Using personalised avatars as an adjunct to a weight loss management programme: a randomised controlled feasibility study (Preprint)

2022 ◽  
Author(s):  
Maria Horne ◽  
Maryan Hardy ◽  
Trevor Murrells ◽  
Hassan Ugail ◽  
Andrew Hill
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Feasibility Study ◽  
Self Efficacy ◽  
Routine Care ◽  
Health Concern ◽  
Secondary Outcome ◽  
Motivation To Change ◽  
Randomised Controlled

BACKGROUND Obesity is a global public health concern. Interventions rely predominantly on managing dietary intake and/or increasing physical activity but sustained adherence to behavioural regimens is often poor. As with all interventions, the lack of sustained motivation, self-efficacy and poor adherence to behavioural regimens are recognized barriers to successful weight loss. Avatar-based interventions have been found to achieve better patient outcomes in the management of chronic conditions by promoting more active engagement and the virtual representations of ‘self’ have been shown to impact real-world behaviour, acting as a catalyst for sustained weight loss behaviour. OBJECTIVE We aimed to evaluate whether a personalised avatar, offered as an adjunct to an established weight loss programme, could increase participant motivation and sustain engagement, optimise service delivery, and improve participant health outcomes. METHODS A feasibility randomised design was used to determine the case for future development and evaluation of avatar-based technology in a randomised controlled trial. Participants were recruited from GP referrals to a 12-week NHS weight improvement programme. The main outcome measure was weight loss. Secondary outcome measures were quality-of-life and self-efficacy. Quantitative data were subjected to descriptive statistical tests and exploratory comparison between intervention and control arms. Feasibility and acceptability were assessed through interviews analysed using the framework approach. HRA ethical approval was granted. RESULTS 10 males (7 intervention; 3 routine care) and 33 females (23 intervention; 10 routine care) were recruited. Initial mean weight of participants was greater in the intervention than routine care arm (126.3 kg vs 122.9 kg); pattern of weight loss was similar across both arms of the study in period T0-T1 but accelerated in period T1-T2 for intervention participants, suggesting that access to the self-resembling avatar may promote greater engagement with weight loss initiatives in the short to medium term. Mean change in weight of participants from T0 to T2 was 4.5kg (95% CI: 2.7-6.3) in routine care arm and 5.3kg (95% CI: 3.9-6.8) in the intervention arm. Quality-of-life and self-efficacy measures demonstrated greater improvement in the intervention arm at both T1 (105.5 routine care; 99.7 intervention arm) and T2 (100.1 routine care; 81.2 intervention arm). 13 participants (11 Female, 2 Male) and two healthcare professionals were interviewed about their experience of using the avatar programme. CONCLUSIONS Overall, participants found using the personalised avatar acceptable and feedback reiterated that seeing a future ‘self’ helped reinforce motivation to change behaviour. This feasibility study demonstrated that avatar-based technology may successfully promote engagement and motivation in weight loss programmes, enabling participants to achieve greater weight loss gains and build self-confidence and belief. CLINICALTRIAL 17953876

scholarly journals Effectiveness of custom-made foot orthoses in patients with systemic lupus erythaematosus: protocol for a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e042627
Author(s):  
María Reina-Bueno ◽  
María del Carmen Vázquez-Bautista ◽  
Inmaculada C Palomo-Toucedo ◽  
Gabriel Domínguez-Maldonado ◽  
José Manuel Castillo-López ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Outcome Measures ◽  
Controlled Trial ◽  
Secondary Outcome ◽  
Foot Orthoses ◽  
Systemic Lupus ◽  
Custom Made ◽  
Randomised Controlled

IntroductionSystemic lupus erythaematosus (SLE) is a chronic autoimmune disease of heterogeneous involvement. The disease may affect feet with a high prevalence of symptoms such as, for example, pain, forefoot and rearfoot deformities, and biomechanics dysfunctions. Custom-made foot orthoses (CMFO) have been previously reported to be effective in patients with other rheumatic diseases. However, as far as the authors know, there exist no studies about their effectiveness in SLE. This study aims at determining the effect of CMFO versus placebo flat cushioning insoles on pain, foot functionality, fatigue and quality of life in patients with SLE.Methods and analysisA randomised controlled trial would compare the effects of (1) CMFO and group B, which received a placebo, flat cushioning insoles, for 3 months. The main outcome measures are foot pain, foot functionality and foot-related disability. The secondary outcome measures are fatigue and quality of life.Ethics and disseminationThe study has been approved by the Portal de Ética de la Investigación Biomédica de Andalucía ethical committee 1494-N-19. The results will be disseminated regardless of the magnitude or direction of effect.Trial registartion numberClinicaltrials.gov identifier NCT04098055.

scholarly journals A randomised controlled clinical trial comparing the effectiveness of bandaging compared to the JuxtaCures™ device in the management of people with venous ulceration: Feasibility study

2021 ◽  
pp. 026835552098822
Author(s):  
Philip Stather ◽  
Carroll Petty ◽  
Helen Langthorne ◽  
Emma Rayner ◽  
Jufen Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Feasibility Study ◽  
Multicentre Trial ◽  
Compression Therapy ◽  
Controlled Clinical Trial ◽  
Venous Ulceration ◽  
Significant Difference ◽  
Potential Benefits ◽  
Randomised Controlled

Introduction The mainstay of treatment for venous ulceration remains compression therapy. Velcro Wrap devices are being increasingly used in these patients despite limited evidence. This feasibility study aimed to compare standard bandaging to the JuxtaCures™ Velcro wrap device. Methods A single centre, unblinded RCT compared participants with venous ulceration randomised to either the JuxtaCures™ device or short stretch bandaging. Participants were followed up for 26 weeks. Results 160 participants were screened with 40 randomised. 3 participants in bandaging and 1 in JuxtaCures™ didn’t complete the study. 60% in JuxtaCures™ healed v 55% in bandaging despite larger ulcers in the JuxtaCures™ arm (9.33 cm2 v 6.97 cm2). There was no significant difference in time to healing (12.17 v 13.64 weeks). JuxtaCures™ showed improved ulcer reduction for those that didn’t heal (14.91–5.00 cm2 v 14.20–8.62 cm2; P = 0.06). JuxtaCures™ had more consistent sub-bandage pressure dropping from 39–36 mmHg versus 41–25 mmHg in bandaging between application and removal (P < 0.001). Quality of life (EQ5D) was improved in JuxtaCures at 3 months (mean difference 0.14, p = 0.04), but not at 1 and 6 months, or in disease specific quality of life. Cost was lower in JuxtaCures™ £842.47 v £1064.68. Duration of appointment was significantly shorter in JuxtaCures™ (41 minutes v 53 minutes; P = 0.003). Conclusion This study has shown the feasibility and necessity of running a multicentre trial to evaluate the use of Velcro wrap devices for venous ulceration. It highlights the potential benefits of more consistent pressure, increased self-care, and potential with regards to ulcer healing, cost, nursing resource and quality of life.

scholarly journals Eating self-efficacy as predictor of long-term weight loss and obesity-specific quality of life after sleeve gastrectomy: A prospective cohort study

2019 ◽  
Vol 15 (2) ◽  
pp. 161-167 ◽  
Author(s):  
Tone Nygaard Flølo ◽  
Grethe S. Tell ◽  
Ronette L. Kolotkin ◽  
Anny Aasprang ◽  
Tone M. Norekvål ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Cohort Study ◽  
Sleeve Gastrectomy ◽  
Prospective Cohort Study ◽  
Self Efficacy ◽  
Prospective Cohort

scholarly journals Quality of Life after Diet or Exercise-Induced Weight Loss in Overweight to Obese Postmenopausal Women: The SHAPE-2 Randomised Controlled Trial

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0127520 ◽  
Author(s):  
Willemijn A. M. van Gemert ◽  
Job van der Palen ◽  
Evelyn M. Monninkhof ◽  
Anouk Rozeboom ◽  
Roelof Peters ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Randomised Controlled Trial ◽  
Postmenopausal Women ◽  
Controlled Trial ◽  
Exercise Induced ◽  
Randomised Controlled

Self-efficacy and quality-of-life in obesity:Roles of diet counseling and degree of weight loss

2001 ◽  
Vol 101 (9) ◽  
pp. A-19 ◽  
Author(s):  
K.J. Melanson ◽  
J. Dell'Olio ◽  
M.R. Carpenter ◽  
D.P. Berlin ◽  
S.J. Knipe ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Weight Loss ◽  
Self Efficacy ◽  
Diet Counseling

Virtual weight loss program for African-American breast cancer survivors: Preliminary results.

2017 ◽  
Vol 35 (5_suppl) ◽  
pp. 163-163
Author(s):  
Jeanne M. Ferrante ◽  
Michelle Doose ◽  
Alicja Bator ◽  
Katie Devine ◽  
Pamela Ohman Strickland ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Weight Loss ◽  
African American ◽  
Cancer Survivors ◽  
Weight Change ◽  
Self Efficacy ◽  
Breast Cancer Survivors ◽  
Weight Loss Program

163 Background: Obesity is associated with higher breast cancer recurrence and death, and poorer health and quality of life. African-American (AA) women have the highest prevalence of obesity, obesity-related comorbidities, and breast cancer mortality compared with other racial/ethnic groups. Weight loss after breast cancer diagnosis may lower rates of recurrence and improve fitness, fatigue, and quality of life. Methods: This 6-month randomized controlled trial pilot-tests the use of a Fitbit activity tracker (Fitbit only group) versus Fitbit plus SparkPeople, a free web-based weight loss program (combined group) among 70 AA breast cancer survivors. Paired t-tests assess changes from baseline to 6-months among each participant in primary (weight, body mass index [BMI], percent body fat) and secondary (24-hour caloric intake, daily number of steps, quality of life, self-monitoring strategies, self-efficacy) outcomes. Two-group t-tests assess differences in outcomes between the two groups. Results: Currently, 36 of 46 (78.3%) eligible participants have enrolled and completed baseline assessments. Mean age of participants is 61.7 years (SD 8.7) and mean BMI is 36.9 (SD 7.0). Analyses of the first 25 participants who completed 3-month assessments (Fitbit only N = 12; combined group N = 13) show significant weight loss in both groups; Fitbit only: mean weight change -6.73 pounds, SD 4.61, p < 0.001; mean BMI change -0.96 kg/m2, SD 0.84, p = 0.002; combined group: mean weight change -5.95 pounds, SD 5.84, p = 0.003; mean BMI change -1.03 kg/m2, SD 0.77, p < 0.001. All participants significantly increased tracking of diet (Fitbit only p = 0.016; combined group p < 0.001) and physical activity (Fitbit only p < 0.001; combined group p = 0.001). Though not significant, combined group participants showed greater increases in self-efficacy for eating healthy and reducing fat and calories, and increases in daily steps (+1308 vs. +285 for Fitbit only group). Preliminary analyses show no statistically significant difference in changes in outcomes from baseline to 3 months between the two groups. Conclusions: Both programs show potential as convenient and efficient weight loss methods for African-American breast cancer survivors. Clinical trial information: NCT02699983.

scholarly journals Effectiveness of a peer-mediated educational intervention in improving general practitioner diagnostic assessment and management of dementia: a cluster randomised controlled trial

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021125 ◽  
Author(s):  
Dimity Pond ◽  
Karen Mate ◽  
Nigel Stocks ◽  
Jane Gunn ◽  
Peter Disler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Educational Intervention ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Mean Difference ◽  
Secondary Outcome ◽  
General Practices ◽  
Randomised Controlled

ObjectiveTest effectiveness of an educational intervention for general practitioners (GPs) on quality of life and depression outcomes for patients.DesignDouble-blind, cluster randomised controlled trial.SettingGeneral practices in Australia between 2007 and 2010.ParticipantsGeneral practices were randomly allocated to the waitlist (n=37) or intervention (n=66) group, in a ratio of 1:2. A total of 2030 (1478 intervention; 552 waitlist) community-dwelling participants aged 75 years or older were recruited via 168 GPs (113 intervention; 55 waitlist).InterventionsA practice-based academic detailing intervention led by a peer educator that included: (1) training in use of the GP assessment of cognition dementia screening instrument; (2) training in diagnosis and management based on Royal Australian College of General Practitioners Dementia Guidelines; (3) addressing GPs’ barriers to dementia diagnosis; and (4) a business case outlining a cost-effective dementia assessment approach.Outcome measuresPrimary outcome measures were patient quality of life and depression; secondary outcome measures were: (1) sensitivity and specificity of GP identification of dementia; (2) referral to medical specialists and/or support services; (3) patient satisfaction with care; and (4) carer quality of life, depression and satisfaction with care.ResultsThe educational intervention had no significant effect on patient quality of life or depression scores after 12 months. There were however improvements in secondary outcome measures including sensitivity of GP judgement of dementia (p=0.002; OR 6.0, 95% CI 1.92 to 18.73), satisfaction with GP communication for all patients (p=0.024; mean difference 2.1, 95% CI 0.27 to 3.93) and for patients with dementia (p=0.007; mean difference 7.44, 95% CI 2.02 to 12.86) and enablement of carers (p=0.0185; mean difference 24.77, 95% CI 4.15 to 45.40).ConclusionPractice-based academic detailing did not improve patient quality of life or depression scores but did improve detection of dementia in primary care and patient satisfaction with GP communication.Trial registration numberACTRN12607000117415; Pre-results.

scholarly journals Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: a systematic review

2019 ◽  
Vol 25 (3) ◽  
pp. 195 ◽  
Author(s):  
Hassan Hosseinzadeh ◽  
Mahmmoud Shnaigat
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Self Efficacy ◽  
Randomised Controlled Trials ◽  
Self Management ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Primary Care Settings ◽  
Randomised Controlled

Chronic obstructive pulmonary disease (COPD) is one of the more disabling diseases and the third cause of mortality worldwide. Self-management is considered an effective strategy for controlling and managing COPD. This review aims to summarise the available evidence on the effectiveness of COPD self-management in primary care settings. Social Sciences, Citation Index, MEDLINE, CINAHL, Academic Search Complete and Scopus were searched for randomised controlled trials of COPD self-management in general practice between 2001 and 2018. Ten randomised controlled trials of COPD self-management trials conducted in primary care settings were included in this review. The identified trials have recruited stable patients; a majority having mild to moderate COPD. The trials implemented different types of interventions and measured improvements in knowledge, skills and behaviours of self-management, mental health, self-efficacy and endpoint outcomes such as hospitalisation and quality of life. The findings showed that COPD self-management trials had positive effects on COPD knowledge and improved self-management behaviours such as adherence to medication, physical activities and smoking cessation in some cases; however, the effect of trials on hospitalisation rate, quality of life and healthcare utilisation were not conclusive. There was also not enough evidence to suggest that the trials were efficient in improving self-efficacy, a major driver of self-management behaviours. Primary care COPD self-management trials are efficient in improving surrogate outcomes such as knowledge of and adherence to self-management behaviours; however, such improvements are less likely to be sustainable in the absence of self-efficacy. Future studies should also focus on improving endpoint self-management outcomes like hospitalisation rate and quality of life to benefit both patient and healthcare system.

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