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Abstract

Background: In 2019, Canada’s Food Guide (CFG) adopted a plate-based approach to promote healthier eating. Mobile health apps provide a promising solution for dietary self-monitoring, yet many focus on calorie tracking, which can be inaccessible for users with limited health literacy and misaligned with the plate-based approach. iCANPlate was designed as a simplified, visual, plate-based app to improve accessibility and adherence. Users track foods as fruits/vegetables, grains, proteins, and ‘other’ foods on a pie chart-style ‘plate,’ with beverages tracked separately. Objective: To assess the acceptability and usability of iCANPlate as a tool for dietary self-monitoring among individuals with low health literacy. Methods: Using purposive sampling, 25 participants (screened with the Newest Vital Sign, score ≤3) were recruited virtually across Canada and asked to use iCANPlate to record their intake over a five-week period. Usability was assessed using the user version of the Mobile App Rating Scale (uMARS), and acceptability was examined with a modified Technology Acceptance Model 3 (TAM3). Quantitative data were analyzed descriptively, while semi-structured interviews with a subset of participants were thematically analyzed using NVivo12 and mapped to the COM-B model. Results: iCANPlate demonstrated good usability with a score of 14.6 out of 20. Participants reported high perceived ease of use (mean = 5.14) and perceived usefulness (mean = 5.74) on the TAM3 scale (1–7), reflecting strong acceptability of the app. Qualitative findings reinforced these results, emphasizing the app’s simplicity and visual appeal as facilitators. Participants also identified areas for refinement, including improved support for categorizing foods, estimating proportions, and setting personalized goals. Importantly, 62.5% of users reported greater awareness of eating patterns, underscoring iCANPlate’s potential to promote dietary reflection rather than numerical tracking. Conclusion: iCANPlate was found to be a usable and acceptable dietary self-monitoring tool among individuals with low health literacy. Its visual, plate-based format supported users in increasing awareness of their eating patterns. These findings suggest that iCANPlate offers a promising and accessible alternative to conventional calorie-tracking apps, potentially reducing barriers to dietary self-monitoring for diverse populations. Further evaluation in larger, more heterogeneous samples is warranted to determine its long-term effectiveness and scalability.