scholarly journals 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 (Preprint)

2020 ◽  
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: <i>self-management</i>, <i>personalized care</i>, <i>autonomy</i>, <i>feel supported</i>, <i>positive self-image</i>, <i>motivation</i>, <i>happiness</i>, and <i>health</i>. <i>Goals and planning</i>, <i>feedback and monitoring</i>, <i>repetition and substitution</i>, <i>shaping knowledge</i>, <i>social support</i>, <i>identity</i>, and <i>self-belief</i> were some of the BCT clusters identified to address these concepts, together with PSD principles such as <i>personalization</i>, <i>tailoring</i>, <i>self-monitoring</i>, <i>praise</i>, and <i>suggestions</i>. 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

scholarly journals 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

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

scholarly journals Persuasive System Design Principles and Behavior Change Techniques to Stimulate Motivation and Adherence in Electronic Health Interventions to Support Weight Loss Maintenance: Scoping Review (Preprint)

2019 ◽  
Author(s):  
Rikke Aune Asbjørnsen ◽  
Mirjam Lien Smedsrød ◽  
Lise Solberg Nes ◽  
Jobke Wentzel ◽  
Cecilie Varsi ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behavior Change ◽  
Goal Setting ◽  
Weight Loss Maintenance ◽  
Behavior Change Techniques ◽  
Self Monitoring ◽  
Support Weight ◽  
And Behavior ◽  
Weight Loss Interventions

BACKGROUND Maintaining weight after weight loss is a major health challenge, and eHealth (electronic health) solutions may be a way to meet this challenge. Application of behavior change techniques (BCTs) and persuasive system design (PSD) principles in eHealth development may contribute to the design of technologies that positively influence behavior and motivation to support the sustainable health behavior change needed. OBJECTIVE This review aimed to identify BCTs and PSD principles applied in eHealth interventions to support weight loss and weight loss maintenance, as well as techniques and principles applied to stimulate motivation and adherence for long-term weight loss maintenance. METHODS A systematic literature search was conducted in PsycINFO, Ovid MEDLINE (including PubMed), EMBASE, Scopus, Web of Science, and AMED, from January 1, 2007 to June 30, 2018. Arksey and O’Malley’s scoping review methodology was applied. Publications on eHealth interventions were included if focusing on weight loss or weight loss maintenance, in combination with motivation or adherence and behavior change. RESULTS The search identified 317 publications, of which 45 met the inclusion criteria. Of the 45 publications, 11 (24%) focused on weight loss maintenance, and 34 (76%) focused on weight loss. Mobile phones were the most frequently used technology (28/45, 62%). Frequently used wearables were activity trackers (14/45, 31%), as well as other monitoring technologies such as wireless or digital scales (8/45, 18%). All included publications were anchored in behavior change theories. Feedback and monitoring and goals and planning were core behavior change technique clusters applied in the majority of included publications. Social support and associations through prompts and cues to support and maintain new habits were more frequently used in weight loss maintenance than weight loss interventions. In both types of interventions, frequently applied persuasive principles were self-monitoring, goal setting, and feedback. Tailoring, reminders, personalization, and rewards were additional principles frequently applied in weight loss maintenance interventions. Results did not reveal an ideal combination of techniques or principles to stimulate motivation, adherence, and weight loss maintenance. However, the most frequently mentioned individual techniques and principles applied to stimulate motivation were, personalization, simulation, praise, and feedback, whereas associations were frequently mentioned to stimulate adherence. eHealth interventions that found significant effects for weight loss maintenance all applied self-monitoring, feedback, goal setting, and shaping knowledge, combined with a human social support component to support healthy behaviors. CONCLUSIONS To our knowledge, this is the first review examining key BCTs and PSD principles applied in weight loss maintenance interventions compared with those of weight loss interventions. This review identified several techniques and principles applied to stimulate motivation and adherence. Future research should aim to examine which eHealth design combinations can be the most effective in support of long-term behavior change and weight loss maintenance.

scholarly journals Clinical Effectiveness of Weight Loss and Weight Maintenance Interventions for Men: A Systematic Review of Men-Only Randomized Controlled Trials (The ROMEO Project)

2015 ◽  
Vol 11 (4) ◽  
pp. 1096-1123 ◽  
Author(s):  
Clare Robertson ◽  
Alison Avenell ◽  
Fiona Stewart ◽  
Daryll Archibald ◽  
Flora Douglas ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Weight Loss ◽  
Confidence Interval ◽  
Behavior Change ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Behavior Change Techniques ◽  
Randomized Controlled ◽  
And Behavior

Men are underrepresented in obesity services, suggesting current weight loss service provision is suboptimal. This systematic review evaluated evidence-based strategies for treating obesity in men. Eight bibliographic databases and four clinical trials’ registers were searched to identify randomized controlled trials (RCTs) of weight loss interventions in men only, with mean/median body mass index of ≥30 kg/m2 (or ≥28 kg/m2 with cardiac risk factors), with a minimum mean/median duration of ≥52 weeks. Interventions included diet, physical activity, behavior change techniques, orlistat, or combinations of these; compared against each other, placebo, or a no intervention control group; in any setting. Twenty-one reports from 14 RCTs were identified. Reducing diets produced more favorable weight loss than physical activity alone (mean weight change after 1 year from a reducing diet compared with an exercise program −3.2 kg, 95% confidence interval −4.8 to −1.6 kg, reported p < .01). The most effective interventions combined reducing diets, exercise, and behavior change techniques (mean difference in weight at 1 year compared with no intervention was −4.9 kg, 95% confidence interval −5.9 to −4.0, reported p < .0001). Group interventions produced favorable weight loss results. The average reported participant retention rate was 78.2%, ranging from 44% to 100% retention, indicating that, once engaged, men remained committed to a weight loss intervention. Weight loss for men is best achieved and maintained with the combination of a reducing diet, increased physical activity, and behavior change techniques. Strategies to increase engagement of men with weight loss services to improve the reach of interventions are needed.

Behavioral Mediators of Long-Term Weight Loss Maintenance

2013 ◽  
Author(s):  
J. W. Coughlin ◽  
C. M. Gullion ◽  
P. J. Brantley ◽  
V. J. Stevens ◽  
A. Bauck ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Loss Maintenance

scholarly journals A Conceptual Model of Long-Term Weight Loss Maintenance: The Importance of Cognitive, Empirical and Computational Approaches

2021 ◽  
Vol 18 (2) ◽  
pp. 635
Author(s):  
Darren Haywood ◽  
Blake J. Lawrence ◽  
Frank D. Baughman ◽  
Barbara A. Mullan
Keyword(s):  
Weight Loss ◽  
Weight Loss Maintenance ◽  
Computational Approaches ◽  
Healthy Habits ◽  
Health Related ◽  
The One ◽  
Major Factors ◽  
Positive Social Support ◽  
Weight Loss Interventions

Living with obesity is related to numerous negative health outcomes, including various cancers, type II diabetes, and cardiovascular disease. Although much is known about the factors associated with obesity, and a range of weight loss interventions have been established, changing health-related behaviours to positively affect obesity outcomes has proven difficult. In this paper, we first draw together major factors that have emerged within the literature on weight loss to describe a new conceptual framework of long-term weight loss maintenance. Key to this framework is the suggestion that increased positive social support influences a reduction in psychosocial stress, and that this has the effect of promoting better executive functioning which in turn facilitates the development of healthy habits and the breaking of unhealthy habits, leading to improved ongoing maintenance of weight loss. We then outline how the use of computational approaches are an essential next step, to more rigorously test conceptual frameworks, such as the one we propose, and the benefits that a mixture of conceptual, empirical and computational approaches offer to the field of health psychology.

scholarly journals Barriers and Facilitators That Influence Providers’ Ability to Educate, Monitor, and Treat Substance Use in First-Episode Psychosis Programs Using the Theoretical Domains Framework

2021 ◽  
pp. 104973232199344
Author(s):  
Oladunni Oluwoye ◽  
Elizabeth Fraser
Keyword(s):  
Substance Use ◽  
Behavior Change ◽  
Theoretical Domains Framework ◽  
First Episode Psychosis ◽  
Barriers And Facilitators ◽  
First Episode ◽  
Evidence Based ◽  
Behavior Change Techniques ◽  
Episode Psychosis ◽  
And Behavior

In this qualitative study, we explore providers’ experiences with addressing substance use among individuals with first-episode psychosis (FEP) enrolled in coordinated specialty care (CSC) programs. Three focus groups were conducted with 24 providers from CSC programs for FEP in Washington. Questions were focused on barriers and facilitators to addressing substance use using the Theoretical Domains Framework (TDF) as a guide. Thematic analysis was used to code all transcripts. Identified TDF domains were then mapped onto the COM-B (Capability, Opportunity, Motivation, Behavior) intervention functions and behavior change techniques. Seven theoretical domains were identified as the most relevant to addressing substance use: “Knowledge,” “Skills,” “Environmental Context and Resources,” “Social Influences,” “Social and Professional Role and Identity,” “Beliefs about Capabilities,” and “Reinforcement.” The use of the TDF provides a framework to explore barriers and facilitators for targeting substance use and suggestions for behavior change techniques when considering implementation of evidence-based strategies to enhance CSC models.

scholarly journals Long-term weight loss maintenance in the United States

2010 ◽  
Vol 34 (11) ◽  
pp. 1644-1654 ◽  
Author(s):  
J L Kraschnewski ◽  
J Boan ◽  
J Esposito ◽  
N E Sherwood ◽  
E B Lehman ◽  
...  
Keyword(s):  
United States ◽  
Weight Loss ◽  
Weight Loss Maintenance ◽  
The United States

Development of a web-based, guided self-help, ACT-based intervention for weight loss maintenance: an evidence-, theory- and person-based approach. (Preprint)

2021 ◽  
Author(s):  
Rebecca Richards ◽  
Rebecca A Jones ◽  
Fiona Whittle ◽  
Carly A Hughes ◽  
Andrew J Hill ◽  
...  
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Evidence Theory ◽  
Intervention Development ◽  
Weight Loss Maintenance ◽  
Theoretical Modelling ◽  
Healthcare Intervention ◽  
Web Based ◽  
Self Help

BACKGROUND The long-term impact and cost-effectiveness of weight management programmes depends on post-treatment weight maintenance. There is growing evidence that interventions based on third-wave cognitive behavioural therapy (3wCBT), specifically acceptance and commitment therapy (ACT), could improve long-term weight management however these interventions are typically delivered face-to-face by psychologists, which limits the scalability of this type of intervention. OBJECTIVE To use an evidence-, theory- and person-based approach to develop an ACT-based intervention for weight-loss maintenance that uses digital technology and non-specialist guidance to minimise resources needed for delivery at scale. METHODS Intervention development was guided by the Medical Research Council framework for the development of complex interventions in healthcare, Intervention Mapping Protocol, and the person-based approach for enhancing the acceptability and feasibility of interventions. Two phases of work were conducted: phase one consisted of collating and analysing existing and new primary evidence, and phase two consisted of theoretical modelling and intervention development. Phase one included a synthesis of existing evidence on weight-loss maintenance from previous research, a systematic review and network meta-analysis of 3wCBT interventions for weight management, a qualitative interview study of experiences of weight-loss maintenance, and the modelling of a justifiable cost for a weight-loss maintenance programme. Phase two included iterative development of guiding principles, a logic model and the intervention design and content. Target user and stakeholder panels were established to inform each phase of development and user-testing of successive iterations of the prototype intervention were conducted. RESULTS This process resulted in a guided self-help ACT-based intervention called SWiM (Supporting Weight Management). SWiM is a 4-month programme, consisting of weekly web-based sessions for 13 consecutive weeks, followed by a 4-week break for participants to reflect and practice their new skills, and a final session at week 17. Each session consists of psychoeducational content, reflective exercises, and behavioural experiments. SWiM includes specific sessions on key determinants of weight-loss maintenance, including developing skills to manage high-risk situations for lapses, creating new helpful habits, breaking old unhelpful habits, and learning to manage interpersonal relationships and their impact on weight-management. A trained, non-specialist coach provides guidance for participants through the programme with four scheduled 30-minute telephone calls and three further optional calls. CONCLUSIONS This comprehensive approach facilitated the development of an intervention that is based on scientific theory and evidence of how to support people with weight-loss maintenance, and is grounded in the experiences of the target users and the context in which it is intended to be delivered. The intervention will be refined based on findings of a planned pilot randomised controlled trial.

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