the increasing prevalence of child and adolescent obesity is a significant public health concern [ 1 , 2 ] .
approximately 34% of the population between the ages of 12 and 19 years is at risk of overweight and 17% is currently overweight .
children who are overweight or obese are more likely to stay overweight or obese into adulthood , thereby increasing their risk of insulin resistance , diabetes , hypertension , and cardiovascular disease . despite significant efforts towards understanding and intervening in children and adolescents ' health behaviors surrounding healthy eating and exercise
the majority of adolescents are increasingly  connected  in a virtual world , using different technologies on a daily basis .
adolescents are avid internet users ; over 90% report access and most report daily use . of these internet - using teens ,
approximately half use online social networking web sites ( sns ) such as myspace ( http://www.myspace.com/ ) and facebook ( http://www.facebook.com/ ) .
other technologies popular among teens include cellular phone , text messaging , and video gaming .
previous research suggests technology may offer great potential for promoting and supporting fitness among adolescents .
communication technologies have been shown to educate via video podcasts about health benefits of exercise and nutrition .
technology may also motivate by inquiring via text message about current activities and nutrition choices , or by sending reminder text pages about a planned activity [ 1113 ] .
finally , technology such as social networking sites provides opportunities to establish and encourage peer - based relationships to share photos or messages .
adolescence is a key period of development during which individuals begin to develop and take responsibility for their own health priorities and behaviors
before such interventions can take place , adolescents ' current use and preference in technology must be determined .
it is important to recognize that differences in preferences may exist between gender , age , and types of communities and these in turn may influence the effectiveness of technology interventions for health promotion .
understanding these differences may provide insights into targeting appropriate technologies to different adolescent groups towards promoting and supporting fitness .
it may further enhance interdisciplinary approaches towards fitness promotion by identifying key roles that are important in different communities .
the primary purpose of this study was to investigate adolescents ' preferences for current and future technology use related to fitness .
second , we aim to explore whether differences exist across age or communities with respect to types of technology used and for what fitness purposes .
this study was conducted between march 2011 and december 2011 and received irb approval from the university of wisconsin .
focus groups were conducted using purposeful sampling with adolescents from urban , suburban , and rural communities across wisconsin , washington , and ohio .
urban communities were defined as those with a population greater than 50,000 , suburban communities had populations between 20,000 and less than 50,000 , and rural communities had populations below 20,000 .
inclusion criteria for this study were being between the ages of 12 and 18 years and residence in the identified community .
potential participants were recruited by word - of - mouth recruitment in the different community settings .
an adult who had established connections with groups of youth was identified as a leader in each community and was asked to recruit colleagues and friends for participation .
adolescents were able to participate in a focus group after explanation of the study was provided and appropriate consent was obtained from parents and assent from teens .
participants were asked both open - ended and prompting questions to elicit ideas and conversation among the group .
topics that were covered included definitions of fitness , activities which promote fitness , technology usage , current uses of technology for fitness purposes , school and community resources available for fitness promotion , and future preferences for personal and community technology for fitness improvement .
the investigators initially reviewed transcripts individually and then jointly discussed findings to determine representative themes and quotations using the constant comparative method .
a total of 28 teens ( 20 females and 8 males ) participated in five focus groups consisting of between 3 and 8 participants .
the average age was 14.9 years ( sd = 1.92 ) and participants ranged from 6th to 12th grade in school .
a total of three themes were identified in our data , including differences in use of technology across age groups , the way in which adolescents achieved fitness in different community settings , and similarities in the types of technologies used and amount of resources between rural and urban cities . first , younger participants described technology as a complement to fitness , 
we 're just running and there 's nothing to listen to  but when there is music on , everyone feels like oh this is fun , let 's run around , let 's be fun .  in contrast , older participants designated technology as a motivator for fitness , 
i mean if i see someone 's ( social networking website ) status is like  going running 
whenever you guys say  running like ten miles ' i 'm like maybe i should .
like my sister she always puts up like things ( on a sns ) for gymnastics like she got a new skill it 's like oh i wanna do a new skill now .
second , differences in fitness activities varied by community location . adolescents in rural settings reported consistently using outdoor resources for fitness , 
i walk around our property , walk my dog , and just shoot basketball . 
on the other hand , adolescents living in urban areas more often took advantage of indoor fitness options , 
i 've got workout videos , like dvd's  and i go to the gym .  though differences existed between communities , adolescents across all communities reported exposure to and enjoyment of video game systems that involve physical movement in order to play ;  i got the kinect and that 's definitely for fitness  cause everything you do is moving ' like your shoulders and stuff  it really gets you moving cause you really get into it . 
interestingly , adolescents from suburban communities ' comments reflected similarities to both urban and rural adolescents ' comments .
lastly , adolescents from urban , suburban , and rural communities related a general lack of fitness - focused resources to their neighborhoods ,  at my house i ca n't do much , i mean it is two and a half acres , but it 's i mean it 's not like a big trail or anything to run on and it does n't have any pavement so i ca n't do skateboarding or nothing . 
i wish our school or community had a rec center , with workout machines , a track , and pool , stuff that would like help you , like vending machines with healthy stuff , instead of stuff like chips or candy . 
our study demonstrates that adolescents ' application of technology differs by age as well as across communities .
younger teens are more likely to use technology in addition to their fitness activities while older teens perceived that they require it as a motivator to accomplish their fitness goals .
additionally , teens regularly use fitness promoting video games and all agree that a common need exists to expand community resources . therefore
, our findings suggest the need for new technology interventions that are targeted to address specific adolescent needs across ages and communities .  
adolescents ' progression through normal stages of development may explain some of the differences in technology use between younger and older teens .
three distinct phases exist in adolescent development : early , middle , and late , during which changes occur in peer interaction and cognition .
early adolescents continue to interact more like children and possess concrete cognition , these attributes may allow them to achieve fitness through playing with technology as a complement to their activities .
in contrast , middle to late adolescents become increasingly influenced by their peers ' behavior and develop abstract thought processes . these changes may contribute to older teens ' perceived need for organized sports or a peer - based motivator for fitness promotion .  
deficiencies in proximity , availability , and safety of resources for physical activity may explain the differences in fitness resources between rural and urban adolescents in our study .
first , proximity to outdoor resources which promote fitness in rural communities is more optimal compared to urban communities where parks and green spaces are less accessible .
second , there are less organized and affordable outdoor activities accessible to urban adolescents , including after - school programs and community centers [ 1719 ] .
lastly , perceived safety concerns by teens in urban communities may impact willingness to engage in outdoor physical activity [ 20 , 21 ] .   despite these differences between ages and communities in their perceived preferences for fitness as well as resources available ,
a common theme was a desire for additional fitness resources . given that the vast majority of adolescents have daily access to technology which may include video games , the internet , and cell phones , opportunities exist to direct these technologies toward fitness promotion .
the findings of our study indicate that a one - size - fits - all approach of providing similar resources to target every age or every community being not likely to be effective .
future technology interventions could target the needs of early adolescents and different communities by providing playful , interactive tools such as implementing video games like kinect or wii as part of organized gym or after - school activities . for middle - late adolescents , who prefer independence in activities but require the motivation of their peers , an online sns group could be supported by schools and community programs which would allow for correspondence about and positive reinforcement of fitness goals .
additionally , technology such as a gps linked to a phone or computer can provide support and encourage teens to meet and set new physical goals .
these options provide ways in which technology can be incorporated to provide accessible , affordable , and safe resources to accommodate the needs of adolescents of diverse communities and across ages .  
first , given our qualitative study approach and concomitant small sample size , we can not ensure that the sample is generalizable to the larger population .
second , we had a greater number of participants who were female compared to male .
further research is needed to determine if needs and preferences are consistent with our findings across other ages and communities .   despite our study 's limitations ,
findings may be particularly useful across the interdisciplinary leaders in communities involved in fitness promotion .
for example , health teachers for younger teens may wish to suggest ways to incorporate wii into exercise routines for urban students .
high school administrators may wish to consider using social media to promote fitness events or competitions .
nutritionists may consider including discussion of social media advertisements for fad diets in their educational materials .
future research may wish to consider incorporation of social media prompts within interventions or program planning .
given the ubiquitous access to technology by teens and adults alike , our study highlights a few ways in which interdisciplinary team members can consider to provide targeted and relevant fitness promotion to today 's teens .
we found that different adolescent age groups have varied needs and preferences relating to fitness achievement , and because of accessibility , different locations also have differing needs for resources .
however , in the end all adolescents describe a greater need for community based resources which can be supported by interdisciplinary teams .
technology presents new opportunities to provide these resources in a way that is tailored to the ages and community of the adolescent group of interest .
 
 introduction . 
 an understanding of adolescents ' use of technology across ages and communities could allow for future targeted obesity intervention strategies . methods . 
 focus groups of adolescents from rural , suburban , and urban cities in three states were conducted . 
 focus groups were led by a trained facilitator to explore how participants used technologies and whether they applied them for fitness purposes . 
 all focus groups were audio recorded and manually transcribed . 
 analysis was conducted by three investigators using an iterative process . 
 results . 
 five focus groups included adolescents between the ages of 12 and 18 years ( 20 females and 8 males . ) 
 three themes were derived from our data . 
 first , we found age differences regarding technology applied to fitness . 
 younger participants described technology as a complement to fitness ; older participants viewed technology as a motivator for fitness . 
 second , differences in fitness approaches existed between rural and urban adolescents . 
 adolescents in rural communities reported focusing on the outdoors for fitness , while urban adolescents relied on fitness - oriented video games . both rural and urban teens related having a lack of fitness - focused resources in their communities . 
 conclusions . 
 our findings indicate differences in adolescents ' application of technology for fitness . despite adolescents ' differing uses of technology across communities , 
 a common need exists to expand their resources . 
1. Introduction
2. Methods
3. Results
4. Discussion
5. Conclusion