Protocol for the MobiMD trial: A randomized controlled trial to evaluate the effect of a self-monitoring mobile app on hospital readmissions for complex surgical patients

This randomized controlled trial evaluated the acceptability and additive effects of self-monitoring avoidant and valued functions of behavior, in the context of self-monitoring physical activity and dietary behavior in a mobile app. The self-monitoring approach was based on the Acceptance and Commitment Therapy (ACT) Matrix. A sample of 102 adults interested in improving their diet and physical activity were randomized to a Health Behavior Tracking app (HBT), HBT plus ACT matrix app (HBT+ACT), or waitlist condition. Online self-report assessments were completed at baseline, mid (2 weeks), and post-intervention (4 weeks). Participants reported high usability, but mixed satisfaction with both apps. About half of the prompted app check-ins were completed on average, with 14% never using the ACT app. Participants in the HBT+ACT app condition reported greater self-reported physical activity over time relative to HBT and waitlist, potentially due to protecting against a decrease over time in physical activity observed in the other two conditions. HBT and HBT+ACT conditions both improved self-reported sedentary behavior relative to waitlist. HBT+ACT improved cognitive restraint with eating more than HBT. Neither the HBT or HBT+ACT app improved other health behavior outcome measures or values processes relative to the waitlist. Overall, findings suggest some benefits of the ACT Matrix app for addressing physical activity by tracking valued/avoidant functions, but mixed findings on acceptability, outcomes, and processes of change suggests impact may be relatively limited.

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Comparing Self-Monitoring Strategies for Weight Loss in a Smartphone App: Randomized Controlled Trial (Preprint)

10.2196/preprints.12209 ◽

2018 ◽

Author(s):

Michele L Patel ◽

Christina M Hopkins ◽

Taylor L Brooks ◽

Gary G Bennett

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Mobile App ◽

Self Report ◽

Smartphone App ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Self Monitoring ◽

Randomized Controlled

BACKGROUND Self-monitoring of dietary intake is a valuable component of behavioral weight loss treatment; however, it declines quickly, thereby resulting in suboptimal treatment outcomes. OBJECTIVE This study aimed to examine a novel behavioral weight loss intervention that aims to attenuate the decline in dietary self-monitoring engagement. METHODS GoalTracker was an automated randomized controlled trial. Participants were adults with overweight or obesity (n=105; aged 21-65 years; body mass index, BMI, 25-45 kg/m2) and were randomized to a 12-week stand-alone weight loss intervention using the MyFitnessPal smartphone app for daily self-monitoring of either (1) both weight and diet, with weekly lessons, action plans, and feedback (Simultaneous); (2) weight through week 4, then added diet, with the same behavioral components (Sequential); or (3) only diet (App-Only). All groups received a goal to lose 5% of initial weight by 12 weeks, a tailored calorie goal, and automated in-app reminders. Participants were recruited via online and offline methods. Weight was collected in-person at baseline, 1 month, and 3 months using calibrated scales and via self-report at 6 months. We retrieved objective self-monitoring engagement data from MyFitnessPal using an application programming interface. Engagement was defined as the number of days per week in which tracking occurred, with diet entries counted if ≥800 kcal per day. Other assessment data were collected in-person via online self-report questionnaires. RESULTS At baseline, participants (84/100 female) had a mean age (SD) of 42.7 (11.7) years and a BMI of 31.9 (SD 4.5) kg/m2. One-third (33/100) were from racial or ethnic minority groups. During the trial, 5 participants became ineligible. Of the remaining 100 participants, 84% (84/100) and 76% (76/100) completed the 1-month and 3-month visits, respectively. In intent-to-treat analyses, there was no difference in weight change at 3 months between the Sequential arm (mean −2.7 kg, 95% CI −3.9 to −1.5) and either the App-Only arm (−2.4 kg, −3.7 to −1.2; P=.78) or the Simultaneous arm (−2.8 kg, −4.0 to −1.5; P=.72). The median number of days of self-monitoring diet per week was 1.9 (interquartile range [IQR] 0.3-5.5) in Sequential (once began), 5.3 (IQR 1.8-6.7) in Simultaneous, and 2.9 (IQR 1.2-5.2) in App-Only. Weight was tracked 4.8 (IQR 1.9-6.3) days per week in Sequential and 5.1 (IQR 1.8-6.3) days per week in Simultaneous. Engagement in neither diet nor weight tracking differed between arms. CONCLUSIONS Regardless of the order in which diet is tracked, using tailored goals and a commercial mobile app can produce clinically significant weight loss. Stand-alone digital health treatments may be a viable option for those looking for a lower intensity approach. CLINICALTRIAL ClinicalTrials.gov NCT03254953; https://clinicaltrials.gov/ct2/show/NCT03254953 (Archived by WebCite at http://www.webcitation.org/72PyQrFjn).

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Development and feasibility of a mobile phone application designed to support physically inactive employees to increase walking

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01391-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Joanna Catherine Nicholas ◽

Nikos Ntoumanis ◽

Brendan John Smith ◽

Eleanor Quested ◽

Emmanuel Stamatakis ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Behavior Change ◽

Rating Scale ◽

Controlled Trial ◽

Mobile App ◽

Trial Registration ◽

Health Concern ◽

Self Monitoring ◽

Step Counts ◽

Randomized Controlled

Abstract Background Physical inactivity is a global health concern. mHealth interventions have become increasingly popular, but to date, principles of effective communication from Self-Determination Theory have not been integrated with behavior change techniques to optimize app effectiveness. We outline the development of the START app, an app combining SDT principles and 17 purposefully chosen BCTs to support inactive office employees to increase their walking during a 16-week randomized controlled trial. We also explored acceptability, engagement with, associations between app usage and behavioral engagement, and perceived impact of the app in supporting behavior change. Methods Following development, fifty insufficiently physically active employees (M age = 44.21 ± 10.95 years; BMI = 29.02 ± 5.65) were provided access and instructions on use of the app. A mixed methods design was used to examine feasibility of the app, including the User Mobile App Rating Scale, app engagement data, step counts, and individual interviews. Linear mixed modeling and inductive thematic analysis were used to analyze quantitative and qualitative data, respectively. Results Walkers rated the app quality favorably (M = 3.68 out of 5). Frequency of entering step counts (i.e., frequency of self-monitoring) on a weekly basis positively predicted weekly step counts measured via Fitbits at both the between-and within-individual levels. App features (entering daily step counts, reminders, and motivational messages) were perceived to assist walkers in fostering goal achievement by building competence and via self-monitoring. Conclusions The START app may be a useful component of walking interventions designed to increase walking in the workplace. Apps designed to promote walking behavior may be effective if they target users’ competence and integrate BCTs. Trial Registration: This study was part of a pilot larger randomized controlled trial, in which a component of the intervention involved the use of the mobile app. The trial was retrospectively registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12618000807257) on 11 May 2018 https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375049&isReview=true.

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