Table 5.

Participants’ co-design output and implemented solution for each PEGASO Fit for Future system component.

Component and participant feedback		Implemented solutions
Companion app
	Not understanding the meaning of the Health Square app icon and Challenge icon; alternative icon design suggested.	The Challenge icon was changed.
	Liked the idea of having a mascot and selected a favorite design.	A Mascot was added based on the design selected by the majority of participants.
	Having a customizable avatar.	Avatars were added based on selected design.
	Not wanting to share data around eating habits.	Sharing of information was limited with control on whether sharing and when.
	Some challenges were difficult, and some were easy; suggested to include incremental challenges.	Incremental challenges implemented.
	Participants suggested to include a leader board as they would be more motivated to engage in health behaviors when seeing their friends’ performance.	Leader board was added.
	Did not like to receive too many notifications or messages.	The number of notifications was fixed to 2/4 messages per day.
	Frustration when receiving notification when it is not possible to respond; suggested to receive notifications in after-school hours.	Notifications timed to be released to later in the day (after school).
	Needing a tutorial or guidance for use of the app.	Tutorial messages implemented.
	Participants did not realize that it was possible to collect points and rewards.	Added a tutorial message and an explanation in the Points section.
	Bypassing the companion app to use other PEGASO F4F apps.	Bypassing the Companion app to access other PEGASO F4F apps will not be possible as soon as all remaining PEGASO F4F system services are integrated.
Serious game
	Did not understand the story narrative of the story; suggested to add a tutorial on what the game is about.	A video introduction and tutorial were created.
	The game world is too easy to explore (suggested to provide further dynamism and complexity; specific design ideas for environments or locations provided).	New locations were added. The number of locations increased from 1 to 4.
	Repeating the same minigame was boring.	2 additional minigames were included (scavenging and research).
	No ranks and competitive elements; suggested to include a leader board.	Leader board was implemented.
	Some participants noted they were progressing to higher levels, but they did not notice clear differences between the levels; suggested to add new type of zombies, environments, and abilities (specific ideas provided) with each level.	The possibility to unlock (in different levels) new zombies, new environments, and new abilities were added.
	Suggested to add audio features and sounds.	Music and audio effects were added to increase engagement.
	Feeling that actions in the game had no concrete relationship to the Companion app; suggested to gain coins that can be used in other parts of the PEGASO F4F system.	Fit coins to be used in other sections in the Companion app were introduced.
eDiary app
	It was difficult for adolescents to understand the servings and food included in a group; suggested to include a tutorial.	A help function in form of a question mark icon was added to provide guidance for the food input.
	Preference of symbolic food icon over food images.	Implemented the icon interface instead of the one based on food images.
	Some icons were difficult to be interpreted; alternative images were suggested.	Some food icons (eg, fried food, soft drink, Asian food, and snacks) were redesigned following participants’ suggestions.
	Selected a favorite design for the graphical feedback on diet.	Design preference implemented.
	Not understanding the meaning of “equilibrium.”	“Equilibrium” changed to “balance.”
	Not understanding the meaning of the “diversity” and “balance.”	Explanation of the indexes added.
	Wanting suggestions on how to improve their diet.	Generic recommendations were shown in the News Stream and personalized recommendations were implemented in the eDiary.
	More instructions were needed.	Tutorial cards as instructions and improved help text added.
	Participants proposed to increase the number of food groups and suggested alternative food groups.	Food groups were restructured adding new icons. For example, the food groups fast food and snacks were represented in more detailed food icons for “Burger,” “Oriental,” “Chicken,” “Pizza,” “Salty,” “Bakery,” “Sweets & Dessert.”
	Preference of receiving advice on which foods should be eaten if a person has food allergies or intolerances.	This was not implemented because of lack of resources.