Mobile phone text messaging to promote healthy behaviors and weight loss maintenance: a feasibility study

BACKGROUND An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. OBJECTIVE This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. METHODS This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. RESULTS A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: self-management, personalized care, autonomy, feel supported, positive self-image, motivation, happiness, and health. Goals and planning, feedback and monitoring, repetition and substitution, shaping knowledge, social support, identity, and self-belief were some of the BCT clusters identified to address these concepts, together with PSD principles such as personalization, tailoring, self-monitoring, praise, and suggestions. CONCLUSIONS The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. CLINICALTRIAL ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988

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Identifying Persuasive Design Principles and Behavior Change Techniques Supporting End User Values and Needs in eHealth Interventions for Long-Term Weight Loss Maintenance: Qualitative Study

Journal of Medical Internet Research ◽

10.2196/22598 ◽

2020 ◽

Vol 22 (11) ◽

pp. e22598

Author(s):

Rikke Aune Asbjørnsen ◽

Jobke Wentzel ◽

Mirjam Lien Smedsrød ◽

Jøran Hjelmesæth ◽

Matthew M Clark ◽

...

Keyword(s):

Weight Loss ◽

Behavior Change ◽

Weight Loss Maintenance ◽

End User ◽

Behavior Change Techniques ◽

Design Elements ◽

Healthy Behaviors ◽

Key Stakeholders ◽

And Behavior

Background An increasing number of eHealth interventions aim to support healthy behaviors that facilitate weight loss. However, there is limited evidence of the effectiveness of the interventions and little focus on weight loss maintenance. Knowledge about end user values and needs is essential to create meaningful and effective eHealth interventions, and to identify persuasive system design (PSD) principles and behavior change techniques (BCTs) that may contribute to the behavior change required for successful long-term weight loss maintenance. Objective This study aimed to provide insight into the design of eHealth interventions supporting behavior change for long-term weight maintenance. The study sought to identify the values and needs of people with obesity aiming to maintain weight after weight loss, and to identify PSD principles, BCTs, and design requirements that potentially enable an eHealth intervention to meet end user values and needs. Methods This study presents the concept of integrating PSD principles and BCTs into the design process of eHealth interventions to meet user values and needs. In this study, individual interviews and focus groups were conducted with people with obesity (n=23) and other key stakeholders (n=27) to explore end user values and needs related to weight loss maintenance. Design thinking methods were applied during the focus group sessions to identify design elements and to explore how eHealth solutions can support the needs to achieve sustainable weight loss maintenance. The PSD model and behavior change taxonomy by Michie were used to identify PSD principles and BCT clusters to meet end user values and needs. Results A total of 8 key end user values were identified, reflecting user needs for weight loss maintenance support: self-management, personalized care, autonomy, feel supported, positive self-image, motivation, happiness, and health. Goals and planning, feedback and monitoring, repetition and substitution, shaping knowledge, social support, identity, and self-belief were some of the BCT clusters identified to address these concepts, together with PSD principles such as personalization, tailoring, self-monitoring, praise, and suggestions. Conclusions The process of translating end user values and needs into design elements or features of eHealth technologies is an important part of the design process. To our knowledge, this is the first study to explore how PSD principles and BCTs can be integrated when designing eHealth self-management interventions for long-term weight loss maintenance. End users and other key stakeholders highlighted important factors to be considered in the design of eHealth interventions supporting sustained behavior change. The PSD principles and BCTs identified provide insights and suggestions about design elements and features to include for supporting weight loss maintenance. The findings indicate that a combination of BCTs and PSD principles may be needed in evidence-based eHealth interventions to stimulate motivation and adherence to support healthy behaviors and sustained weight loss maintenance. Trial Registration ClinicalTrials.gov NCT04537988; https://clinicaltrials.gov/ct2/show/NCT04537988

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High or low intensity text-messaging combined with group treatment equally promote weight loss maintenance in obese adults

Obesity Research & Clinical Practice ◽

10.1016/j.orcp.2016.01.001 ◽

2016 ◽

Vol 10 (6) ◽

pp. 680-691 ◽

Cited By ~ 14

Author(s):

Kristy Zwickert ◽

Elizabeth Rieger ◽

Jessica Swinbourne ◽

Clare Manns ◽

Claire McAulay ◽

...

Keyword(s):

Weight Loss ◽

Group Treatment ◽

Text Messaging ◽

Weight Loss Maintenance ◽

Obese Adults ◽

Promote Weight Loss ◽

Low Intensity

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Stayin' on Track: the feasibility of developing Internet and mobile phone-based resources to support young Aboriginal fathers

Australian Journal of Primary Health ◽

10.1071/py16151 ◽

2017 ◽

Vol 23 (4) ◽

pp. 329 ◽

Cited By ~ 7

Author(s):

Richard Fletcher ◽

Craig Hammond ◽

Darren Faulkner ◽

Nicole Turner ◽

Lisa Shipley ◽

...

Keyword(s):

Mobile Phone ◽

Feasibility Study ◽

Role Models ◽

Text Messaging ◽

Research Process ◽

Culturally Appropriate ◽

Aboriginal Communities ◽

Social And Emotional ◽

South Wales ◽

Viable Approach

Young Aboriginal fathers face social and emotional challenges in the transition to fatherhood, yet culturally appropriate support mechanisms are lacking. Peer mentoring to develop online- and mobile phone-based resources and support may be a viable approach to successfully engage these young men. This feasibility study engaged two trusted Aboriginal mentors and researchers to partner with one regional and two rural Aboriginal communities in New South Wales, Australia. Early in the research process, 20 young Aboriginal fathers were recruited as co-investigators. These fathers were integral in the development of web-based resources and testing of mobile phone-based text messaging and mood-tracking programs tailored to provide fathering and mental health support. Overwhelmingly positive feedback from evaluations reinforced community pride in and ownership of the outcomes. The young men’s involvement was instrumental in not only developing culturally appropriate support, but also in building their capacity as role models for other fathers in the community. The positive results from this feasibility study support the adoption of participatory approaches in the development of resources for Aboriginal communities.

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Improving Adherence to Weight‐Loss Medication (Liraglutide 3.0 mg) Using Mobile Phone Text Messaging and Healthcare Professional Support

Obesity ◽

10.1002/oby.22930 ◽

2020 ◽

Vol 28 (10) ◽

pp. 1889-1901

Author(s):

Ang Li ◽

Michelle Cunich ◽

Nicholas Fuller ◽

Katrina Purcell ◽

Allanah Flynn ◽

...

Keyword(s):

Weight Loss ◽

Healthcare Professional ◽

Mobile Phone ◽

Text Messaging ◽

Professional Support ◽

Weight Loss Medication

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Incorporating a Static Versus Supportive Mobile Phone App Into a Partial Meal Replacement Program With Face-to-Face Support: Randomized Controlled Trial (Preprint)

10.2196/preprints.7796 ◽

2017 ◽

Author(s):

Emily Brindal ◽

Gilly A Hendrie ◽

Jill Freyne ◽

Manny Noakes

Keyword(s):

Weight Loss ◽

Mobile Phone ◽

Text Messaging ◽

Controlled Trial ◽

Meal Replacement ◽

Face To Face ◽

Message Service ◽

Clinical Trials Registry ◽

Face Support ◽

Meal Replacement Program

BACKGROUND Mobile phone apps may be acceptable to users and could improve retention and adherence over more traditional methods, but there is mixed literature supporting their efficacy. In the weight management space, very little is known about how a mobile phone app integrating features beyond text messaging (short message service) can affect behavior, particularly when combined with face-to-face support. OBJECTIVE The objective of this study was to examine the effectiveness of a mobile phone app when combined with a partial meal replacement program including face-to-face support. This paper compares a static versus supportive app over a 6-month randomized trial for effects on weight loss, weight-related biomarkers, and psychological outcomes. METHODS Overweight and obese adults (71.2% female, 104/146; mean 48.11, SD 11.75 years) were recruited to participate in the weight loss study, and they were randomized on a 1:1 basis using a computer algorithm. The supportive app (n=75) provided information, food intake recording, rewards, prompts for regular interaction through reminders, and the opportunity to review personal compliance with the dietary program. The static app (n=71) included only recipes and weight loss information. Both groups recieved equal amounts of face-to-face support in addition to app. RESULTS The overall reduction in app usage over 24 weeks was lower for the supportive app in comparison with the static app; approximately 39.0% (57/146) of the users were still using the app at week 24. Despite the promising results for app usage, there were no differences in weight loss between groups (F1,128.12=0.83, P=.36). However, it should be noted that almost 60% (49/84) of all participants lost 5% or more of body weight during the trial. No weight-related biomarkers were significantly different between groups. Both groups experienced an increase in positive mood, but this was significantly higher for those who received the static app (F1,118.12=4.93, P=.03). CONCLUSIONS Although the supportive app was well received by users, we found little evidence of the added benefit of this versus the static app in combination with face-to-face support in a community-delivered weight loss program. Future versions of the app may incorporate more unique behavioral techniques beyond those provided by the consultant to improve the potency of the app. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12613000547741; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=364187 (Archived by WebCite http://www.webcitation.org/6yivwfMI9)

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