want bananas to show up in your reminders A Just things want to stay away from definitely wouldn t want to see hot dogs C can t even feed my dog anymore Cause the smell of the dog food So my husband has to feed the dog Moore Anything you haven t said that you really want to get out there Pretend like this magically happens A feel like we re around suggesting a lot for an app but know what apps are capable of It just seems like a lot of work If you get it all together it would probably be really good Maybe not even just a weight tracker like an all around pregnancy app Cause know they have other ones where they do certain things but if you have everything in one spot it just makes it so much easier Like they have the what to expect book Everything s in there and you can just go right to that book and use it but you re not gonna carry that book with you wherever you go So it would be easy cause you carry your cellphone with you D 39 Page Jenkins So based on that thought an all encompassing pregnancy application that would make you want to use it more than just a weight tracker C Honestly if just
165. necologists 2010 p 241 A pregnant woman who had a normal pre pregnancy BMI only needs an additional 300 calories per day during pregnancy American College of Obstetricians and Gynecologists 2010 p 241 Ultimately a healthcare provider should provide the necessary amount of each food group mypyramid gov only provides recommendations Table 2 2 provides sample recommendations for a healthy woman of average size Table 2 2 Sample Recommended Pregnancy Diet MyPyramid gov 2010 Food Groups 1st Trimester 2nd Trimester 3rd Trimester Grains1 7 ounces 8 ounces 9 ounces Vegetables2 3 cups 3 cups 3 ounces Fruits 2 cups 2 cups 2 cups Milk 3 cups 3 cups 3 cups Meat and Beans 6 ounces 6 ounces 6 ounces 1 Make Half Your Grains Whole Aim for at least this amount 3 ounces 3 ounces 4 ounces of whole grains per day 2 Vary Your Veggies Aim for this much weekly Dark Green Vegetables 3 cups 3 cups 3 cups Orange Vegetables 2 cups 2 cups 2 cups Dry Beans amp Peas 3 cups 3 cups 3 cups Starchy Vegetables 3 cups 6 cups 6 cups Other Vegetables 6 cups 7 cups 7 cups Oils and Discretionary Calories Aim for this amount of oils per day 6 teaspoons 6 teaspoons 7 teaspoons Limit your extras extra fats amp sugars to this amount per day 265 calories 290 calories 360 calories 11 Page In addition to eating healthy one proven benefi
166. ng pregnancy can also result in American College of Obstetricians and Gynecologists 2010 p 25 e Reduction in backaches constipation bloating and swelling e Boost in mood e Promotion of muscle tone strength and endurance e Help in sleeping better The American College of Obstetricians and Gynecologists recommends 30 minutes of moderate exercise every day They define moderate exercise as exercise that gets the heart rate increased but does not prevent the woman exercising from talking at a normal level The American College of Obstetricians and Gynecologists note that the actual act of physical activity and exercise do not need to be done at one time during the day For example three separate walks for 10 minutes each at a brisk pace during the same day would offer equal benefits as one 30 minute walk a brisk pace It is recommended that women who have not been exercising regularly prior to pregnancy begin with as 13 Page little as 5 minutes per day and add 5 minutes day weekly or as they feel comfortable until they reach 30 minutes per day Recommended exercises for pregnant women beginning an exercise program are walking swimming cycling aerobics Most other exercises except contact sports are appropriate for pregnant women such as running racquet sports and strength training However they are not recommended for first time exercisers 2 3 Gestational Weight Gain Pregnancy or gestation in humans is a well stu
167. ng Oils come from many different plants and from fish Some common oils are e canola oil e corn oil F 18 Page e cottonseed oil e olive oil e safflower oil e soybean oil e sunflower oil Some oils are used mainly as flavorings such as walnut oil and sesame oil A number of foods are naturally high in oils like e nuts e olives e some fish e avocados Foods that are mainly oil include mayonnaise certain salad dressings and soft tub or squeeze margarine with no trans fats Check the Nutrition Facts label to find margarines with 0 grams of trans fat Amounts of trans fat will be required on labels as of 2006 Many products already provide this information Most oils are high in monounsaturated or polyunsaturated fats and low in saturated fats Oils from plant sources vegetable and nut oils do not contain any cholesterol In fact no foods from plants sources contain cholesterol A few plant oils however including coconut oil and palm kernel oil are high in saturated fats and for nutritional purposes should be considered to be solid fats Solid fats are fats that are solid at room temperature like butter and shortening Solid fats come F 19 Page from many animal foods and can be made from vegetable oils through a process called hydrogenation Some common solid fats are e butter e beef fat tallow suet e chicken fat e pork fat lard e stick margarine e shortening e How do I count t
168. ng such an application from the viewpoint of various user demographics which allowed us to tailor the application to appeal to a wide variety of users in this specific niche market o What did you like and not like about navigating the application o What did you like and not like about the application o What do you think of the appearance of the screens we have shown you o Given what we have shown and told you about the application Would you be interested or not interested in using it o Based on what you have seen what changes do you suggest making to the application 46 Page We specifically designed these questions to be very open ended with the goal to elicit discussion amongst the group The application was stepped through to ensure all relevant sections of the application were covered and discussed The discussion can go in any direction as long as it pertains to something relevant to the application We used a variety of probing questions whenever there was any lull in discussion o Would you explain further o Would you give me an example of what you mean o Would you say more o Tellus more o Say more o Is there anything else o Please describe what you mean o Does anyone see it differently o don t understand While also open ended these questions gave guidance to the discussion and helped rouse conversation One of the most important things in a focus group was to hear from everyone hence the use
169. now Jenkins How about the rest of you would this be something that would be helpful for you to use B would use it if it has other reminders and weekly updates A Maybe if you guys didn t want to put it for free you could have a lite version where you would have just the basics and in the paid version you could have the full blown thing Jenkins With all the libraries of information A Just because someone doesn t want to pay for it doesn t mean they shouldn t be able to utilize some of the features Moore Frankly we re not knowledgeable about how all these cost As physicians we just want to make a great product that would be helpful to help pregnant women D 35 Page A But it does cost money to do all this so if you want all the extra things charge like 2 99 or something and if you don t you can just use the lite version which would just give you the weight the food the stuff to keep you healthy Moore It sounds like many of you already use online computer based things or for those you that have these types of phones is there anything in them that we haven t already talked about that we don t have here that you would really like to see here that would be critical to make this something you would use Or if we have talked about it we d like to make sure we hear you loud and clear A Maybe if you ve done good for a certain amount of time it could suggest junk food you could eat or so
170. nt categories and search for what you re looking for Rosal So what you re suggesting is you start entering the information perhaps and it moves you to where it is and you just click yes A Or you could just input it yourself like chips and then press okay and it would be added to the list and the information would come up B it could give a sample of chips to choose from D 22 Page A Yeah cause different ones do have different calories And then for like vegetarians you should have like cause they have different foods without all the additives So a lot of their foods wouldn t even be considered in the ones you have because there are different ingredients in theirs Rosal So you re suggesting considering brands as well A Well how they have the all natural if you go to the vegetarian shop on Chandler St they have the ones without additives work with someone and she was explaining to me how theirs are all natural vs the ones with chemicals in it So that has a factor in the food too C would find it more useful if could customize my menu instead of picking from a pre if could put in the name the serving the calories and could do it myself and then have it be stored in my own personal menu and then could just select it Cause maybe eat 3 pieces of pizza instead of 2 Just be able to customize it myself make it my own menu Rosal So you would want to enter the calories you would want to e
171. nt week in pregnancy in order to determine the GWG trajectory It then compares the user s weight gain during the week GWG to see whether this weight gain falls in line with the GWG trajectory Figure 4 6 summarizes how this sub component works Pre pregnancy Week BMI Get the GWG trajectory Calculate GWG based on the pre pregnancy Trajectory BMI and the current week in pregnancy GWG gt GWG Trajectory WG lt GWG Trajectory GWG within GWG Trajectory You are not You are gaining You are doing gaining enough too much weight weight great Figure 4 6 Weight feedback algorithm 65 Page 4 5 2 Nutrition Feedback The nutrition feedback sub component looks at the user s daily food intake and determines whether the user is eating a healthy balanced diet based on his her BMI and exercise pattern Figure 4 7 summarizes this feedback process Get recommended amount of fruits vegetables grains gt x cups of fruits You should eat Consider healthy more vegetables alternatives to Give some sweets and examples desserts You should eat You should eat recommended you more grains Give more fruits Give eata some examples some examples variety of vegetables Figure 4 7 Nutrition feedback algorithm 66 Page 4 5 3 Fitness Activity Feedback The fitness activity feedback checks to make sure that the user is exercising at least 30 minutes a day and lets the user know if he she
172. nter the C would be able to read my little thing on the package and Jenkins What other information would you want to be able to track C Vitamins right now do a lot of label reading for vitamin D vitamin C track folic acid calcium The things your OBGYN tells you are very important to be taking in also to try to track the food pyramid the servings of bread and the serving s fruit per day that I take in just to try to keep my intake balanced It s not necessarily like could eat pizza all day but it s not really good for me so want to be able to know got my 4 servings of vegetables my 3 servings of milk and things like that Rosal How do you normally know that C keep a food diary and write it down A Maybe in the different stages of the pregnancy you could give suggestions on what to eat to get the most vitamins know at the end of the pregnancy the baby is storing up iron so it tells you to eat a lot of red meats So maybe at different stages you could give suggestions on what the person could eat to get the most of them Jenkins When you set up your profile in this application it knows when your due date is so it will know what time you are C Which trimester Jenkins Yeah Rosal So that would be feasible Also certainly entering the information would also be feasible Those are great suggestions Any other suggestions up to now D 23 Page Jenkins As far as the weight input screen o
173. of questions seeking different opinion Analysis Strategy Upon completing each focus group the team debriefed and compared their notes This was important in order to determine the major themes of the conversation as well as to identify and prioritize relevant items to the backlog Because of the timeframe of this project it was imperative that we prioritized the most important facets of the application that came from the discussions and incorporated them into our development plan After both focus groups were conducted we identified 47 Page major themes and produced a summary of our findings that were them put into the backlog Because we linked the entry survey with comments in the discussion it was possible to see what items concerned those with various backgrounds as well The extraneous items that were discussed but did not fall within the scope of our project were put into our suggestions for future work see Chapter 5 for details The team met with the customers on the following dates November 10 the team discussed the details of the focus group designs and the development progress on the application so far November 17 the team finalized the details for the focus group sessions and got feedback from the customers Once this feedback was incorporated the group submitted the focus group designs for IRB approval The team also presented the developed components to the customers for feedback Sprint 3 November 29
174. of vegetables In general 1 cup of raw or cooked vegetables or vegetable juice or 2 cups of raw leafy greens can be considered as 1 cup from the vegetable group The chart lists specific amounts count as 1 cup of vegetables in some cases equivalents for cup are also shown towards your recommended intake Amount that counts as Amount that counts as 1 cup of vegetables cup of vegetables Dark Green Vegetables Broccoli 1 cup chopped or florets 3 spears 5 long raw or cooked F 7 Page greens turnip greens kale Spinach 1 cup cooked 2 cups raw is equivalent to 1 cup of egetables Raw leafy greens Spinach 2 cups raw is equivalent to 1 cup of romaine watercress dark green vegetables leafy lettuce endive escarole cup raw is equivalent o cup of vegetables 1 cup raw is equivalent Greens collards mustard 1 cup cooked 1 Y cup of vegetables Orange Vegetables Carrots 1 cup strips slices or chopped raw or cooked 2 medium 1 medium carrot 1 cup baby carrots about 12 bout 6 baby carrots Pumpkin Dn cup mashed cooked Sweetpotato 1 large baked 2 1 4 or more diameter 1 cup sliced or mashed cooked 1 cup cubed cooked 14 acorn squash baked cup Winter squash acorn butternut hubbard Dry beans and peas Dry beans and peas Such as 1 cup whole or mashed cooked black garbanzo kidney pinto or soy beans or black eyed peas or split peas Tofu 1 cup 12 cubes a
175. olutions similar to our project Requirements Gathering Before we began development of the application we gathered the requirements for the application and produced the product backlog We met our customers for the first time on the third week of A term From this meeting we were able to determine the high level requirements of the product We prepared a document detailing our understanding of the product and its requirements and presented it to the customers before the end of the term for feedback We then used this feedback to finalize the requirements and form our product backlog and got the signoff from the customers b B term During the second term the team concentrated on building the software system Our goal was to spread the development of the application across both B and C terms We also conducted focus groups to gather feedback on the UI and the usability of the application Therefore we focused on developing the high priority components which were the front end components such as the UI weight tracking food tracking etc to use for the focus group sessions This term was split into 3 two week development sprints Each sprint consisted of a sprint backlog with a number of components from the product backlog which depended on the complexity of said components The team met with the sponsors once a week to discuss the progress of the project and made changes as needed 42 Page Sprint 1 October 26 November 8
176. om that meal but after that maybe we could add a customizable list Evan Would you like to have it create a favorites list 3 Yeah early on in pregnancy you are probably very stuck to certain regime of what s working for you and whats not so maybe like 10 foods that you are able to tolerate You know so instead of always scrolling for those same things at the beginning It might be nice if they were kind of right there as your favorites Jenkins For the specific meal or just in general For example would you split it up into breakfast lunch and dinner or just have an overall favorites list 2 Yeah if they just came up 3 Like yogurt pineapple mean if each one came up individually Jenkins How about the colors and the readability of the screens Were you able to see everything easily Were there different colors you would like to see 1 Maybe you can personalize it Like for your pregnancy Like you are having a boy or having a girl you know Jenkins Oh ok that s a good idea Rosal How would you personalize it Any specific things 1 don t know like on my computer keep track of my pregnancy by going to baby somethin com keep track but it is my own personal profile Like it says Welcome you are how many weeks You baby has this much progress And you set a background to it 3 When that progress comes up is that gunna be like a chart Just like the icon is You could show you know your weig
177. on between faculty and students as well as schedule and course management Because many mobile applications particularly smartphone applications are cost effective many institutions are taking advantage of them Keane amp Rege 2009 This not only allows for better management of the students from an administration standpoint but also prepares students for the ever evolving medical field so they can become better physicians Another advantage of mobile medical technologies can be seen in the ease of deployment and how well they facilitate treatment especially in developing countries The Rockefeller Foundation has invested 100 million into an infrastructure for health systems in Africa and Asia Fortner 2009 The goal is to utilize smartphone applications on this new infrastructure to improve the efficiency increase the overall access and ultimately increase the quality of care One of the major advantages to phone based applications is the versatility Phones are able to be taken into environments not well suited for even laptops A lot of developing countries have some form of cellular network therefore allowing much easier deployment for such systems Fortner 2009 This allows physicians to continue to stay up to date with the latest information pertaining to their specialty wherever they may be Mobile technologies have allowed a drastic increase in the ability for doctors to provide the best care to their patients at a relatively lo
178. ore than these sites especially with products that are very lucrative for health care companies such as formula For example Pregnancy org is a not for profit resource started by parents that seeks to empower mothers to do what is best for their children The important difference here is that these organizations sites are specific to pregnancy and have been built from the ground up to address all aspects of pregnancy As a result of lesser advertising revenue there may not be as much of the specialty content regularly updated expert blogs etc but the social community rivals those of the mainstream health sites 18 Page There are also websites that offer specific information related to pregnancy Mypyramid gov and Livestrong com are resources that have heavy focus on nutrition These sites offer a customizable nutrition plan for pregnant women as well as other tools to help tailor diet While these sites are more specialized they also offer additional information but not at the same level as the larger more full featured websites 2 4 2 Social Networking Social networking has been one of the most revolutionary innovations of the last few years allowing online communities of people to share information and communicate in new ways Health has been one of the areas where social networking has taken off exemplified by the many forums and groups on popular social networking sites facebook com etc for various medical conditions Pre
179. ority components Likelihood of risk Potential impact on the project Ways to address this risk The finished application may be cumbersome to use despite a high quality design Low probability The risk will likely result in a reduced adoption rate for pregnant women It is very important that the project team creates prototypes and continuously gathers feedback on those prototypes to enhance the functionality and usability of the application The team will also deploy a pilot program to gather feedback and overall usability of the application This risk will be A 4 Page heavily managed by focusing heavily on the usability of the application Likelihood of risk Potential impact on the project Ways to address this risk Patients are not receptive to the technology Low probability The patients will not provide adequate feedback on the application which will hinder further development It is important that the project team s test groups consist of women that are also receptive to new technology which is the target group for this application e Economic Feasibility 1 According to our project timeline during A term we will spend approximately 268 hours researching and working out the project plan These tasks are broken down into the following components Planning Analysis Design Project Plan 42 hrs Paper 29 h
180. ors would you want to see 1 What if someone doesn t want to know maybe have a yellow or green color maybe Jenkins Thank you guys for your input thank you again for coming This is definitely going to help us out a lot 12 8 2010 Focus Group Moore We are in the process of developing a program for handheld devices That we hope will help women gain the right amount of weight in pregnancy which is a tough thing to do Since a lot of people now have devices and have various programs for lots of different things we thought that we might see if something like this might be helpful We are in the very beginning phases of this so really anything you have to say about what yours like to see there or what you d like it to look like anything Although we all are in the room and will have something to do with what ultimately our goal is to make it the best it can possible be No comment is too small We take everything as good positive feedback and we d rather you tear apart rip it up and tell us everything so we can move forward and make it the best possible You are invited because you re pregnant and this is the population we anticipate using this device Because this is a research study we re going to record what you say We don t take pictures of you or take your names or anything But because we need to type the notes you have green cards that have a number on it In the notes you ll be referred to as a number We will never
181. ort of application to give you reminders Or just one or the other C want to be able to choose A Yeah Jenkins Does anyone else have anything else they would like to add to the discussion Anything from the font used to the colors anything A It should just all be customizable Moore Another very specific question it sounds like all of you text at least back and forth to family and friends Do any of you currently receive texts from a baby type of program or anything like that Do you actually read them or do they just pop up and you ignore them D read them D 37 Page A signed up for emails and it s annoying because they just send so many emails get them sent as updates to my phones as text messages and notifications So they just keep coming Moore So if some of these reminders came to by text Generated by the system when you signed up Do you think they would be the kind of things you d open and read or do you think eventually you d grow tired of them and start ignoring them C would read them religiously at first and then eventually I d see a pop up and say oh I have to eat lunch Probably after a while once got used to what they were They d pop up and it d be a reminder and probably wouldn t read it so closely Moore So what would keep you invested in reading them C Honestly have no idea Because do tend to ignore that kind of stuff after a while Even my bank stat
182. ot pregnant Five of the participants reported that they did not own a scale at their homes Six of the participants reported they are currently on their first pregnancy Results Themes a Desire for a full featured pregnancy application There was an overall desire for a fully featured pregnancy application that would provide the participants with a one stop shop for everything related to their pregnancy This is an overall theme that resulted from the focus group Several of the components from the other themes involved suggestions to make the application into a full featured pregnancy application Many of the participants wanted an application that did more than help them manage their weight gain during pregnancy They wanted the application to be their information source for everything related to their pregnancy they requested a variety of features that ranged from nutrition and baby development facts to a social networking 78 Page component While the purpose of this particular group of focus groups was to evaluate the user interface it was important to note that this theme was prevalent throughout the discussion b More information The most prevalent theme from the focus groups were the women desired a lot and a variety of information regarding their pregnancy This desired information included e Activity based information o How much is healthy There were concerns about how much they should get and how to avoid getting too
183. ould want to be looking for on the label For example calcium and fiber and the total fat low Have it point out servings Rosal So those could be single messages or separate tips for different days 3 Yeah maybe it could talk about calcium one day and give you some information on that Rosal That s the educational piece Moore Simas Do you think it would be valuable or undesirable to get the same message a couple times maybe worded slightly differently Like something about calcium monthly or what have you How would you like to see this kind of message 4 Not that repetitive 3 Maybe focusing on a specific time like you are at this week and your baby s bone growth is important now so then you get the message Something like that Maybe you are at a certain week and you have having digestive issues here s stuff about fiber Rosal So tailoring it to your pregnancy Jenkins How would you want to see that A reminder in the application or something on the home screen there are different ways to do this 1 Maybe you could send it through a text message or something to remind you Jenkins So something that would appear on the front screen of your phon Moore Simas So you wouldn t have to go into the application Rosal What types of messages do you think would be interesting Because text messages don t require you to buy into the application and you can just receive then what would you want to see there 1 Well
184. ping World http www huffingtonpost com 2009 04 07 world health day mobile t_n_184149 html 94 Page University of Cincinnati 2009 Selected List of Free Mobile Device Software http www libraries uc edu hsl reference elec pda cfm Cockburn A amp Highsmith J 2001 Agile Software Development The People Factor IEEE Computer Society http ieeexplore ieee org xpl freeabs_all jsp arnumber 963450 Cockburn A amp Williams L 2003 Agile Software Development It s About Feedback and Change IEEE Computer Society http ieeexplore ieee org Xplore login jsp url http ieeexplore ieee org iel5 2 27119 012043 73 pdf 3Farnumber 3D1204373 amp authDecision 203 Cockburn A amp Highsmith J 2001 Agile Software Development The Business of Innovation Software Management http www adaptivesd com articles IEEEArticle1Final pdf Constantine L L and Lockwood L A D 1999 Software for Use A Practical Guide to the Models and Methods of Usage Centered Design Reading MA Addison Wesley Consumers and health information technology a national survey 2010 California HealthCare Foundation http www chcf org publications 2010 04 consumers and health information technology a national survey Fortner P 2009 Mobile Phones Drive Health IT Innovation in Developing Countries http www ihealthbeat org features 2009 mobile phones driving health it innovation in developing countries aspx Fowler Martin 2005 December 1
185. present these entities Figure 4 5 shows the entities that we created in the SQLite database for the application 4 5 Feedback engine The feedback engine for our application is used to provide qualitative and quantitative feedback to the user based on their data input It is used to let the user know if she is gaining the appropriate amount of wait eating a healthy diet and exercising enough all of which are important factors to take 63 Page into account during pregnancy The information and criteria used by the feedback engine were taken from the research project our sponsors provided to us This information is summarized in our background chapter section 2 2 The feedback component is divided into the following sub components weight gain feedback nutrition feedback fitness activity feedback oodinput type type weight foodID hour activity type servings minute duration timestamp mealtype monday timestamp dayofweek timestamp tuesday dayofweek week dayofweek wednesday week dayofmonth dayofmonth thursday dayofmonth month month friday month year year saturday year sunday ActivityType kees type description wea description FoodCategories catego category calories image screenid description Figure 4 5 Entity Relationship diagram 64 Page 4 5 1 Weight Gain Feedback The weight gain feedback subcomponent uses the pre pregnancy BMI information and the curre
186. put what they really ate today in this test The user will not be asked to do anything between this step and the next one for example the user will not be asked to return to the home screen of the application D Input Activity The user will be asked to input 30 minutes of running exercise The user will not be asked to do anything between this step and the next one for example the user will not be asked to return to the home screen of the application E View Progress Feedback The user will be asked to view progress for the weight food and activity screens The user will not be asked to do anything between this step and the next one for example the user will not be asked to return to the home screen of the application F Set reminder s The user will be asked to set a weight reminder for 8 PM on Sundays After the volunteer had performed the requested tasks we asked the following questions each question is detailed with what we hoped to garner from their responses The first set of questions was designed to gather the user s impression of the application If the user did not seem to have any opinions we asked them to rate these questions on a 1 10 scale when they provided their number rating we asked why they gave that rating e What did not work as you expected when you were navigating the application 51 Page o This question was designed to specifically evaluate how intuitive the application s navigation was Sin
187. r What type of weight messages would you like to receive for example if you are over gaining What types of messages would you like to see D 13 Page 4 More healthier foods maybe things you should stay away from if possible Rosal So you want that if you enter weight that is above what you should be gaining that it would give you suggestions right there 2 It could tell you to cut down on the sweets or something along those lines Rosal So it could give suggestions based on the foods that are being inputted 1 Even for an activity maybe it could tell you what to do 3 Maybe it could even say the risks associated with high weight gain or low weight gain A lot of research states these things and it is very important Especially to a mother this would be great to keep up with you and your baby Take control of it before it is too late with information and education Rosal So by getting this beforehand as opposed to after it is too late ok Jenkins How would you want to see that so it is not depressing or discouraging 3 So if it tracking your weight and you are starting to gain more it would say excessive weight gain leads to high blood pressure and other stuff If it could correlate the weight food and activity tracking it could give you a more tailored Rosal We have covered a lot of suggestions but what are some things you wish you had learned earlier on in your pregnancy or in previous pregnancies Moore Simas O
188. r even things you still don t know Rosal What other things do you want to know about you weight diet or physical activity things that would make you feel in control with your pregnancy 3 Is anybody interested in how to read food labels Something like that where it can be slightly confusing you know like if it were a tip of the day Like to look for things like fiber and calcium Maybe it could also point out bad aspects to food like total fat and serving sizes things like that If there are things being inputted into the food there should be things to help you do that Rosal Do you have any sense of what might be helpful to help read food labels or other aspects to food 1 Well maybe with the food part when you click on what food you are searching for it could give you information on it and you could click the back button or whatever so you could know all of that Harris Key nutrition facts or a more elaborate full set of information 1 Maybe the full one just so like if there is something you guys maybe wouldn t have put in there D 14 Page Rosal So you are talking about entering the food with the brand perhaps 1 Yeah and the nutrition labels Cuz different brands have different labels Rosal Did you mean to say anything about how to bring nutrition label into the application You mentioned the tip of the day kind of thing is there anything else you can suggest 3 There are important aspects to what you w
189. r feelings We just want to make this the best application we can because eventually it s going to help other people Also feel free to use the phones the whole time we re trying to get as much feedback as we can All comments will improve our design fire alarm wel start with the presentation to get you guys familiar with the application Basically this is a cellphone application that is supposed to be a self help to help you guys and other pregnant women when it s done to maintain your weight and to eat healthy and educate you about other things such as reading food labels This is the main screen you see on the phones There are three different main components to this that we record that you use in this application The weight tracking overall seeing if you re in the recommended ranges for pregnancy food tracking that tracks your calories for different meals and activity tracking which tracks how many calories you expend Also on this screen there s profile where you set up your profile and progress but we won t be worry about those too much Wel be looking at the weight food and activity tracking and the reminders section Let s start with the weight overview On all of these screens the weight food and activity tracking they look very similar The first screen you will see is an overview screen it gives you an idea of how well you re doing Pretty much it D 20 Page will say good if you re in the range For the
190. r removed from it due to change in the customers interests These requirements become the tasks that the development team must complete in order to develop the product The sprint backlog is a subset of items from the product backlog that a team commits to complete during a particular sprint This allows the team to break down the product into smaller and therefore more manageable units of work The sprint burn down chart shows the daily progress for a particular sprint as the sprint progresses This allows the scrum master to stay on top of the sprint backlog and make sure that the development team is keeping up with the tasks and that deadlines are met c Meetings For each sprint in the scrum project there are usually three main meetings the sprint planning meeting the sprint review meeting and the sprint retrospective Aside from these there are also daily scrum standup meeting 36 Page The sprint planning meeting occurs before the start of each sprint The main objective in this meeting is to prepare the sprint backlog for the current sprint so that the development team will know what tasks to work on The sprint review meeting occurs at the end of the sprint During this meeting the scrum team reviews and presents their completed work to the stakeholders and gets feedback from them This feedback is then incorporated into the product backlog in the form of requirement changes or changes in the priority of certain ite
191. r the activity input screen do you have any input on that A You know how you do the calorie counter If one of your meals is a little bit over you can make suggestions for the meals for the rest of the day to kind of even out the calories You could give a couple suggestions to help the person out to stay with the calories Rosal So you would like the suggestion based on the number of calories that you ve eaten so far A Yeah that you ve eaten so far during the day or that you have left for the day or that you need to eat know some people don t gain enough weight so they need more calories B And then also with the activity with walking let s see I ve had so many calories per day and wanted to lose some it can suggest if you walk 30 minutes you re going to lose this much calories that would be fine too Rosal So you want to know the calorie expenditure B Yes A Some way to even things out kind of Rosal Any specific activities that you would want to know about in terms of the number of calories A What about cleaning D Housework A Cause you re lifting you re bending Rosal Absolutely A know it s a lot of work now Rosal Any other activities that you normally do A Shopping C Maybe yoga Rosal Any other activities Walking is something that we always hear We can add that too A Well know a lot of pregnant women now are cleaning and getting the baby stuff set up So you re
192. range of weights and the IOM guidelines are developed specifically for American women The need for these revisions has developed from an increasing number of people who are obese in the United States According to the National Research Council and Institute of Medicine women are currently leading the epidemic at a prevalence rate of 33 National Research Council and Institute of Medicine find this rise in obesity to be particularly a concern in women of childbearing age because of serious pregnancy related complications and the IOM warns these complications can extend into post pregnancy years The National Research Council states that Gestational Weight Gain is a modifiable factor during pregnancy that can be controlled through habits including healthy eating proper portioning and exercise National Research Council 2007 However the IOM contends that some women who fall in the normal weight category and many women in the overweight and obese category will exceed the GWG guidelines without an intervention The IOM states that part of intervention needs to occur at the individual level and include components related to both improved dietary intake and increased physical activity IOM NRC 2009 p 3 The IOM s gestational weight gain guidelines for pregnancy are provided in Table 2 4 Table 2 4 2009 IOM Gestational Weight Gain Guidelines IOM NRC 2009 p 2 Pre Pregnancy BMI kg m2 Total Gestatio
193. rawberry lactose reduced milks lactose free milks Milk based desserts Puddings made with milk ice milk frozen yogurt ice cream Selection Tips parmesan soft cheeses ricotta cottage cheese processed cheeses American Yogurt All yogurt Fat free low fat reduced fat whole milk yogurt Choose fat free or low fat milk yogurt and cheese If you choose milk or yogurt that is not fat free or cheese that is not low fat the fat in the product counts as part of the empty calorie allowance If sweetened milk products are chosen flavored milk yogurt drinkable yogurt desserts the added sugars also count as part of the empty calorie allowance For those who are lactose intolerant lactose free and lower lactose products are available These include hard cheeses and yogurt Also enzyme preparations can be added to milk to lower the lactose content Calcium fortified foods and beverages such as soy beverages or orange juice may provide calcium but may not provide the other nutrients found in milk and milk products What counts as 1 cup in the dairy group The chart lists specific amounts that count as 1 cup in the dairy group towards your daily recommended intake F 12 Page Amount that counts as 1 cupin Common portions and cup the dairy equivalents Milk 1 cup choose fat free or low 1 half pint container fat milk most often cup evaporated milk 1 slice of hard cheese is equ
194. reen and tabbed overview details and input screens The intent was to make it easy to navigate to different parts of the similar nature 75 Page i CH 6 59PM Welcome back lt User s Name gt D ear ji back ji s Name gt Activity Tracking lt Message gt Detaits oo Status Sedentary Food amp Lifestyle Nutrition Activity Progress Profile Additional Information Information Additional information Figure 5 1 Figure 5 1 Initial Home Screen UI Desigr Design Figure 5 2 Initial Overview Screen UI Design Our next iteration of the User Interface had one goal make it look nicer Our first interface stressed the functionality of the application but was too unrefined to bring to our focus groups We wanted our feedback from participants to focus mostly on the layout and ease of use of the application In order to limit discussion on the bland and sterile nature of the Ul a number of small changes were made One major change to the home in this iteration was adding a background image and changing from large text buttons to smaller icons with text below This made the application easier to follow and easier to look at In addition to making changes to the home screen at this point we implemented our first food input screen The Interface in this iteration can be found in Figure 5 3 and Figure 5 4 5 1 1 Focus Groups Summary Background Focus group research was conducted to aid in th
195. rmation Button Feedback Button Information Your Profile User Name Mary Jane Pregnancy Stage 2 weeks Current Height 5 feet 8 inches Current Weight 135 0 BMI 22 1 Goals Tab Profile Information Screen Help Button Home Button finished Your Profile screen is where you can view a quick summary of your pregnancy information including the stage height current weight and Body Mass Index BMI In addition to your pregnancy profile at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when C 16 Page Appendix D Focus Group Transcripts 12 6 2010 Focus Group Moore You all kind of came from within the system and so work with all of them And so at the end of tonight if you have any questions especially medically related then would sort of be your go to person for that and or would refer you back to your providers Let me introduce Rosal am Milagros Rosal and the principle investigator for the project Basically what we are going to do doing tonight is just a discussion very informal You are going to be helping us with giving us ideas for the application that the students are developing and your feedback will be helpful and who knows it might help you in
196. rs Program Analysis amp Design 51 hrs Documentation 5 hrs Program Prototype 146 hrs Total 273 hrs Each team member will contribute to the research paper and will help design a project plan for developing the application the following term Assuming that we project member puts in 8 hours per week and there are 5 project members we can accomplish around 40 hours of work per week The time frame for building the application is 7 weeks Therefore we have a total of 280 hours to build the A 5 Page application and test it Given the above calculations we deem it economically feasible to deliver the project plan and a rough draft of the research paper in the given time frame The standard entry level IT consultant hourly rate range is between 14 41 31 11 hr http www payscale com research US Job Information_Technology_ IT _Consultant Hourly_R ate The median of this hourly rate is 22 76 hrso the total cost of consulting in A term will be 6213 48 2 According to our project timeline during B term we will spend approximately 235 hours developing the software application The application is broken down into the following components Google Health Component 40 hrs Smartphone Component 80 hrs Object Layer 10 hrs Notifications Component 35 hrs Data Layer 10 hrs Scoring Mechanism 60 hrs Total 235 hrs Each member of the team will be coding part of a component Assuming again that we
197. s a little bit different The idea is to balance your sedentary vs your physical activity So you would choose the type of activity so you re you know either a standing activity or a sitting activity Then you ll click the select activity box and a pop up will come up and it will say what activity is it walking running swimming that sort of activity and you ll select duration after that and submit it Then it will record your activity information The next input screen is the food input screen and this one requires a little bit more effort as well A You guys really have peas and broccoli under snacks Jenkins this is just a sample food library we don t have the full one in there yet For the food overview is the same as the others but the input is a little different So you select the meal type and we ve got breakfast lunch dinner and snacks in there Once you select the meal type you click continue and it will show you what foods are on your list of foods for that specific meal To add foods to that list you click D 21 Page the add food and the first thing that will come up as your most commonly chosen foods So let s say for breakfast you eat a lot of bananas and orange juice for breakfast those would show up there because vou ve added them a lot Let s say you re going to eat mini wheat s or some of different cereal you d click more and then it would give you a list of food categories within there you d fin
198. s tells us that the women would be willing to use our application and that they would like to see it evolve into a full fledged pregnancy application that they can carry around as their my pregnancy book The application will act as an intervention mechanism that will help guide the patient to gain the right amount of weight throughout her pregnancy through tracking tools feedback and suggestions Therefore patients will be able to take matters into their own hands which could reduce the number of visits to their physicians thus saving the patients time and money and reducing the strain on the hospitals and clinics resources This said our application is the first Android application that helps pregnant women to optimize their gestational weight gain and it represents a small step towards the advancement of mobile healthcare Our recommendations include further extending the application and converting it into a more comprehensive pregnancy tool and conducting long term testing to evaluate the effectiveness of the application There is yet much to accomplish and we hope that future groups will be able to pick up where we left off iv Page HI Acknowledgements We would like to extend our thanks to our project sponsors Dr Milagros Rosal and Dr Tiffany Moore from UMass Medical School for their support and their insight throughout the project Their research on Gestational Weight Gain was central to the smartphone application we bui
199. se had gained so much already that she wasn t worried about it People gain weight at different rates so don t know if you could use that for something Rosal So information about the rate at which people gain weight A So the sun would have a sad face but you d actually be where you re supposed to don t really know how to explain it because not everyone gains weight at the same pace There s other underlying health issues that could be part of it Rosal So your suggestion is to take that into consideration when giving feedback A So maybe if you have a thyroid problem or diabetes that s all going to come into play too So if there s a space where you could put that in Rosal So information about things that could make weight gain different for different women A So the sun is not discouraging you because of something it isn t aware about Rosal What other thoughts do you have Things you would like to see Things that you don t see that you think would be helpful C Could you have a daily or weekly diary section Or a notes section Jenkins Everything is possible C Something that is instead of just notes a calendar where you put in notes for the day Jenkins So you d want that on the main screen C Yes another icon that says diary or whatever Jenkins As far as feedback we talked about this a little bit but wel be giving like You haven t eaten vegetables in a few days how
200. ser Manual serorari a ii ieee ah ees eas E EAAS CO Appendix D Focus Group Transcripts D 1 Appendix E Feedback One Hengen e e seed E 1 Appendix F Nutrition GWG Guidelines Food Information cccccecsessscececeeesessessseeeceeeeseessssseaeees F 1 F 1 MyPyramid Gov Nutrition Equations c cccccccccccsssssscececeeecessesseaecececeeessesesaeaeseesesesesessaeeeeeeeens F 1 Le GWG GUTS EE F 2 F 3 MyPyramid Food Information F 3 ix Page List of Figures Figure 2 1 Distribution of Available Applications on the Apple AppStore for iOS by Category Source uguery AppStore Search Engine Oct 2010 sscccsseden seszesuland aces veretoaauracatansdantcnzsadialacetaainsgaaadecaaiathesdteadanssuans 5 Figure 2 2 Distribution of Available Applications on the Android Market for Android OS by Category Androlib Android Market Search Oct 2010 as accavsessrvevenneitevannacvanan ear sa Oldveesaaveraaaedeventes 5 Figure 2 3 Distribution of Available Applications on the BlackBerry App World for BlackBerry by Category BlackBerry AppWorld Search Oct 20101 6 Figure 2 4 Fetal Growth Health Mango 2010 Second Trimester of Pregnancy Health Mango 2010 10 Figure 2 5 Android Software Stack Source Android Developer 2011 29 Figure 4 1 MVC Pattern Source Microsoft 2011 56 Figure 4 2 Android Activity Lifecycle Android Developer 2011 57 Figure 4 3 System Ai EE 60 Figure 4 4 Package diagram Suisun anere a E O O a a
201. ser interacts with 2 Notifications Reminder component This component is used to generate notifications to remind the user to input his her weight food or activity data 3 Weight Monitoring component This component is for the users to input and keep track of their weight and get feedback based on their gestational weight gain 4 Dietary Information component This component is for the users to input and keep track of the food that they eat on a daily basis and get feedback on whether they are eating a balanced and health diet 5 Activity Monitoring This component is for the users to input and keep track of their sedentary active and exercise times to make sure that they are exercising enough 6 Google Health component 39 Page This component is used to interface with the Google Health service in order to log the user s weight dietary and exercise information into their Google Health profile 7 Feedback component This component is used to generate feedback for the user based on his her weight food and activity input 8 Information library This component contains all the text for the help screens information on serving sizes food information suggestions for users and textual feedback for the feedback component 9 User manual This component consists of a comprehensive guide on how to use the application This is where we started to deviate from the original scrum process Our artifacts only include the product back
202. st receivers to listen for when the application needs to alert or notify the user 4 2 6 Information library The information library is the component that provides educational information on pregnancy and gestational weight gain as well as the fun facts that we present throughout the application This information is stored in the SQLite database and the information library component accesses the database to retrieve information requested by one of the following components activity tracking weight tracking or nutrition tracking The content of the information library can be found in appendix Appendix F 4 3 Package diagrams We utilized packages to separate our source code into the different components Figure 4 4 shows how we organized our packages The main package is the mqp momometer package Inside of this package we have create a separate package for the different components we are implementing The activities package contains all of the application s activities controllers and within this package the 62 Page activities are further divided into their respective components The model package contains the classes that represent the business entities in the application Figure 4 4 Package diagrams 4 4 Database model The database model represents the business entities we identified based on the product requirements From this model we were able to build the objects and classes in our application to encapsulate and re
203. stand patients behaviors the application could be expanded in content as well as customization The food library is one area that can be improved on For example there is potential to query an online food database to maintain an up to date listing of food and nutrition information This would allow the user to input and find information on a wider variety of foods without additional effort An enhanced food library would also help in tracking of how nutritious the user s diet is because all of the macro and micronutrients could be taken into account when giving 91 Page feedback The application could also track the exact times foods are eaten and perhaps give feedback on alternative times to eat It could also include a key for problematic foods so that it can give better feedback on alternatives As the application stands now there is no feature for including problematic toppings on foods such as unhealthy dressings on vegetables Future iterations could include a prompt to add those toppings when the foods are added This could also include common pairings of foods when one item is selected The exercise portion of the application could also be improved upon As the application is now only exercise is tracked and feedback based on active vs sedentary time is optional This could be improved by developing a better way of defining active and sedentary time to help motivate the user to change her habits The input for activities could also be e
204. t 2010 5 Page Utilities 756 7 Weather 45 0 Business 380 3 Education 171 2 Travel 307 3 Entertainment Finance 203 2 476 4 Health amp Wellness 360 IM amp Social Networking 170 2 Maps amp Navigation Test Center 3 0 258 2 Sports amp Recreation Music amp Audio 526 5 343 3 News 377 3 Shopping 93 1 Photo amp Video 122 1 Productivity 408 4 Figure 2 3 Distribution of Available Applications on the BlackBerry App World for BlackBerry by Category BlackBerry AppWorld Search Oct 2010 This surge of applications entering the market is mostly because of the ease of smartphone application development All of the popular smartphone platforms have software development kits SDK available which allows anyone with a computer and programming knowledge to develop and publish applications on the respective software market for little money These applications are available for free for sale or via subscription service Hemmenginger 2010 While the vast majority of applications currently available are for entertainment there have been great advancements in business applications Web browsing and email are now standard on smartphones with the feature set expanding out to geo location video and now even augmented reality Hemmenginger 2010 The medical sector has been heavily influenced by new mobile technology from treatment to education There are vario
205. ted information about serving sizes particularly what is a serving size of a particular food and how do you know how much they had available directly from the food input screen Coupled with this desire for more information the participants wanted the food input screen to offer a dialog that showed a sample food label and how to read it Additional food input screen feedback included The participants wanted a list of favorite of preferred foods to come up immediately when they input what meal they are entering Additionally they wanted their favorite foods to show up 81 Page regardless of what meal they are entering e g they noted they often eat the same core foods regardless of time of day e The participant s wanted to be able to create a list of favorite foods for easy access and entry this was opposed to the application generating the list of foods based on the user s past entries e There was a strong desire to be able to create and enter a food that does not already exist in the food library of the application e There was an interest in the ability to customize the stored food menu and be able to track vitamins and other additional nutritional information not already defined in the application e There was a suggestion to offer an alternative library that consists of vegetarian foods since they contain different or no additives e Several participants wanted a search box that they could type in and search for foods oppos
206. the future too if you other babies Jenkins I m the guess lead person from our group here working on this project my name is Tom Jenkins We are not doctors so defer to Tiffany and Milagros for any sort of medical advice We want all of your feedback so feel free to talk about anything you want It doesn t matter if you have never used the phone before or if you have had smartphones your whole life It really doesn t matter we really want to know what you think of all parts of our application We re going to kind of go through a presentation in a minute to kind of go through everything Rosal Do we have the consent forms Jenkins We have the consent forms they filled those out And right below the consent forms in this packet here there is a one page survey Oh ok cool you guys filled that out too Awesome Rosal Do we have the original Jenkins Yes we have the original right here Yeah that s it pause It doesn t matter positive or negative comments You won t hurt our feelings if you say anything about our application You know we really all comments We have name tents so if you guys could just write your name on it so can refer to you during our discussion Let s get started with the presentation in just a sec Oh do you guys want to hand the phones to them too Evan Sure Jenkins So we are going through a presentation we will show you on the screen what the application looks like You guys will a
207. then it will start the GHealth Setup Activity If it is set up then the activity checks to see if the user s profile has been setup If not then it will start the Setup Activity Otherwise if both the Google Health profile and the user s profile have been setup the activity will launch the Home screen activity Figure 4 10 Main activity Figure 4 11 shows how the GHealth Setup Activity First the activity will pull up a list of the Google accounts stored in the user s phone and ask the user to choose one to associate with the application This information is then stored into the shared preferences so that the application does not need to ask the user again Next the application retrieve s the selected account s authorization token from the phone s account manager component in order to log into Google Health The application will then retrieve the user s Google Health profile and prompt the user to select one to use with the 69 Page application If the user does not have a Google Health profile set up then a default one will be created This profile information is then stored into the shared preferences and the set up activity is launched Figure 4 11 GHealth setup activity Figure 4 12 shows how the setup activity works The activity asks the user for her current pregnancy height and weight and stores this information into the shared preferences It then launches the home activity Figure 4 12 Setup acti
208. ther research related aspects of the project Work Plan and Sprints The timeline for our project is split into three seven week terms For details on the dates and durations of each term please refer to appendix Appendix B The following sections go over the details of our work plan for each of the terms a A term During the first term we conducted initial background research into gestational weight gain and we gathered and documented all the requirements for the software application that we are building which lead to a technical specifications document Please refer to appendix Appendix A We also started building a small prototype of each of the different components of our application in order to determine the technical and economic feasibility of building each module in its entirety The feasibility studies lead to the decision of whether we can build the application and the time it will take us to do so Using all this information we then came up with a work plan for the rest of the terms At the end of this term we formed our product backlog Research Literature review was the primary method of gathering background information for our project We utilized a variety of sources mainly discovered through the WPI Gordon Library Additionally our 41 Page sponsors provided us with a few background documents and books Other resources included general web searches and application catalog searches to determine the availability of s
209. tion Button Feedback Button Mom o Mater A La Details Your Nutrition overview Se D Eriendly Tip The My Pyramid food groups are Vegetable group Fruit group Milk group Grain group Meat and beans group Your baby currently looks like a ube and is about the size of a Details Tab Input Tab Your Status Indicator Well Balanced Diet Next Baby Fact Screen Help Button Home Button The Nutrition tracking overview screen provides a brief summary of your current nutrition level and nutrition goals This is expressed through the combination of the quick overview bar and your status indicator Your status indicator will be closer to the green end if you are doing well at following your goals and closer to the red if you are having difficulty Below the quick overview bar is a friendly tip to help you meet your dietary goals In addition to displaying your Nutrition overview and tips at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished C 12 Page Navigation Changing Tabs In order to access other tabs press the desired tab Getting Feedback In order to access feedback on your reminders press the feedback button on the bottom le
210. tions from health care professionals A 2 Page a Constraints We have the constraint of the timeframe for this project but with adequate communication and coordination we will be able to finish this project in an efficient manner within the time allotted b Standards e Any function must have its description before coding that specifies the name of the function the description of what the function do and what input and output variables are available including all datatypes e Any variable and function must be named first word lowercase and capitalize first letter of every words that follow after the first word o eg helloWorld o eg getCharCocaCola e Any name value of string at strings xml must be all lowercase o eg capturefoot o eg strings myprofile e Any strings must be retrieved from strings xml c CASE Tool For the application we are developing our team will utilize Visual Paradigm which is installed on school computers during the analysis phase to create integrated diagrams of the system The team will create UML class and package diagrams that will describe the overall structure of the system as well as data models that will describe the tables and entities we have identified for the application We will also create diagrams for the various components of the application These diagrams will serve as the blueprint for that will guide our development efforts throughout the agile software development lifecycle A 3 Page
211. tive solution Michael focuses on core design patterns and principles that will allow the team to develop an application with clean code and that is easily maintainable and extensible A 8 Page Evan Duderewicz has experience in information systems both on a small scale for a restaurant and on a large scale for Fidelity Investments He has working experience as a systems analyst and has worked on initiatives including bringing an order management system to a restaurant and working closely with a financial unit on automating their client reporting He is very experienced in working on project teams His experiences include working with relational databases object oriented design UI analysis and design and hardware Evan s combined experiences and skill set enable him to work closely with businesses to design a system that fully meets their needs Ken Miyauchi has experience in both e commerce marketing and designing at a small scale company in Japan The experience lies in launching iPhone application to the AppStore as well as analyzing and designing six different e commerce websites His expertise on both marketing and development aspects will contribute on identifying true wants of the users their behaviors on the application and the most efficient programming solution to the project members In this project Brendan Harris will be the User Interface Lead His strong background in UI design makes him a strong candidate for this positio
212. to the flexibility of the application for errors and fixing said errors by the user In addition the application should attempt to prevent errors by properly responding to different yet sensible responses Finally the reuse principle states that the design should be consistent in its look feel and behaviors whenever possible All of these principles will instill confidence in the user because they address the broad aspects of how humans interact and complete tasks as straightforward as possible There have been other variations of this philosophy notably Raskin s in The Human Interface Raskin 2000 and Nielsen s Usability Inspection Methods Neilson 1994 that offer slightly different 24 Page takes on these basic design considerations yet still maintaining the same thought The major philosophy here is not to confuse the user and streamline the way by tasks are completed which needs to be kept in mind the whole process While the guidelines are important the feedback from focus groups and interviews by actual users will be the most important feedback we will get in tailoring the interface to this niche group User feedback can be attained in a number of ways for example conducting interviews and or focus groups and showing various prototypes from which to get constructive responses on The feedback given by the participants of such interviews has the potential for not only uncovering design feedback but also opinions on functionali
213. tom reminder text These findings were consistent with those we gathered from the focus groups 5 3 Discussion 5 3 1 Implications Takeaways and Achievements Because of the specific nature of this project our group learned a lot about developing an application in the healthcare environment Aside from the design and development of the application there were additional special considerations for dealing with pregnant women at many levels The first aspect of this that we were careful to keep in mind throughout the project was that this application is not a replacement for a doctor This influenced our development in a number of ways so that we not only provide relevant information but also to not provide conflicting information that may have the potential to negatively affect the user By working with our sponsors we were able to carefully design and review every aspect of the application to follow generally accepted information and to also 87 Page motivate the user to eventually improve her health This was especially important because the application gives feedback on the information the user provides While we were aware that there would be organizational differences between WPI and UMass Medical School we quickly learned that scheduling and planning of the various aspects of our project was going to be fundamental to our success Because of the nature of our agile development methodology we collaborated with our advisors and
214. ton Weight by Week Weight 190 Details Tab Input Tab Graph Title Weight Reading Week Screen Help Button Home Button The weight Details screen is where you View a detailed graph of your weight over time The line shows all of the weight readings throughout your pregnancy In addition to graphing your weight readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished C 7 Page Input Screen Description Bar Weight Tab Weight Input Box Cancel Button Toggle Baby Facts Screen Information Button Feedback Button BAM 6 28 PM Details Tab Input Tab ounds Kilograms Toggle Submit Button Next Baby Fact Screen Help Button Home Button The weight input screen is where you can input your periodic weight readings In addition to inputting weight readings at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Inputting a Weight Reading 1 Press the Weight Input Bo
215. ttons 2 Yeah just how they are pretty much 1 The activity one could be someone jogging or something Jenkins Ok 1 Yeah because you can t really tell what she is doing looks like she is just standing there 2 Do your activities only have walking standing and running think there should be more Jenkins There will be more this is just some sample content for this demo Rosal What other things would you want to see D 5 Page 2 Like other things people do pilates yoga like other things like that and the duration Things that are more you know like yeah maybe some moms go out running but a lot of times that might be a setback in their pregnancy So maybe more like swimming things that are less impact Rosal Any other activities you can think of Any activities you have done that you would like to see in there Jenkins Was there anything you didn t like about the application How about anything you particularly liked so far Rosal What are other improvements that could be made 3 The food know like you said you were putting in a lot of them like the pictures know was clicking on one and put in broccoli and it said it was like 1 serving Maybe if there was a measurement so people knew like that s a big misconception with nutrition is that people don t know what a serving is So maybe putting in if its possible something like that Jenkins There is help section where information like serving
216. tus pregnancies bring in so many unique variables to an already involved process 90 Page 6 Conclusions and Recommendations In order to enhance mobile healthcare technologies we developed a functional Android smartphone application which will empower pregnant women to better monitor their gestational health By utilizing Scrum an agile methodology we were able to quickly develop a prototype application and held focus groups to solicit feedback on our initial design After analyzing the initial feedback we were able to refine our prototype and gather more feedback through a series of interviews In order to build a more comprehensive pregnancy application we have several recommendations Recommendation 1 Add Functionality to Enhance Real time Communication The patient provider communication was taken into account with the ability to share information with providers through Google Health but it can be taken a bit further For instance there could be a feature that would allow the user to live chat with a real person for questions or concerns There could also be a reporting feature that would allow the user to print out a report to bring to her doctor or nutritionist In addition there is the potential for social networking that could not only allow professionals to contribute but also allow other women to connect with each other Recommendation 2 Expand Content and Enable Further Customization To better allow the user to under
217. ty The utilization of actual users interacting with various stages of the application can facilitate the custom tailoring to the target audience thus resulting in a better product in a shorter period of time Gould 1995 This is particularly advantageous of applications with a niche user group but the design of the interviews and focus groups will determine the quality of feedback and eventually the final system The second step is to instill confidence in the application as a whole by providing content that is both trustworthy and seeks to motivate the user to not only start using the application but then to find value in it and continue using it This particular project relates to pregnant women and their weight eating and activity levels All of these are sensitive topics making it even more imperative that the content provided relate to the woman in a positive constructive way The difficult part in this case is there will be the potential for negative feedback if the user is not meeting goals in the application Of all of the facets of the wording and feedback addressing the negative properly will be most imperative to keep a user engaged To accomplish this the negative feedback must be framed in a positive light as more of a help than a criticism The content aspect of this application requires extensive user feedback 25 Page to attain the proper level of user satisfaction and confidence thus motivating to utilize the feedba
218. u like it to know that 1 Probably like something funny Like so you wont get offended easily Rosal So using humor somehow so for example what might that look like 1 don t know like Lay off the cheese its Rosal Any other suggestions 3 Yeah like comical and maybe it could even give you tips based on what you have recorded in the previous weeks Like if you are recording activity and food for the last 3 weeks like if it can pull from your data and maybe try increasing your activity another 30 minutes one more day a week or try switching a snack to a fruit Like if it can actually give you feedback on your data 2 Give you hints or tips for healthier eating Jenkins Like outside lets say you go the page to add activity or food 2 Yeah like when you open it up maybe it can say a tip of the day or something D 8 Page Rosal Great idea what other things would you like to see These are great ideas 1 I m just curious how is it like you are saying Cuz know think it was one month out of the pregnancy gained like a lot of weight but the next month only gained 2 pounds How is it going to tell you that you are gaining too much weight How is it going to track it Rosal How would you like to see it 1 don t know like how is it going to track our weight Jenkins There is graph with a range on that graph for your weight gain so you would put in what your weight is before like when you start your preg
219. u like or maybe would be appropriate to put ina handheld device so it becomes a reminder 1 Well have this pregnancy ticket on my phone and it is just counting down the days until the baby is there It has every month that has a new picture and it says every couple weeks it will have a new fact or something like that could show you what it looks like have my phone here 2 Yeah because like watching the baby develop Jenkins You guys touched on the smiley face instead of that what would be a good indication of how well you are doing like something on the home screen to kind of show progress a little differently 2 Like a pregnany belly like watching like they show pictures every month and they show pictures of the fetal development and inside Jenkins Oh ok cool Rosal So the information about the baby would draw you in the application 2 Yeah cuz that is what always check on my computer Like I m always checking the baby s weight D 10 Page Rosal This is kind of like what you were saying with the information about the baby Jenkins What s that called baby ticket 1 Um yeah its called a baby ticket but got it off of babygaga com Rosal What types of information about the baby do you find moticational or inspring What types of things would you like to see on your phone or computer 2 Like development maybe have it show you how the baby is growing week to week Jenkins So you were saying graphica
220. ucted the user interviews to gather some more feedback on the usability of the final product User Interviews To further refine the development of our application we conducted one on one interviews with volunteers The interviews were conducted with potential users of our application The purpose of these interviews was to gather intuitiveness of the different screens menus buttons and navigation of the application Additionally the interviews may review minor bugs or unusual developmental decisions that we have overlooked The interviews can also help us identify areas for potential future development Our interview protocol was to give the volunteers a phone running the application and then ask them to perform tasks that would be both typical of a new user but would also be reoccurring throughout the application s use The tasks we asked the user to perform were 50 Page A Launch Application The user will be asked to turn on the phone and access the application by clicking on its icon B Input Weight The user will then be asked to go to the weight input screen and instructed to input a weight they will be told their real weight does not need to be inputted The user will not be asked to do anything between this step and the next one for example the user will not be asked to return to the home screen of the application C Input Food The user will be asked to input a sample lunch again they will not be asked to in
221. uidelines compared to 4 3 of normal weight women and 51 2 of underweight women gain weight below the recommended guidelines compared to 10 4 of normal weight women Endeavors to control GWG thus far have been resource and time intensive for both physicians and pregnant women These women have to visit their physicians regularly for a checkup as most of them do not keep track of their GWG on their own and their physicians might not be able to give them immediate feedback sometimes it can take up to a week or two for women to get feedback on their GWG According to Moore et al 2010 no publication to date has utilized mobile technology to assist in the optimization and management of GWG However there have been developments in web based interventions for general weight management These web based solutions help adults to effectively manage their weight and weight loss Likewise many weight loss and weigh control applications have been developed for the various smartphone platforms see section 2 5 Yet none of these solutions as of this publication specifically address the optimization of weight gain loss during prenatal stages Moore et al 2010 A large percentage of women of child bearing age are internet connected either through their computers and or handheld devices and welcome the idea of utilizing tools such as the Internet for optimizing GWG People carry their smartphones wherever they go which allows them to be connecte
222. uncher at the top of the screen which the user can pull down to check The reminder component of the system makes use of the notification manager to set up repeating reminders for specific dates and times e Broadcast receivers According to the Android developer s guide 2011 a broadcast receiver receives and reacts to broadcast announcements In our application we used broadcast receivers to listen for reminders set by our reminders component Once the broadcast receiver receives a reminder to input weight food or activity data it will call the notification manager to alert the user that it is time to input his her data f Account manager The account manager provides access to a centralized registry of the user s online account accounts The account manager manages the user s credentials and permissions to access the accounts through other applications Our system makes use of the account manager to gain access to the Google Health services through the user s Google Gmail account 58 Page 4 2 System design Based on the requirements of our application and the amount of resources we had we decided to abstract our code into multiple layers using the MVC pattern This allowed us to clearly separate our development tasks in order to have each developer work on his her own independent layer without affecting the other layers As mentioned in section 4 1 we were able to easily divide the system into several modules as seen on
223. urrently not eating This could be tied into the desire for more information since there are times when a pregnant woman needs more of certain nutrients because it is vital to the baby s development The participants would like to know what these nutrients are and what they do for the baby s development In general the participants wanted the suggestions tailored based on their recorded information A recommendation was to create suggestions that are based on the date for example o During the end of the year holiday season when extra weight gain is common the application could offer suggestions for minimizing this weight gain o During the summer the application could give suggestions and reminders to and how to stay hydrated A desired suggestion was tips for cooking at home The participants noted aversions to certain foods and desired food suggestions based on these foods that are disliked In addition if they noted that they disliked foods that offer key nutrients for the baby s development than the applications should provide suggestions on how to acquire these nutrients The participants would prefer the feedback is supportive and or funny they do not want to feel like their phone is yelling at them e Feedback on Food Input Screens The food input screen requires the highest amount of inputs of any screen and therefore generated a lot of feedback This feedback included again the desire for more information The participants wan
224. ury Healthcare providers and experts in the field have been looking for ways to provide quality healthcare at affordable rates One such way has been through the use of technology which has been rapidly evolving over the past years Mobile technologies in particular have been gaining traction in recent years and making their way into a great number of industries revolutionizing the way business is done in these industries The use of mobile technologies in the healthcare field also known as Mobile Healthcare is relatively new and unexplored Hence our goal with this project was to design and develop a smartphone application to empower patients with the ability to self manage their health Based on academic literature on gestational weigh gain GWG our team focused on developing an application that would allow pregnant women to keep track of and optimize their weight gain during pregnancy which is a factor that can significantly affect the immediate and long term health of both the mother and child There is currently no Android application in the marketplace that serves as a tool for pregnant women to optimize their GWG Drs Rosal and Moore developed a set of guidelines regarding GWG Depending on a patient s body mass index BMI that patient must gain a certain amount of weight also known as the GWG trajectory each week throughout their pregnancy Using this research we set forth to build an Android application that would allow pregnant wo
225. us types of medical applications available ranging from drug information to exercise Selected list of 2009 These applications target a variety of user groups from professionals to laymen and provide various levels of functionality and content 6 Page The pharmaceutical sector has especially taken advantage of this new technology releasing many corporate branded applications Byrne 2010 Table 2 1 represents various examples of applications developed by major pharmaceutical companies for the iPhone This again shows the wide variety of uses for mobile technology in health related areas These applications range from self help tools to tools for medical professionals While many of these applications are branded or linked to a particular product they show the wide range of uses for mobile software for a variety of audiences Table 2 1 Examples of iPhone Applications by Major Pharmaceutical Companies Byrne 2010 Name of App Date Launched Sponsor Creator Primary Category CareConnector 12 28 2008 Johnson amp Johnson Consumer Healthcare amp Fitness Products Company Sleep Tracker Tylenol PM 5 30 2009 Tylenol McNeill Johnson amp Healthcare amp Fitness Johnson Dr Mobile 6 5 2009 Wyeth Pharmaceuticals France Medical Blackbag Medical 6 5 2009 Ortho McNeil Janssen Medical Resources Pharmaceuticals Inc Pneumonia Management 6 22 2009 Ortho McNeil Janssen Medical Tool Pharmaceuti
226. vity 70 Page Figure 4 13 shows how the home activity works The home activity represents the application s home screen from which the user can access all of the application s features Figure 4 13 Home activity Figure 4 14 shows how the weight tracking activity works This activity allows the user to access the weight tracking features The user can selected from one of the three tabs weight overview details or input and can also get general feedback on her weight gain by pressing the feedback button Feedback is generated by getting the user s weight data from the SQLite database calculating the GWG and retrieving feedback from the Feedback Generator using the current week and the calculate GWG The feedback is then displayed to the user 71 Page Figure 4 14 Weight tracking activity Figure 4 15 shows how the weight overview activity works The activity calculates the user s GWG over the past week using data retrieved from the SQLite Database It then retrieves the GWG trajectory for the current week from the Feedback Generator and compares this to the current GWG to calculate the user s progress This progress is then displayed to the user using the progress bar Figure 4 15 Weight overview activity Figure 4 16 shows how the weight details activity works This activity displays the user s weight gain over by week over the past weeks It retrieves the user s weight data from the SQLite database
227. w cost The next step for mobile specifically smartphone systems is to empower patients By keeping the patient at the center of the treatment of a disease we can begin to shift to a preventative medical system instead of the reactionary system we have today The demand 8 Page is there even for personal health records According to a study the California HealthCare Foundation conducted in 2010 participants said they have taken additional steps to improving their health and becoming more knowledgeable because they had online access to their health records California HealthCare Foundation 2010 In addition 40 of those surveyed that did not have personal health records stated they would like to use them It is a seemingly logical response that if there is easier access to the information the more people will use it but speaks volumes to the value behind improving personal health These new technologies have the potential to transform the way the world does healthcare while also being extremely available even to developing countries 2 2 Pregnancy In humans pregnancy lasts 40 weeks and between conception and childbirth there are three phases or trimesters of pregnancy Mayo Clinic 2010 As the baby develops see Figure 2 4 and the expecting mother moves from one trimester to the next there are numerous physical changes and behavioral recommendations The first trimester covers the time from conception through the twelfth week
228. want to track my weight can go to weightwatchers com If you want a real pregnancy weight tracking and things like that there needs to be things that if I m pregnant have certain needs certain requirements that need to track not just my weight A We have a lot of worries a lot of questions especially if it s your first kid know spent a lot of time going on the internet looking for something but if it s right there you don t have to take the time to go search you could put a search bar in there but it would still be in one spot That s something else you could charge a price for that would be in the full version compared to the lite version The lite version could be this and the full version could be the one with everything you need Cause it s a long 9 months or however long it is after you find out you have a lot of questions a lot of things you don t know a lot of worries Moore Terrific thank you so much Jenkins Thank you guys a lot this is great D 40 Page Appendix E Feedback Content Dietary Feedback If the amount of fruit servings entered is less than recommended suggest a fruit from the library and show a tip to help eat more fruit It is recommended you eat insert servings of fruit per day considering trying one of these fruits display 2 or 3 fruits from library A good way to eat more fruit is show tip If the same fruits are always inputted the application will say
229. x 149 2 Type your weight 3 Select pounds or kilograms Ob Dg 4 Press the submit button Submit l 5 A confirmation message will display C 8 Page 6 The Activity Screen Overview Screen Description Bar Details Tab Input Tab Overview Tab Quick Overview Your Status Indicator Active side Sedentary side Toggle Baby Facts Next Baby Fact Screen Information Button Screen Help Button Feedback Button Home Button The activity tracking overview screen provides a brief summary of your current activity level and activity goals This is expressed through the combination of the quick overview bar and your status indicator Your status indicator will be closer to the green end if you are doing well at following your goals and closer to the red if you are having difficulty In addition to displaying your activity overview at the bottom of the screen there are facts about the development of your baby Below that is a navigation menu which will allow you to access feedback or information about your reminders provide instructions for adding or modifying a reminder and returning to the home screen when finished Navigation Changing Tabs In order to access other tabs press the desired tab Getting Feedback In order to access feedback on your reminders press the feedback button on the bottom left Getting Information To get more information about reminders press the info butto
230. xpanded upon with a pedometer or the ability to incorporate Bluetooth pedometers to give more accurate feedback on how many calories were actually consumed This could be supplemented with the GPS capabilities of the phone as well In addition to expanding the content the application could also allow users to personalize their experience by customizing the look and feel of the interface The application could be improved by adding additional color themes for the user to choose from The food library could also allow input of custom foods that are unlisted in the current library in order to allow the patient to keep even more accurate records Recommendation 3 Enhance Provider s Access to Information From the provider point of view there is also a lot that can be improved The first of these improvements is in the ability to generate reports on specific patients This would allow doctors to keep up on their patients between visits and also have the ability to do more with those visits Another feature that would be valuable for physicians and researchers is the ability to aggregate all the data from 92 Page a pool of users that can be used for a variety of research on gestational weight gain and pregnancy in general There is potential for data on usability to be aggregated as well which would be especially helpful in conducting a pilot study of the application and further improving its effect on users To conclude our application
231. y entered the wrong weight 82 Page Figure 5 3 Iteration 2 Home Screen Figure 5 4 First attempt at input screen After conducting the focus groups and receiving generally positive feedback detailed in section 5 1 1 we decided to make a few smaller changes to the interface This mostly involved changing the color scheme and making baby facts more accessible to the user The final iteration is shown in Figure 5 5 and Figure 5 6 83 Page Mom o Mater Mom o Mater Welcome Overview Details Input Please input your meal Select Meal Type Breakfast Continue Figure 5 5 Iteration 3 Home Screen Figure 5 6 Iteration 2 Input Screen 5 1 2 Data Storage amp Graphing In order make the application run smoothly and to finish on time we made changes to our data storage features and graphing mechanism Initially we wanted all of our data to be stored online via Google Health As we progressed further we realized that if the user didn t have an internet connection with their phone then the data would not be saved In order to address this we created a local database of all the information and synchronized it with Google Health whenever possible This change not only fixed several bugs with data storage but also made our application run smoother By reducing dependency on outside data new features and ideas could be implemented One of these major changes was changing the way that our graphs were cre
232. y our team used to develop our software system we refer to Table 3 1 According to this table the methodology that best suited our project was Agile The software system we developed was relatively simple for which we knew what the requirements were and which we were able to break down into several smaller modules This allowed us to skip some of the more time demanding tasks such as modeling and diagramming and start off development as soon as possible Next we look at our familiarity with the technology Android applications are built using the Java language and our team has extensive experience programming in this language The third and most important factor is time Our schedule was strictly limited to 21 weeks which was a fairly short development cycle considering that software systems usually take from 6 months to 2 years to develop This said adopting an agile methodology allowed us to develop a system within a shorter period of time than other methodologies and provided us with very clear schedule visibility 3 3 Agile Development Methodology Agile software development is a programming methodology that focuses on flexibility to streamline the system development lifecycle Fowler 2005 The standardized tenets of the agile development process are given in the Agile Manifesto that was written in 2001 by a panel of experts who practice different programming methodologies Beck amp Cunningham 2001 The main values of the Agile Manifesto
233. you had in mind that would be different better or appealing E just don t like the smiley face Rosal We got that Jenkins As far as the icons do you like them or not like How could we change them to make them better As far as the main navigation how you go through the app E Icons are fine Rosal What do the icons tell you A Exactly what they say Rosal because you all saw the application already but she hasn t seen it so her input would be very valuable E My opinion think the icons are fine they tell you right to the point what they are would probably want them more on the side not in the middle of the phone Jenkins Would there be anything else you d want to see on this screen Tip of the day Or facts Progress E I m on Facebook every Friday it sends me an update and what to expect C Would you be able to have an area to input how many times a week you throw up Things like that D 33 Page Jenkins Just like a notes section C Something you could track how nauseous you are when you get tired Rosal Any type of symptoms C So when go see my doctor just pull out my phone and say this is what happened to me this week or this month When I m feeling sick don t want to be writing it in my daily journal A didn t gain weight how you normally do gained a lot in the beginning and then went a month or a month in half without gaining anything My doctor said it was fine becau
234. you sort of an idea of how well you are doing in this So lets go through this key terms we kind of covered we didn t go through the vocabulary You guys are a little bit familiar with applications with software just a little bit Like you have used a computer with Microsoft Word which is kind of an application or piece of software This is a piece of software on a cell phone essentially so its mobile Its you know made for you to take with you Its not something you are supposed to leave So back to the buttons those 6 buttons was talking about there and on the bottom of the screen there is the feedback help info buttons And then below that are like the hard buttons built into the phone Really the only one you are going to worry about is the back button and that is the one with the little arrow Ok so lets go to the weight input screen So the goal of this is to capture your weight and give you an idea of how well you are doing On each screen there are 3 different tabs There is the overview screen tab the details tab and the input tab Right now it is selected on the input tab but the overview tab basically will show you like you see on your screen this little graph It shows kind of overall how you are doing just like a very basic idea of how you are doing The details we are not going to cover today it is just basically a graph over time We are not going to worry about that today but the input is really D 2 Page what we want

Mom-O-Meter - Worcester Polytechnic Institute

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