Elimination Diet Journal
App Design Paper
Joelle Zaslow
Mobile Health Design
Summer 2013
EXECUTIVE SUMMARY
This paper follows the design and development process from concept to evaluation for a new
mobile health app, the Elimination Diet Journal. The app’s goal is to provide users with a stepby-step guide through the elimination diet. This app offers a unique approach to food allergies in
that it not only tracks foods and symptoms through each step of the diet, but it allows users to
connect with both their healthcare professional and other dieters.
The Elimination Diet Journal will be developed in partnership with a large healthcare leader as
well as Food Allergy Research & Education. Although still in its development phase, the
Elimination Diet Journal will be made available on iPhones and Androids within the next year
after extensive beta and pilot testing.
BACKGROUND
Mobile Health Use
Mobile apps have significantly altered the way we find information and learn. With the
development of apps, information is available at the swipe of a touchscreen, no matter the time of
day or the location. The field of health, which encompasses medicine, fitness, nutrition, and
much more, has especially felt the impacts of this shift. According to the latest industry data
available, there are presently 31,000 health, fitness, and medical related apps on the
market today1. With so many new mobile health apps on the market, competition continues to
increase. Mobile app designers must find ways to distinguish themselves from the competition
and offer unique features to entice users. The ever-evolving field of mobile health has exciting
implications for the future of the medical world, the doctor-patient relationship, and how patients
access information.
Elimination Diet
Food allergies have drawn increasing media and medical attention in recent years. Researchers
estimate that up to 15 million Americans have food allergies2 and many others have food
intolerances that often go undetected by common doctor-administered allergy tests. One method
of detecting food allergies when a standard food allergy test is negative is the elimination diet.
An elimination diet is an eating plan that omits certain foods believed to trigger food allergy
symptoms. Once all trigger foods have been eliminated, each food is gradually added back into
the diet to isolate which food causes the symptoms. Although there are multiple approaches to an
elimination diet, the six food elimination diet is a commonly used method and the focus of this
paper. This diet focuses on the six types of foods most commonly associated with food allergies:
wheat, dairy, eggs, soy, seafood (fish and shellfish), and peanuts and tree nuts3.
The elimination diet begins with planning and preparation. Depending on the individual, the diet
can present a drastic lifestyle change and proper planning should be considered. The next step is
the avoidance phase where all trigger food groups are eliminated from the diet. Patients should
follow this phase for at least ten days. This gives the digestive system sufficient time to rid the
body of the possible trigger foods. After ten days, the challenge phase begins in which food
groups are slowly introduced back into the diet. Food groups should be introduced back into the
system every three or four days and only in small quantities. The food group should be
introduced for a day and then removed to see if symptoms occur over the next two days. Then
the patient can introduce the next food group to test for symptoms4. Once the challenge phase is
complete, the patient can assess which foods, when isolated, triggered their symptoms. Given
their observations, they can then create a long-term diet plan.
It should be noted that a patient’s symptoms will often worsen before they begin to improve.
Other risks associated with the elimination diet include: activation of “latent” eating disorders;
malnutrition; socioeconomic implications; reduced enjoyment of eating; fear of food; and
unexpected diet results based on patient non-compliance.
NEEDS ASSESSMENT
Target Audience
The target audience for this app is primarily those that suffer from chronic symptoms commonly
associated with food allergies. These include:

Tingling or itching in the mouth

Hives, itching or eczema

Swelling of the lips, face, tongue and throat, or other parts of the body

Wheezing, nasal congestion or trouble breathing

Abdominal pain, diarrhea, nausea or vomiting

Dizziness, lightheadedness or fainting6
They have had ongoing or reoccurring symptoms and are feeling frustrated because they cannot
pinpoint the source. They may have already spoken with a gastroenterologist, dietician, or their
primary care provider but with inconclusive results. They are trying the elimination diet to
hopefully find a solution.
Thanks in part to celebrities, the elimination diet has become the new diet sensation. With that in
mind, this app is also targeted to those who are diet conscious and want to change the way they
eat. They may have minor symptoms such as low energy or frequent skin breakouts but no major
health concerns that disrupt their daily lives. They are curious as to how they could feel better
and possibly lose weight.
Additionally, the app will assist health professionals such as gastroenterologists, dieticians, or
primary care physicians, whose patients are trying the elimination diet. The app will allow the
health professional to track their patient’s progress and provide support throughout the process.
Personas
Personas provide a prototype of the target audience(s), their characteristics and their goals. They
present narratives of a single person who, although fictional, is based on a segment of real people
and their needs. Personas are vital in the app design process in
that they inform content, strategy and messaging.
Jason
Target Audience: Chronic allergic symptoms
Jason is twenty eight years old. He has lived in Chicago for three
years where he works at a marketing firm. Jason is a bachelor and
has a busy social calendar, whether it’s happy hour with his
coworkers after a long day or playing basketball with friends at
the park on the weekends. He has an iPhone and is constantly using it for work and to text his
friends. He has downloaded multiple apps and uses them to both help him manage his day-to-day
life, such as Fitness Buddy to track his workouts, and for fun, such as Snap Chat and Words with
Friends.
He has no history of major health concerns and for the most part has lived his life without
medical issues. However, Jason has been dealing with reoccurring digestive upset almost the
entire time he has been living in Chicago. He thought it was food poisoning, but when it started
to become a reoccurring pattern every seven to ten days, he realized it was something else. Jason
has a primary care physician but has yet to discuss his digestive issues with his doctor. Instead of
seeking professional help, he relies on Pepto-Bismol and repeatedly cancels his plans with
friends. Jason has a gluten allergy, but because he repeatedly ignores the signs, he hasn’t realized
it yet.
A Day in the Life of Jason
Jason wakes up at 6:30 in the morning on a Friday. He showers, gets dressed, and is out the door
by 8:00. He picks up a bagel with cream cheese from the local café on his way to work. He
arrives at the office by 9:00. He runs into his friend and coworker, Rob, and they chat about their
plans for the weekend. Jason tells Rob his close friends from college are visiting tonight and they
have tickets to see the Dave Matthews Band, which was their favorite band in college. He hasn’t
seen these friends in years and Jason is excited for the reunion. After sharing their weekend
plans, they agree to meet up for lunch at noon. By 10:00 AM Jason is starting to feel stomach
cramping, but he ignores it and keeps working. He has an upcoming deadline and tries to focus
on his work instead of the stomach cramps which have become almost a daily occurrence.
Jason meets up with Rob and two of their other coworkers for lunch. They walk over to a
sandwich shop located near their office. They enjoy lunch outside on a beautiful spring day and
reluctantly return to the office to finish up the work day. As the afternoon progresses, Jason’s
stomach cramps return. He goes to the bathroom at work and has diarrhea. By 2:00 Jason’s
digestive upset has gotten progressively worse. He is able to make a last minute appointment
with his primary care provider for that afternoon. Jason leaves work early and rushes over to his
appointment. Upon explaining his symptoms, Jason’s doctor recommends a food allergy test and
the elimination diet. The doctor shows Jason the Elimination Diet Journal app and suggests he
download it to help him through the process. They schedule a food allergy test for next week and
Jason heads home, still feeling ill and skeptical about the elimination diet.
His gastrointestinal problems continue throughout the late afternoon. Jason worries that his
digestive ailments will keep him from seeing his friends. At 5:00 his college friends call to ask
where and when they should meet up. At that moment, Jason has to admit that he won’t be able
to join them for the concert. His friends are very disappointed and before hanging up, they make
plans to meet up for lunch tomorrow. Jason eats some crackers in the hopes of settling his
stomach, but that seems to do more harm than good.
As the night progresses, Jason begins to get very frustrated with his health situation. He is
annoyed that his stomach issues have yet again come in the way of his plans. He downloads the
Elimination Diet Journal app which provides information about what the elimination diet entails.
He sees that it will take him through each step of the diet and will also provide support through
community message boards. Jason is intrigued and decides to begin the diet on Monday.
Marie
Target Audience: Those who have
taken food allergy tests but results
have been inconclusive
Marie is 35 years old. She lives in a
small suburb twenty minutes outside
Atlanta, Georgia with her husband,
Doug, and their two children,
Genevieve (age 3) and Samuel (age
5). Before kids, Marie worked full time, but when Samuel was born, Doug and Marie decided it
would be best for Marie to quit her job and take care of their newborn son. Doug still works in
the city and often puts in long hours. With the addition of Genevieve to the family, Marie has her
hands full. She has an Android but has only downloaded a few apps. She finds the Grocery IQ
app especially helpful for her trips to the market.
A month ago Marie started experiencing lightheadedness and she noticed hives often
accompanied her symptoms. She saw her primary care physician who thought it could be related
to food allergies. They ran a food allergy test but the results were inconclusive. Her PCP
recommended she consult a dietician for a second opinion. Two weeks ago she saw a dietician
who told Marie that although the allergy tests were inconclusive, she could still have an
undetectable intolerance to a certain food group. The dietician suggested she try the elimination
diet, which Marie was unfamiliar with. It sounds complicated and Marie is worried she won’t
have time for it in her busy life.
A Day in the Life of Marie
Marie wakes up at 5:30 AM on a Tuesday to Genevieve shaking her awake. Lately Genevieve
has been waking up early to watch her cartoons. Marie gets out of bed and accompanies
Genevieve downstairs. While her daughter watches TV, Marie makes herself a cup of coffee.
She reads the morning paper and at 7:15 AM stands up to wake Samuel to get him ready for
kindergarten. As she stands up, she experiences lightheadedness and is yet again reminded that
she should follow her dietician’s recommendation of the elimination diet. The morning is a
whirlwind of helping Samuel get dressed, eat breakfast, and make sure he catches his bus at 8:15
while making sure Genevieve eats breakfast and stays entertained. Doug breezes into the kitchen
at 7:45, grabs a cup of coffee and lunch that Marie also prepared for him this morning, and
rushes out the door by 8:05.
Marie is finally able to quickly shower and get herself ready around 9 AM. While styling her hair
in the mirror, she notices a new cluster of hives have formed on her neck. She throws on a scarf
with her outfit, gets Genevieve dressed, and they head out for playgroup with some of Marie’s
friends and their children.
Marie and Genevieve make it home in time for Genevieve’s nap at 1:00. This is Marie’s favorite
time of the day. She has three hours to herself to make herself lunch, pay bills, or catch up on
Downton Abbey. Today Marie decides to finally look into the elimination diet. She discovers the
Elimination Diet Journal app in her searches and downloads it. She was planning on going to the
grocery store that afternoon after Genevieve’s nap and finds a list of suggested groceries for
Phase 1 of the diet. She adds some of these foods to her grocery list on Grocery IQ. She also
finds a topic on the message boards for busy mothers trying the elimination diet. Marie reads
through the messages and finds comfort in knowing that other mothers will be going through the
same experience as her. She writes her first post on the topic and says, “Mother of two young
children about to start the diet. Any tips or words of wisdom would be appreciated!” Marie looks
forward to bonding with these women throughout the process.
Samuel arrives home from kindergarten at 3:30 and Genevieve wakes up from her nap shortly
after. Marie takes the two of them to the local grocery store with her new list of elimination dietfriendly foods in hand. Seeing the list of foods Marie can eat makes her feel more encouraged.
That night Marie makes her last meal before beginning the diet tomorrow. The whole family
enjoys Marie’s lasagna. After dinner while the kids are playing and Doug is watching the news,
Marie creates an entry on the app with how she is feeling post-lasagna. She lists any symptoms
she is currently experiencing, and rates her overall health on a scale from 1-5. She checks the
message boards and finds a few people have already written back to her posting from earlier in
the day.
Marie puts the kids to sleep by 8:00 and reads in bed for a while. She goes to sleep, ready to
begin the diet in the morning.
Patricia
Target Audience: Those who are curious about seeing how they could feel better- have minor
symptoms such as low energy or minor indigestion / Health conscious or want to change the way
they eat
Patricia is 52 years old. She lives in San
Diego with her husband Charles. Both
Patricia and Charles are successful lawyers
and live in a condo by the beach. Patricia
and Charles have always been very focused
on their careers and decided early on that
they did not want kids.
Patricia has an iPhone but doesn’t use it for much more than basic phone capabilities. Unlike
many of her friends, she has been slow to adopt new technology. Only two years ago Charles
finally convinced her to set up a Gmail account.
Patricia is very health-conscious. She enjoys going for runs on the beach in the morning before
work and she plays tennis with Charles on the weekends. She often tries new diet crazes- she
tried the low-fat diet for a year in the 90s and the Atkins diet in 2003. When she isn’t following a
fad diet, Patricia focuses on eating healthfully. She has no food allergies or major health
concerns but often feels fatigued. She needs energy for her job and would like to rely less on
caffeine to sustain her throughout the day.
A Day in the Life of Patricia
Patricia wakes up at 6:30 on a Saturday morning. Charles gets up with her and they get ready to
play an early morning game of tennis. They walk out to the courts outside their condo at 7:15
and play a long game of tennis. At 8:30 they make their way back to their condo and enjoy eggs
and whole wheat toast that Patricia prepares for them while Charles brews some coffee.
After breakfast, Patricia catches up on email. Since setting up her email account two years ago,
she has enjoyed keeping in touch with friends through email. With her busy job she often doesn’t
have time to call friends and has found email to be a quicker alternative. Once she has sent out a
few emails, Patricia showers and gets ready to meet her friend Liz for lunch.
Liz and Patricia have been friends for years. They met at a fitness class at the gym they both used
to belong to. Like Patricia, Liz is health and diet conscious. When they get together they enjoy
sharing new exercise and diet tips. Today Patricia meets up with Liz at a local café for salads at
12:30. When ordering, Liz asks for her salad with no cheese or croutons. She tells Patricia that
she’s trying the elimination diet. Patricia is intrigued and asks Liz to explain more. Liz
enlightens Patricia about the diet and shows her the Elimination Diet Journal app on her phone.
She says it has been beneficial in helping her through the process and making sure she sticks to
it. Liz has been on the diet for two weeks and is already feeling more energized and her skin
quality has improved. Patricia decides she wants to try it, and asks Liz to help her install the app
on her phone too.
After a long lunch catching up with Liz, Patricia makes her way to the grocery store to prepare
for her new diet. She calls Charles on her drive to the store to tell him the plan. Charles has
always been supportive of her diets even though he insists she doesn’t need to lose any weight.
He agrees to try the diet with her for moral support. At the grocery store, the app helps guide
Patricia in deciding what she should buy.
Patricia comes home and she and Charles enjoy a quiet night at home. They cook dinner, watch a
movie, and go to bed at 9:30. The next morning Patricia wakes up at 6:00 and goes for a run on
the beach. She returns and heads to the kitchen to make breakfast. Instead of making her usual
eggs and toast, she prepares a smoothie with pineapple, spinach, flax seed, and banana. She
tracks this in the app and afterwards records how she is feeling both physically and emotionally.
She tracks her lunch and dinner on the app as well, noting that physically she is feeling hungry
and unsatisfied from her meals and irritable from the hunger pains. At the end of day one, she
receives a note from the app that explains people often feel tired, hungry, and cranky the first
few days but symptoms will improve by day three or four. She appreciates that the app offers
helpful tips and words of encouragement.
Disclaimer: Patients should always consult a health professional before beginning any new diet
regimen. In reality, some people, such as Patricia, often will not seek medical advice before
embarking on a new diet. Although this is not recommended, this segment of the dieting
population must be taken into consideration when designing a diet-related app. With this
population in mind, the content of this app will be generated from health professionals to provide
all users, especially those like Patricia, with valid and certified information. In doing so, the app
will help ensure users are receiving correct information about the elimination diet.
Dr. Benjamin
Target Audience: Health
professionals with patients doing
the elimination diet
Dr. Benjamin is a 55-year-old
gastroenterologist in Boston. He
is a well-known doctor in the
Greater Boston area and patients
come from all over
Massachusetts to seek his
services. One of his patients that comes from afar is Matthew. Matthew is 40 years old and lives
in the Berkshires. Matthew was recommended to Dr. Benjamin from his PCP after complaining
of stomach cramps as well as itchy mouth. Matthew came in for his appointment with Dr.
Benjamin last week. After examining Matthew, Dr. Benjamin recommended he try the
elimination diet. He helped Matthew download the Elimination Diet Journal app onto his iPhone
and explained that he will be able to check in on Matthew’s progress and will receive
notifications if he has any questions throughout the process.
A Day in the Life of Dr. Benjamin
Dr. Benjamin wakes up at 6:45 on a Wednesday to get ready for work. He checks his
appointments for the day on his smartphone and sees that he has another busy day. He showers,
gets ready for work and gets on the T from his home in Cambridge at 8:00.
He arrives at his office by 8:45. His first appointment is at 9:30 so he has time to make himself a
cup of tea and catch up on a few tasks at his desk. He also checks the app to see how Matthew is
doing. From the health professional portal of the app, he is able to see what foods Matthew has
eaten since beginning the diet on Monday. He also can see how Matthew has been feeling
throughout the day. He sees that Matthew ate peanuts yesterday for an afternoon snack but
besides that, he has been on track with the diet thus far.
Dr. Benjamin has a busy morning and does not have time to break for lunch until 1:30. At that
time he checks his phone and sees a notification from the app from Matthew. Dr. Benjamin has
set his preferences to receive a notice when a patient using the app asks him a question. Matthew
asks if edemame is allowed in Phase 1. He is able to write back in the app and explain that
because edemame is soy, it is not allowable.
Dr. Benjamin has four more appointments in the afternoon and finishes up for the day at 6:30.
After making dinner, his phone alerts him that Matthew has sent him another message saying
that his itchy mouth symptoms have returned. Because Dr. Benjamin has never been one to leave
his work at the office, he responds to Matthew at 8 PM and offers him advice to make sure he
stays away from peanuts for another few days to see if the symptoms clear up. He then silences
his phone for the night, watches some television and goes to sleep at 10:00.
Lessons Learned from Personas
From the persona development exercise, it is clear that the app needs to provide basic
information on the elimination diet. Both Jason and Marie were unfamiliar with the diet but used
the app to learn more before diving in. Connectivity was also important, both for dieters and
healthcare professionals. Everyone handles new challenges uniquely, but for those like Marie
and Patricia who want social support, the app should offer a way for them to reach out and
receive encouragement. For healthcare professionals like Dr. Benjamin whose busy schedules
keep them from frequently meeting their patients face-to-face or answering phone calls, a doctorpatient connection would offer instant and quick communication.
COMPETITIVE ANALYSIS
A competitive analysis is crucial in app development. It helps scan the market for what apps are
already available and identifies how to design your app to differentiate it from the competition.
The competitive analysis process involves three steps:
1. Identify your competitors
2. Create a chart to help analyze and evaluate your competitors (see below)
3. After you complete your chart, assess what you want to borrow, avoid and how to
distinguish yourself.
1. Identify your competitors.
The target personas (Jason, Marie, Patricia, and Dr. Benjamin) would look for apps by either
doing a Google search for the topic and apps related to the topic or by word of mouth from a
health professional or friends. Search terms would include “food allergy”, “elimination diet”, and
“restricted diet”.
A pattern developed while conducting a thorough search of available apps in app stores and on
Google using these keywords. There are two types of competitive apps on the market: One set of
competitors helps with identifying food allergies while the other helps with those already on
restricted diets. Competitors for helping with identifying allergies include: Food Allergy
Detective, Allergy & Gluten Free Diet Tracker, mySymptoms Food Diary, and Allergy Journal
Free. Competitors for helping with restricted diets include: iAvoid Food Allergy, Allergy Caddy,
Cook IT Allergy Free, ipiit the Food Ambassador, Food Intolerances, Is That Gluten Free?,
AllergyEatsMobile, Eatible, Living Well with Food Allergies.
2. Create a chart to help analyze and evaluate your competitors
After reviewing the list of available apps, Food Allergy Detective, iAvoid Food Allergy,
mySymptoms Food Diary, and Allergy Journal Free were identified as the closest competitors to
the app.
1. App name,
logo, url
App 1
App 2
App 3
App 4
Food Allergy
Detective
iAvoid Food Allergy
mySymptoms Food
Diary
Allergy Journal Free
http://ibkrllc.com/
2. Objective at
a glance
What is the
objective,
problem, or
challenge the
app seems to
be
addressing?
3. Purpose and
Goals
How clear are
the purpose
and goals of
the app at a
glance from
name, tagline,
and imagery?
Does it match
the objective
at a glance?
4. Users
Is there any
information
about users
through
descriptions,
images,
stories,
testimonials,
or usage data?
http://www.foodaller
gydetective.com/
Paperless food
journal that helps you
discover hidden food
allergies and
sensitivities
http://iavoidfoodaller
gy.blogspot.com/
Helps to identify and
avoid products and
ingredients
responsible for the
eight most-common
food allergies
http://skygazerlabs.co
m/wp/
Food journal to help
track daily foods and
food allergy
symptoms
Helps to track and
identify foods that
trigger food allergyrelated symptoms
The purpose and
goals are clear based
on name, tagline and
imagery. It would
perhaps be more
helpful to include
mention of food
journal somewhere in
the name or imagery.
The purpose and
goals are clear based
on name, tagline and
imagery. Based on
the imagery, it is
clear that it has a
medical component.
The logo is very
clever too.
The purpose and
goals are clear based
on name, tagline
(“food diary and
symptom tracker”)
and imagery.
The purpose and goals
are clear based on the
name, but not on the
tagline (“Food Allergy
Journal is your friendly
weapon in the fight
against food allergies”)
or imagery. The logo
does not provide any
information on the
purpose of the app.
There is no specific
information about
users. From
testimonials, it seems
to be targeted for
those who want to
identify what foods
they could be
potentially allergic to.
There is no specific
information about
users. It seems to be
targeted for those
who have already
identified their food
allergies and are
looking for a source
to find what they
should avoid eating
There is no specific
information about
users. However, it
provides a list of
diseases (such as IBS
and Crohns) that it
can help track
symptoms for. Could
potentially be for
users with these
diseases. Many
testimonials are from
There is no specific
information about
users. From the
testimonials/reviews,
the app is intended for
those who want to track
their eating habits in
hopes of finding
patterns with their
food-allergy symptoms.
those with
health/digestive
issues.
5. Ratings and
reviews
What are the
ratings,
reviews, and
feedback?
6. Downloads
and use
How many
users/downloa
ds are there?
Is there data
about
retention?
7. Research
Was there any
research,
evidencebased
guidelines, or
experts
involved?
Received positive
reviews from
AppAdvice, Food
Allergy Assistant
Blog, and My
Appinions.
Recommended by
iPhone 4S All-In-One
For Dummies. The
current version
received 4.5 stars on
iTunes (7 ratings).
Information not
available
The current version
received 5 stars on
iTunes (5 ratings).
Average 4.1 stars on
Google app store (48
reviews); average 3.5
stars on Amazon app
store (6 reviews).
Average 2.5 stars on
iTunes for all versions
(14 ratings). There
were multiple
comments on the app
not being user-friendly.
Of importance to noteone user noted that the
journal could not be
exported to share with
a doctor.
Information not
available. However, it
has a top position
when “food allergy”
is searched in the app
store
4,794 as of June 23rd, Information not
according to Amazon available.
app store. No
information about
data retention
Does not specify. At
the bottom of the site
it says: Disclaimer:
This software is for
informational
purposes only and
may not be construed
as medical advice.
The information is
not intended to
replace medical
advice offered by
physicians or trained
medical personnel.
Always seek the
advice of your
physician or other
qualified healthcare
provider(s) when
experiencing
symptoms or health
problems, or before
Yes, the app delivers
publicly available
content from
respected sources,
such as Food Allergy
Research and
Education website.
Sarah Silverman,
MD, designed the
app.
No, this app was
created by the
founder of SkyGazer
Labs who does not
appear to have a
medical background
No, this app was
created by IBKR
Analytics which does
not have a medical
background. They have
designed other apps,
but Allergy Journal
appears to be their only
health-related app.
Others include Price
Check Guru, El Gifto,
and Size That Up.
starting any new
treatment or diet
plan. The app
designer, Evil
Timmy, does not
seem to be affiliated
with a health
professional or
expert.
8. Design
How
professional is
the design?
Characterize
it (modern,
simple,
crisp…) and if
the design
Simple and
works given
uncluttered design.
the app
Design is appropriate
purpose.
for the app’s purpose
and goals.
9. Layout and
navigation
What sections
does the app
have and are
they
delineated by
content type,
roles, or user
needs? How
usable and
organized are
the layout and
There are four
sections: I’m Eating;
I Feel; Analysis; and
Settings. Layout is
very organized. The
four sections have
icons at the bottom of
the screen that you
can tap on to move
from one to the next.
“I Feel” and “I’m
Eating” have
checkboxes and a
Simple, if not boring,
design. Given the
straightforward
nature of the
information, the
design is appropriate.
Main page offers a
list of the allergens.
Checking off an
allergen will bring
you to a age of foods
to avoid. Bottom
navigation has icons
for each allergen that
you can click on.
Easy to navigate.
There is only one
role- user.
Modern design.
Design is appropriate
for app’s purpose and
goals
Simple design.
Considering the content
and types of usergenerated information
the app is asking for,
the simple design is
appropriate.
There are three
sections: Diary,
Results, and
Organizer. The three
sections have icons at
the bottom that you
can tap on to
navigate. The Diary
navigates you
through each event
throughout your day,
with multiple
customizable options.
There are three
sections: Entries,
Reports, and Journal.
The three sections have
icons at the bottom that
you can tap on to
navigate. Easy to select
which kind of report
(organized by food or
by symptom) you
would like to view. The
app is easy to navigate.
There is only one role-
navigation
(including
labels and
menus)? Do
they make
options
apparent?
10. Branding
and external
affiliations
Who created
the app and
why? Is there
organizational
branding,
accreditation,
sponsorship,
or
advertising?
11. Expert
content
What are the
expertgenerated
components
(including
text, graphics,
audio, video,
blogs,
directions, ask
the expert,
glossary, quiz,
chat with an
expert)?
12. Authors and
oversight
Does expert
content
identify the
notes section- very
simple and
straightforward.
Analysis has options
for 6, 12, 18, and 24
hour analyses. Charts
that accompany
analyses are bar
graphs that are simple
and easy to read.
There is only one
role- user.
Evil Timmy created
the app. There is no
information on who
is behind Evil Timmy
or if there are any
affiliations.
It is not clear if an
outside statistician, etc
does the analysis and
creates the charts.
Besides the chart, most
content is usergenerated
No- there is no
mention of authors
(besides the app
developer), experts,
an advisory board, or
The layout is very
organized. There is
only one role- user.
user.
Sarah Silverman,
MD, created the app.
There is no
explanation as to why
she created it. She
took her information
from Food Allergy
Research &
Education and credits
them as a source. Not
clear as to whether
FARE provided
sponsorship or
funding for the app.
FARE provides the
content for the app.
The foods to avoid
are presented in list
format.
Darren, the founder
of SkyGazer Labs,
created this app. It
was inspired by his
own personal issues
with food
intolerances. There
appears to be no
sponsorship or
accreditation.
IBKR Analytics
created the app. There
is no information
available on the
company or if there are
any affiliations. They
appear to specialize in
app design.
It is not clear if an
outside statistician,
etc does the analysis
and creates the chart.
Most content is usergenerated.
IBKR Analytics
generates the reports on
either food or symptom
trends. However it is
not clear if IBKR
should be considered
an “expert” for
generating this content.
Sarah Silverman cites
FARE as the content
provider. Silverman
is an MD.
No, there is no
mention of authors
besides the app
developer. There is
no mention of an
No, there is no mention
of authors besides the
app developer. There is
no mention of an
advisory board or
author and
clinician involvement
date written
and reviewed?
Is there an
advisory
board or
clinician
involvement?
Content is very clear
13. Literacy and and easy to
understand. Graphs
readability
Is the content are simple. Most
clear and easy content is generated
to
through check boxes.
understand?
Anyone with a basic
What reading reading
level is it?
comprehension could
use it.
Users input what
14. Userfoods they’re eating,
generated
the amount of food,
content and
how they’re feeling,
sharing
What are the
and (optionally) the
userdate and time they ate
generated
the food or felt a
components
specific symptom.
(including
There is no social
discussion
media component,
forums, blogs, but the app itself has
videos,
a Facebook page and
“likes”,
Twitter handle.
comments,
ratings, and
reviews)?
Which, if any,
social media
is used? Can
content be
shared?
There is no privacy
15. Policies
Are there
policy
explicit
privacy
policies or
ones for how
information is
The content is very
clear and easy to
understand. Anyone
with a basic reading
comprehension could
use it.
The user selects
which allergen they
would like to see lists
for. There is no social
media aspect and
content cannot be
shared.
No privacy policy but
it is not much of a
concern because the
user is not entering
their personal
information to
generate the results.
advisory board or
clinician
involvement.
clinician involvement.
The content is
relatively clear and
easy to understand
although it is not as
intuitive as the other
apps. It seems like it
may take some time
to become familiar
with the layout and
navigation.
The user inputs their
foods, events,
symptoms and time
of event/symptom.
There are no
discussion forums or
blogs. The app has a
Facebook and Twitter
page. Food diary can
be exported as
HTML report for
printing and sharing.
The content is very
clear and easy to
understand. Anyone
with a basic reading
comprehension could
use it.
There is no privacy
policy.
There is no privacy
policy.
The user inputs their
foods, symptoms, and
time/dates of their food
and symptoms. There is
an option to email the
reports but there is no
social media aspect.
used?
16. Registration
Do users
register and, if
so, what can
they do before
and after
registering?
What
information is
tracked or
displayed?
How is
personal
information
used?
17. Cost
Is there a cost
for the app or
for premier
features?
18. Devices and
websites
Does the app
tie into any
others apps,
devices, or
websites?
19. Support and
feedback
Is there a
website or
support forum
for users? Is
there a way to
provide
feedback? Is
there a
feedback
survey?
No, users do not
register. Information
about food and
symptoms are tracked
for analysis and
displayed in graphs.
It is not clear how
personal information
is used.
No, users do not
register. Information
regarding what foods
to avoid is displayed.
Personal information
is not a factor.
No, users do not
register. Information
regarding foods and
symptoms are tracked
for analysis and
displayed in the
graphs. It is not clear
how this information
is used by the
developer.
No, users do not
register. Information
about food and
symptoms are tracked
and displayed in report
format. It is not clear
how personal
information is used.
The cost is $3.99
The app is free.
The cost is $2.99
The app is free.
No, it does not tie
into other apps or
devices. Users can
export data analyses.
No, it does not tie
into other apps or
devices.
It ties to its Facebook
and Twitter accounts,
and links to
allergyuk.org as a
source of more
information
No, it does not tie into
other apps or devices.
Users can email their
reports.
There is a contact
page with a form
users can fill out with
comments. No
feedback survey.
There is no contact or
feedback
form/information.
Yes, there is a page
for support. They
provide an email
address to contact for
technical issues as
well as a separate
email address for
feedback and
suggestions.
IBKR has a feedback
form on its website.
20. Overall
assessment
What are the
overall best
and worst
features of the
app?
Best parts: easy to
use, clean design,
checkboxes make
inputting data quick
and straightforward,
bar graphs offer a
simple visual
representation of the
data.
Worst parts: No
information on the
designer or their
background/expertise
. No professional
affiliations leads to
questioning the
legitimacy of a
health-related app.
Name and imagery
don’t immediately
clarify the app’s
purpose. Only
available for iPod and
iPhone- not iPad or
Androids.
Best parts: simple
layout, easy to
understand, created
by an MD and cites
source of allergen
information so there
is more legitimacy,
provides list of food
and non-food sources
of the eight most
common allergens
Worst parts: boring
layout/color palate,
no contact form
Best parts: many
options for “events” –
more than just meals
(stress, medication,
exercise), symptoms
rated on scale from 15, able to export food
diary, available for
iPhone, iPad and
Android
Worst parts: can’t
export analysis, not
sure who is doing the
analysis and how,
doesn’t record
measurements of
foods, navigation
isn’t as intuitive or
simple- may take
some time to learn
Best parts: simple
design, available for
both Android and
Apple platforms.
Worst parts: no
information on IBKR.
From reviews, it does
not seem user friendly
and data often gets
erased. Imagery and
tagline do not
immediately clarify the
app’s purpose. No
function to export food
diary to doctor, etc- can
only email reports.
3. After you complete your chart, assess what you want to borrow, avoid and how to distinguish
yourself.
a.
Borrow – what features or capabilities do you want to include? Simple design layout;
visual components; customizability for user-generated components; from iAvoid Allergyinclude citations/proof of expert-generated content to certify legitimacy; creative logo that
matches goals/purpose of the app.
b.
Avoid – what did you learn that you want to make sure you don’t do? Include
information about developer and privacy policy- transparency will eliminate risk of skepticism
by potential users; mention experts or the developer’s qualifications for designing a healthrelated app (omitting this leads to questionable accuracy of content); test app before releasing to
avoid major flaws such as deleting user-generated content.
c.
Distinguish yourself – what capabilities, knowledge, or branding do you have that you
can capitalize upon to stand out from your competition? All of the apps compared in the
competitive analysis only had one role (user). To distinguish this app, it will include a health
professional role which will also help expand the app’s target audience and increase number of
downloads. All four of the apps also did not have an affiliation/partnership with a health-related
company or organization. To increase legitimacy of the app, developers will partner with a
health-related company or organization such as an insurance provider or hospital system.
Another option is to partner with a distinguished expert in the field, such as a nutritionist,
dietician, or other healthcare provider.
DESCRIPTION OF APP DESIGN
App Components
The app will contain two portals- one for patients/users and one for health professionals. The
idea for two portals was inspired by the competitive analysis which noted that, of the apps
analyzed, all of them only offered one role for users. Offering a second role for health
professionals will distinguish the app from its competitors and also widen the target audience.
When the downloader opens the app for the first time, they will be brought to a welcome screen
which will ask them to select a role. Their selection will determine which portal will open every
time they open the app.
The user/patient portal will have four main components: Profile & Settings; Journal; Message
Board; and Medical Connect. Profile & Settings will allow the user to input basic personal
information as well as adjust their privacy and other settings. The privacy policy will be clearly
presented in this section as well as a link to the feedback/contact form. This component
originated from the competitive analysis after noting that many apps do not make the privacy
policy transparent which makes potential downloaders wary of trusting the app with sensitive
information. The competitive analysis also revealed that many apps also do not have an easy way
to either contact the developer or provide feedback. Making these two subjects easily accessible
will distinguish the app from its competitors. In the Settings section, the user will have the option
of turning off notifications, such as a pop up at 2:00 in the afternoon that would remind them to
track their lunch foods and symptoms if they had not already done so that day or messages
containing words of encouragement. In the Profile section, the user will also have the option to
list their healthcare professional if they are also using the app. This feature will link up the two
usernames and allow the healthcare professional to track their patient’s progress.
The Journal component will be broken out into three subsections: Pre-Diet Planning, The Diet,
and Long-Term Diet Plan. The Pre-Diet Planning subsection will have general information about
the elimination diet for those who are considering the diet but do not know much about it. This
component originated from the persona development exercise after realizing that many users of
this app may not be well-versed in elimination diets and will want basic information. This
subsection will also have checklists of foods suitable for each phase of the diet and which foods
to avoid. Thanks to the mobility of smartphones, the patient can refer to this checklist as a guide
when they are at the grocery store before beginning the diet. All of this content will be generated
by experts in the field of nutrition and properly cited.
The Diet subsection will contain categories for each of the six food groups (wheat, dairy, eggs,
soy, shellfish and nuts) as well as a category to the preliminary phase when all six food groups
are eliminated from the diet. The categories will be set to an automatic timer and the patient will
not be able to move from one category to the next until three days (or 10 days for the preliminary
phase) have passed. Within each category, there will be a food diary component and a
symptom/check-in component. The food diary will allow the user to input what foods they ate
and the time of day. The symptom/check-in component will allow the user to track their
symptoms using a dropdown list of common allergy symptoms (itchy mouth, hives, swelling,
abdominal pain, etc., with an option for “other”). This element was inspired by the competitive
analysis which noted the need for customizability for user-generated content. Offering write-ins
will fulfill this need. Users can also input the time of their symptoms and there will be a textbox
to type out how they are feeling. At the bottom of the page will be a scale where they can rate
how they are feeling on a scale from 1-5. There will be no limit to how many times the user can
input a new food or symptom entry.
The Long-Term Diet Plan subsection will allow the user to view charts of patterns that emerged
between the foods they ate and their symptoms. This element was inspired by the competitive
analysis which made note of other apps currently on the market that offer a graphing component.
Charts and graphs are ideal visual representations that would be easy for the user to understand.
The third component, the Message Board, will be the social component, allowing users to
connect with others who have downloaded the app and are going through the elimination diet as
well. This component originated from the competitive analysis after noting that no other app on
the market has a community support function. The message board component was also inspired
by the persona development exercise which observed the personas’ need to connect and receive
social support. The message boards will feature areas for those in all phases of the diet (pre,
during and post) and can be utilized to connect with others, share helpful tips, or just complain
about foods that they currently cannot eat. The message board component will also link to the
app’s Facebook and Twitter pages where users can further connect via social media. The
emphasis on the app’s social networking features originated from the competitive analysis which
observed that some apps on the market do not have a Facebook or Twitter page and, if they do,
they are sparsely updated. The social media components will be a key element in the community
support aspect of the app. They will be updated on a regular basis with food allergy-related
articles as well as announcements of upgrades to the app.
The fourth component, Medical Connect, is where patients and their healthcare professionals can
interact. From the user portal, patients will be able to submit questions to their healthcare
professional via a text box. Post-diet, patients can view any comments or suggestions their
healthcare professional provided upon reviewing their charts. This component was inspired by
discussions in Mobile Health Design lecture surrounding mobile health and the doctor-patient
relationship. Mobile health presents new opportunities to enhance the doctor-patient relationship.
The Medical Connect aspect of the app takes advantage of these new opportunities to interact in
a digital space.
The healthcare professional portal will be more simplified than the user/patient portal. There will
only be two components: Profile & Settings; and Patient Connect. Profile & Settings will be the
same for both the user and healthcare professional portals. The Patient Connect component will
have three subsections: Patient Journal, Patient Questions, and Patient Charts. In the Patient
Journal subsection, the healthcare professional will be able to view their patient’s journal
including foods consumed and symptoms. The Patient Questions subsection will send
notifications to the healthcare professional’s smartphone if/when a new question has been
submitted by the patient. This will prompt the healthcare professional to open the app and
address the question. Lastly, the Patient Charts subsection will allow the healthcare professional
to view their patient’s charts and submit comments and feedback via a textbox to their patient.
Persona Use- Jason, Marie, and Patricia
Before the Diet
Jason and Marie can learn about the diet via the information provided on the app and both can set
their apps to connect with their healthcare professionals. Marie can also use the message boards
to get advice before she begins the diet. Both Marie and Patricia can use the food checklists at
the grocery store the day before they start the diet.
During the Diet
All three personas can use the journal to track their food intake and symptoms. Marie can use the
message boards for support as she juggles two young children and a new diet. Jason and Marie
can ask their healthcare professionals questions via the Medical Connect component. Patricia can
find Liz on the message boards and they can swap helpful tips.
After the Diet
All three personas can use the charts to see patterns in their symptoms. Jason can see a visual
representation depicting how his symptoms were closely associated with gluten. Marie’s charts
can show her where her hives and lightheadedness spiked. Patricia can see what foods gave her
the most energy and where she felt like a “5 out of 5.” Jason and Marie can both view what their
healthcare professionals recommended as they begin figuring out their long-term diet plans.
Persona Use- Dr. Benjamin
Dr. Benjamin can check in on Matthew’s journal throughout the day to track his food intake and
symptoms. He can answer Matthew’s questions when he receives notifications on his phone. Dr.
Benjamin can also review Matthew’s charts when he is done with the elimination diet to look for
patterns and offer recommendations.
WIREFRAMES
Welcome Screen:
Health Professional Portal with
Notification:
Patient Portal:
EVALUATION PLAN
Evaluation is vital in all phases of the app design process because it allows the developer to get
valuable feedback. Scripted focus groups will be conducted during the design phase of the
Elimination Diet Journal app with both health professionals who would use this app to help their
patients and with those who have previously gone through the elimination diet. Participants will
use a beta version of the app to test for: usability, relevancy, major or minor bugs, proper storage
of user-generated content, proper connection between user-generated content and health
professional portal, proper postings on message boards, and overall design and aesthetic. Those
who have previously gone through the elimination diet will offer insight into what features they
would have wanted in an app when they were on the diet. The aim is to recruit at least five health
professionals and five patients to the beta test focus groups.
Once these focus groups have been conducted, the feedback has been compiled and appropriate
adjustments have been made, a new group of health professionals and patients will be recruited
for a pilot roll out of the full app. Once again, the aim is to enroll at least five health
professionals and five patients who have recently completed the diet. This group will participate
in an unscripted session in which they scroll through each section of the app to test for userfriendliness and practicality. Although formative evaluations lack the context of a real-life
interaction with the app7, the simulated environments will provide insight into how typical users
would interact with the app. This pilot will provide a last chance to make any final revisions
before the app’s official release.
Once the app is officially released, evaluations will be conducted by looking through the usersubmitted feedback. Feedback, support, and contact forms will be made available on the app and
the app’s website. The competitive analysis noted that some apps do not offer feedback or
support forms, which is important for both the app designer (for evaluation reasons) and the
consumer (for feeling as if they have someone to contact regarding questions or comments).
Feedback forms as well as reviews on app store websites will be monitored as a means of
continual evaluation. Surveys will also be periodically sent to random downloaders via a pop-up
notification on the app. These surveys will ask a brief series of questions regarding the user’s
satisfaction with the app and any suggestions for improvement.
DEVELOPMENT PLAN
Cost
The cost of developing this app will be reduced thanks to a partnership with a healthcare leader
such as Harvard Pilgrim, Sanofi, or Abbott Nutrition. A consultant will be hired to assist in app
development. The estimated total costs for developing and designing the app are $40,000.
Timeline
The total timeframe from the development phase to official public release spans nine months.
Development and design will take six months. Working with a consultant, the wireframes (as
seen above) will be transformed into the beta version of the app. The app will initially be
developed for use on smart phones, with plans to expand to iPads and other tablets in the near
future.
The beta version of the app will be tested in focus groups, as previously mentioned in the
formative evaluation section. Recruiting participants, scheduling the focus groups, and actually
conducting the sessions will take two months.
A finalized version of the app will be ready four months after focus groups have been conducted
and revisions have been made. The initial rollout of this finalized version to the pilot group will
last a month. In this time period, the pilot group will help ensure the app is ready for public
release.
Once the pilot group has confirmed that the app is ready, version 1.0 will be released to the
general public. The first few months after the release will be spent carefully studying user
feedback and reviews. These comments will be taken into consideration as version 2.0 is
prepared for release six months after the app’s initial debut. Additional updates and new versions
will be released as needed to keep up with user demands.
MARKETING PLAN
Platform
The app will be available for both Androids and iPhones with plans to later release a version for
iPads and other tablets.
Promotion
As previously mentioned, the app will be developed in partnership with a healthcare leader such
as Harvard Pilgrim, Sanofi, or Abbott Nutrition. A partnership will also be formed with Food
Allergy Research & Education which will receive recognition for their expert-generated content.
The app will use these two partnerships for cross-promotion. The app will piggy back on current
advertising efforts and will be mentioned on the organization’s social media feeds, in addition to
providing a link to the app’s website and Facebook and Twitter pages. This partnership will not
only benefit the app but also the company. In addition to brand recognition and exposure to a
health-minded audience, supporting the app will build on the company’s emphasis on advanced,
innovative healthcare.
The app will be promoted to both healthcare professionals as well as the general public. The
marketing message to healthcare professions will focus on how the app enhances the doctorpatient relationship and helps facilitate the elimination diet process for their patients. Promotion
to the general public will target those who are considering the elimination diet or those who have
food allergy symptoms. The app will be marketed as a step-by-step guide through the elimination
diet, complete with built in food journal and charts to help track symptoms.
Price
The app will cost $1.99 for both the user portal and healthcare professional portal. With all the
components to the app including symptom charts, community forum, and option to connect the
user-generated content with a healthcare professional, the cost is justifiable. Many similar apps
currently available averaged around this cost. The free options were those that had basic
capabilities and did not offer multiple functions. Charging a low rate for the app will also result
in an ad-free experience for users.
LIMITATIONS
The elimination diet can pose a significant lifestyle change to some participants which could
result in users straying from the diet’s guidelines. If users do not follow the diet and thus do not
input sufficient data into the journal, the final results post-diet could be skewed or inconclusive.
Issues with participation could also impact the message boards. The message boards will be most
functional if all users participate to create a web of community support complete with dynamic
discussions. If only a handful of users post, the message boards will serve little to no use.
With so many health-related apps on the market and 140 apps listed under an app store search for
“food allergy,” it will be difficult to ensure this app is able to emerge as a strong competitor in
this field. It will be important to emphasize its dual role function as well as its step-by-step
approach to the elimination diet, both features that are missing from its competition.
Another limitation could arise if the healthcare provider does not have a smartphone and thus
cannot utilize the healthcare professional portal while their patient uses the patient portal to guide
them through the diet. A similar limitation could arise if the patient does not have a smartphone,
although this may be uncommon. It is worth noting that this app is marketed with the
understanding that the elimination diet is popular amongst those who can afford a restricted diet.
This audience is also typically wealthy enough to afford a smartphone. In this case, cost and
access are not limitations to the app’s success amongst patients.
REFERENCES
1. Mobile health care apps growing fast in number. (2013, April 15). Retrieved from
http://mhealthwatch.com/mobile-health-care-apps-growing-fast-in-number-20052/
2. Food Allergy Research & Education. (2013). Facts and statistics. Retrieved from
http://www.foodallergy.org/facts-and-stats
3. Children's Hospital of Orange County. (2013). 6-food elimination diet overview.
Retrieved from http://www.choc.org/eoe/index.cfm?id=P00982
4. University of Wisconsin School of Public Health. (2013).Elimination diet. Retrieved
from http://www.fammed.wisc.edu/sites/default/files/webfmuploads/documents/outreach/im/handout_elimination_diet_patient.pdf
5. Rakel, D. (2012). Integrative medicine. (3rd ed., Vol. Chapter 84, pp. 776-788). Elsevier
Inc.
6. Mayo Clinic. (2011, February 11). Food allergy symptoms. Retrieved from
http://www.mayoclinic.com/health/food-allergy/DS00082/DSECTION=symptoms
7. Gualtieri, L. (2013). A guide to formative evaluation for health apps and websites. (Tufts
University).
ABOUT THE AUTHOR
Joelle Zaslow is a non-matriculated student in the Tufts University Health Communication
graduate program with hopes of enrolling in the program and earning her MS in Health
Communication. She received her bachelor’s from Emerson College in Communication Studies.
Joelle is currently the Grants and Finance Coordinator for ChildObesity180, in collaboration
with Tufts University, which works to reverse the trend of child obesity.
Joelle has been gluten and dairy free for four years thanks, in part, to the elimination diet. Joelle
is a strong believer in eating a healthy, well-balanced diet that nourishes the individual. With her
degree in Health Communication, she hopes to pursue a career in health coaching or program
planning and advocacy for a nutrition or fitness-focused organization.