PURmgmt: A Culturally Tailored Digital Intervention for High-Purine Diet Management in China (Preprint)

BACKGROUND Background: High-purine diets are prevalent in traditional Chinese cuisine, and excessive purine intake is strongly associated with an increased risk of gout and hyperuricemia. In China, particularly among populations with lower socioeconomic status and in coastal provinces such as Guangdong, Shandong, and Zhejiang, managing purine consumption is challenging due to low nutritional awareness and the cultural prominence of purine-rich foods like seafood, organ meats, and broths. OBJECTIVE Objective: This study aimed to develop and evaluate a culturally tailored mobile health (mHealth) application, PURmgmt, designed to support users in regulating purine intake and reducing hyperuricemia- and gout-related risks. METHODS Methods: The study was conducted in two phases. First, an exploratory qualitative study involving semi-structured interviews (N=110) was carried out to identify user challenges and needs, which informed the design of PURmgmt. Second, a 100-day controlled trial (N=20) was conducted to assess the feasibility, user acceptance, and preliminary efficacy of the app. RESULTS Results: Participants in the intervention group significantly reduced their average daily purine intake from 850.5 mg to 403.5 mg and showed marked improvements in knowledge related to purines and hyperuricemia. In contrast, the control group exhibited no significant changes. User feedback indicated high satisfaction with the app’s usability and culturally adapted features. CONCLUSIONS Conclusions: PURmgmt demonstrates potential as an effective digital tool for purine intake management in China. The results underscore the value of culturally sensitive design and contextualized nutritional guidance in promoting sustainable dietary behavior change. Further large-scale and long-term studies are warranted to validate these findings.