Effectiveness of Obesicare application use in promoting healthy eating behaviours: a quasy-experimental study in Aceh, Indonesia

Authors

DOI:

https://doi.org/10.47197/retos.v74.117549

Keywords:

Behavior change, health, mobile apps, nutrition counseling, obesity prevention, 5A’s Model

Abstract

Introduction: Obesity rates in Aceh, Indonesia are rising, partly due to low nutrition literacy and the limited effectiveness of conventional counseling. This study aimed to develop and evaluate the effectiveness of the Obamacare mobile app in improving healthy eating behaviors using the 5A’s behavioral counseling framework.

Methodology: A quasi-experimental, mixed-method study was conducted from January to April 2025 in Banda Aceh and Aceh Besar. The study involved 46 nutritionist for app validation and 96 adult participants who were randomly assigned to 5A’s based counseling groups.

Results: The app demonstrated high functionality and usability. Significant improvements were observed in knowledge, attitudes, and behavior, with greater effect sizes in the 5A’s group. Did analysis showed a significant intervention effect.

Discussion: Obamacare application has good functionality and suitability, with a score of, an average satisfaction score of, and good functionality, thereby confirming its potential as an effective nutritional intervention tool in preventing obesity. This study also highlights that the ease of use of the Obamacare app aligns well with trends in other digital health apps. The study found that while usability scored, there are several technical aspects that need improvement, particularly in terms of app stability and error handling. This opens opportunities for gradual improvements to the app's structure, especially in enhancing its reliability when used by the general public.

Conclusions: The Obamacare app is an effective m Health tool for delivering behavioral nutrition counseling. The 5A’s approach yielded superior outcomes and is recommended for broader implementation in primary care to support obesity prevention.

Author Biographies

  • Agus Hendra Al-Rahmad, Poltekkes Aceh, Indonesia

    He is a doctoral student at Syiah Kuala University in Banda Aceh, Indonesia

  • Hizir Sofyan, Universitas Syiah Kuala, Banda Aceh, Indonesia

    He is a lecturer in Mathematics at the Faculty of Mathematics and Natural Sciences, Syiah Kuala University, Aceh, Indonesia

  • Said Usman, Universitas Syiah Kuala, Banda Aceh, Indonesia

    Said Usman was born in Meureudu in Pidie District on October 15, 1970. Usman went to Simpang Tiga State Primary School from 1978 to 1984, Meureudu 2 Middle School till 1987, State Nursing of Health Department in Banda Aceh till 1990, and Cut Meutia High School in Banda Aceh till 1991. Usman received the B.S. degree in English language at the University of Serambi Mekkah, Banda Aceh, Indonesia, in 1997, and his M.S. degree of public health from the Faculty of Public Health at the University of Indonesia, Jakarta, Indonesia, in 2002. Usman received the Ph.D. degree in public health at the Public Health Faculty of North Sumetera University, Medan, Indonesia, in 2015. Usman was a Junior Staff Nurse at Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia, from 1990 to 1999; next Usman was the Head of the Training and Education Installation from 1999 to 2000. Usman worked at the Training and Education Department Dr. Zainoel Abidin Hospital, from 2000 to 2016. Usman was the Dean of the Public Health Faculty of Serambi Mekkah University, Banda Aceh, Indonesia, from 2004 to from 2017; next Usman has been a Rector at the same university from October 2017 till now. Besides that, from 2017 until now, Usman has been working at the Faculty of Medicine in Syiah Kuala University, Banda Aceh, Indonesia. Usman is experienced in public health, medical education, hospital management, changing of health behavior, and health promotion and is a Researcher and a Journal Reviewer. Usman has been active in the Nursing Association from 1989 to the present and a Member of the Public Health Association. Usman has been a participant and also a presenter at local, national, and international public health conferences and has also participated in community activities to improve the health of the community.

  • Mudatsir Mudatsir, Universitas Syiah Kuala, Banda Aceh, Indonesia

    Employment, Universitas Syiah Kuala Fakultas Kedokteran: Banda Aceh, Aceh, ID

References

Alessandri, G., Zuffianò, A., & Perinelli, E. (2017). Evaluating intervention programs with a pretest-posttest design: A structural equation modeling approach. Frontiers in Psychology, 8(MAR), 1–12. https://doi.org/10.3389/fpsyg.2017.00223

Alunyo, J., Mukunya, D., Napyo, A., Matovu, J., Okia, D., Wanume, B., Okello, F., Tuwa, A., Wenani, D., Okibure, A., Omara, G., & Olupot-Olupot, P. (2024). Factors Associated with Teenage Pregnancies During the Covid-19 Period in Pakwach District, Northern Uganda: A Case-Control Study. Adolescent Health, Medicine and Therapeutics, Volume 15, 93–108. https://doi.org/10.2147/ahmt.s378048

Arce-larrory, O. (2025). Validación del modelo teórico hábitos de vida saludables en el ámbito curricular de Educación Primaria Validation of the theoretical model of healthy lifestyle habits in the Primary Education curriculum Autores Resumen Cómo citar en APA Palabras clave Key. 2025, 59–74.

Ariani, D., Dradjat, R. S., Kumboyono, K., & Zuhriyah, L. (2025). A Model for Fostering Self-Efficacy in Breastfeeding Mothers through Self-Directed Learning in Nursing Care. Malaysian Journal of Nursing, 16(4), 10–22. https://doi.org/10.31674/mjn.2025.v16i04.002

Arifin, S. R., Tanziha, I., Ekayanti, I., & Ahmad, A. (2025). The impact of a free nutritious meal program on elementary school students’ concentration levels. AcTion: Aceh Nutrition Journal, 10(3), 790. https://doi.org/10.30867/action.v10i3.2737

Armaita, A., Nisa, S., Lucintarillova, B., Aprihatin, Y., Krishna, N. R., Alimuddin, A., Ockta, Y., Festiawan, R., Soedirman, U. J., & Alimuddin, A. (2025). Reducing anxiety in pregnant women by prenatal gentle yoga Reducir la ansiedad en mujeres embarazadas a través del yoga prenatal suave Authors How to cite in APA Keywords Resumen Palabras clave. 2025, 1056–1064.

Biernat, E., Piątkowska, M., & Mynarski, W. (2018). Prevalence and socioeconomic determinants of leisure time physical activity among Polish farmers. Annals of Agricultural and Environmental Medicine, 25(1), 151–156. https://doi.org/10.26444/aaem/75927

Botagariyev, T., Mambetov, N., Aralbayev, A., Mukhanbetaliyev, A., Ispulova, R., & Akhmetov, N. (2024). Web-Based Technologies in Middle School Physical Education. Retos, 51, 171–178. https://doi.org/10.47197/RETOS.V51.100310

Brumby, S., Chandrasekara, A., Kremer, P., Torres, S., McCoombe, S., & Lewandowski, P. (2013). The effect of physical activity on psychological distress, cortisol and obesity: Results of the farming fit intervention program. BMC Public Health, 13(1). https://doi.org/10.1186/1471-2458-13-1018

Brumby, S., Chandrasekara, A., McCoombe, S., Torres, S., Kremer, P., & Lewandowski, P. (2011). Reducing psychological distress and obesity in Australian farmers by promoting physical activity. BMC Public Health, 11. https://doi.org/10.1186/1471-2458-11-362

Camargo, E. M. De, Denise, E., & Bacil, D. A. (2024). 2 (27) = 58,6,. 2041, 332–340.

Capili, B. (2021). Selection and implementation of outcome measurements. American Journal of Nursing, 121(8), 63–67. https://doi.org/10.1097/01.NAJ.0000767840.30291.31

Cristina Valls Bautista. (2023). 97093-Texto del artículo-362422-1-10-2023031. 2041, 312–326.

Damschroder, L. J. (2020). Clarity out of chaos: Use of theory in implementation research. Psychiatry Research, 283(April 2019). https://doi.org/10.1016/j.psychres.2019.06.036

de Vocht, F., Katikireddi, S. V., McQuire, C., Tilling, K., Hickman, M., & Craig, P. (2021). Conceptualising natural and quasi experiments in public health. BMC Medical Research Methodology, 21(1), 1–8. https://doi.org/10.1186/s12874-021-01224-x

Elwy, A. R., Wasan, A. D., Gillman, A. G., Johnston, K. L., Dodds, N., McFarland, C., & Greco, C. M. (2020). Using formative evaluation methods to improve clinical implementation efforts: Description and an example. Psychiatry Research, 283(April 2019), 112532. https://doi.org/10.1016/j.psychres.2019.112532

González, J. A. (2025). Efectos de 8 semanas de entrenamiento flywheel durante la temporada sobre el rendimiento físico en jugadoras de fútbol Effects of 8 weeks in-season flywheel training on physical performance in female soccer players Authors How to cite in APA Keywords Resu. 2025, 479–490.

Hamilton, A. B., & Finley, E. P. (2020). Reprint of: Qualitative methods in implementation research: An introduction. Psychiatry Research, 283(April 2019), 112629. https://doi.org/10.1016/j.psychres.2019.112629

Korf, M. N., Van Geloven, N., Krijthe, J. H., & Labrecque, J. A. (2025). Causal clarity in statistical software. International Journal of Epidemiology, 54(4), 0–5. https://doi.org/10.1093/ije/dyaf136

Kurnia, A., Said, F. M., & Panduragan, S. L. (2025). Experience of Burden in Self-Care of Type 2 Diabetes Mellitus: A Qualitative Study in Indonesian Context. Malaysian Journal of Nursing, 16(4), 33–44. https://doi.org/10.31674/mjn.2025.v16i04.004

Kuspanov, N., Botagariyev, T., Ryskaliyev, S., Doshybekov, A., Syzdykov, A., & Gabitov, A. (2024). The influence of information technology on the professional readiness of future trainers in Kazaksha kures. Retos, 51, 365–372. https://doi.org/10.47197/RETOS.V51.100350

Leao, A., & Lorente-Catalán, E. (2024). Educación Física de Calidad: Diseño y validación de una herramienta orientada a la reflexión e innovación en los procesos educativos. Retos, 51, 32–46. https://recyt.fecyt.es/index.php/retos/index

Manzano, S. S., de Oliveira, P. B., Magdaleno, A. R., & Ariza, A. R. (2022). Effect of a C-HIIT program in the inhibitory control and behaviour of young ADHD. Retos, 45, 878–885. https://doi.org/10.47197/retos.v45i0.92903

Mat, N. H., Musa, R. M., Mat, F., & Zaffri, Z. F. (2025). Identification of essential anthropometric and health-related markers for effective weight loss program in middle-aged women. Retos, 65, 1077–1085. https://doi.org/10.47197/retos.v65.109475

Miller, C. J., Smith, S. N., & Pugatch, M. (2020). Experimental and quasi-experimental designs in implementation research. Psychiatry Research, 283(June 2019), 112452. https://doi.org/10.1016/j.psychres.2019.06.027

Muharram, N. A. (2025). Desarrollo de una pulsera de detección de frecuencia cardíaca basada en IoT para el entrenamiento de resistencia en voleibol Authors Development of IoT-based pulse rate detection bracelet for volleyball endurance training Abstract How to cite in APA Keywo. 2025, 931–940.

Niu, Z., Iván-Baragaño, I., & Ardá, A. (2023). Análisis multivariante mediante árbol de decisión de los tiros libres indirectos en la Superliga China 2020. Retos, 48, 358–365.

Parada-Flores, B., Faúndez-Casanova, C., Cruz-Hidalgo, N., Díaz-Riquelme, J., Muñoz-Muñoz, F., & Castillo-Retamal, M. (2023). Estilos de vida de adultos en cuarentena total y cuarentena parcial, durante la pandemia por COVID-19 (Lifestyles in adults in total quarantine and partial quarantine, during the COVID-19 pandemic). Retos, 48, 494–504. https://doi.org/10.47197/retos.v48.94282

Purnama, H., Ibrahim, M., Juniarni, L., & Lindayani, L. (2025). Evaluating the Impact of a Mobile Application on Mental Health and Help-Seeking Behaviour among Adolescents in Bandung, Indonesia. Malaysian Journal of Nursing, 16(April), 1–9. https://doi.org/10.31674/mjn.2025.v16isupp2.001

Rajan, R., Dovbenyuk, R., Kshatriya, M., Yanikomeroglu, S., Banfield, L., Athale, U., Thabane, L., & Samaan, M. C. (2025). The Impact of Virtual Care on Health-Related Quality of Life in Pediatric Diabetes Mellitus: A Systematic Review. Adolescent Health, Medicine and Therapeutics, Volume 15, 109–117. https://doi.org/10.2147/ahmt.s482859

Rosyad, Y. S., Aljaberi, M. A., & Natarajan, S. B. (2025). Strategies for Preventing and Reducing Psychological Problems and Mental Disorders among Deaf and Hearing-Impaired Communities. Malaysian Journal of Nursing, 16(4), 314–324. https://doi.org/10.31674/mjn.2025.v16i04.031

Rueda, M., González-Peño, A., Franco, E., & Coterón, J. (2024). Teachers’ perceptions of the teaching situation in Physical Education in secondary education: a qualitative study. Retos, 51, 912–922. https://doi.org/10.47197/RETOS.V51.99207

Setyawati, H., & Pramono, H. (2025). Development of a web-based athletic sports learning model in sports talent schools Desarrollo de un modelo de aprendizaje deportivo basado en la web en escuelas de talentos deportivos Authors How to cite in APA Keywords Resumen Palabras clave. 2025, 1018–1031.

Siregar, S., Pardilla, H., Hasibuan, N., Fahmi, M., Kasih, I., & Faridah, E. (2025). Enhancing refereeing skills: exploring the influence of an Android table tennis app on student referees. Retos, 66, 75–85. https://doi.org/10.47197/retos.v66.112160

Smith, J. D., & Hasan, M. (2020). Quantitative approaches for the evaluation of implementation research studies. Psychiatry Research, 283(August 2019), 112521. https://doi.org/10.1016/j.psychres.2019.112521

THE MALAYSIAN JOURNAL OF NURSING VOL. 16(4) April 2025 | i. (2025). 16(April), 2025.

Turdaliyev, R., Botagariyev, T., Ryskaliyev, S., Doshybekov, A., & Kissebaev, Z. (2024). Virtual Reality Technology as a Factor to Improve University Sports. Retos, 51, 872–880. https://doi.org/10.47197/retos.v51.101213

Valle, F. (2010). Universidad de Valencia. Universidad de Valencia, 28(2020), 237–257.

Yachsie, B. T. P. W. B., Pranata, D., Dewanti, G., Famelia, P., & Kozina, Z. (2024). Validity and reliability of archery sport arm muscle endurance training program based on body weight training. Retos, 60, 477–482. https://doi.org/10.47197/retos.v60.105803

Yau, K. W., Tang, T. S., Gorges, M., Pinkney, S., Kim, A. D., Kalia, A., & Amed, S. (2022). Effectiveness of Mobile Apps in Promoting Healthy Behavior Changes and Preventing Obesity in Children: Systematic Review. JMIR Pediatrics and Parenting, 5(1), 1–16. https://doi.org/10.2196/34967

Downloads

Published

27-11-2025

Issue

Vol. 74 (2026)

Section

Original Research Article

License

Copyright (c) 2025 Agus Hendra Al-Rahmad, Hizir Sofyan, Said Usman; Mudatsir Mudatsir

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and ensure the magazine the right to be the first publication of the work as licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgment of authorship of the work and the initial publication in this magazine.
  2. Authors can establish separate additional agreements for non-exclusive distribution of the version of the work published in the journal (eg, to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
  3. Is allowed and authors are encouraged to disseminate their work electronically (eg, in institutional repositories or on their own website) prior to and during the submission process, as it can lead to productive exchanges, as well as to a subpoena more Early and more of published work (See The Effect of Open Access) (in English).

This journal provides immediate open access to its content (BOAI, http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess) on the principle that making research freely available to the public supports a greater global exchange of knowledge. The authors may download the papers from the journal website, or will be provided with the PDF version of the article via e-mail.

How to Cite

Hendra Al-Rahmad, A., Sofyan, H., & Usman, S. (2025). Effectiveness of Obesicare application use in promoting healthy eating behaviours: a quasy-experimental study in Aceh, Indonesia. Retos, 74, 598-614. https://doi.org/10.47197/retos.v74.117549