J. Med. Internet Res. - Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial.

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Resumo

CKGROUND: There is growing interest in the use of information communication technologies to treat obesity. An intervention delivered by smartphone could be a convenient, potentially cost-effective, and wide-reaching weight management strategy. Although there have been studies of texting-based interventions and smartphone applications (apps) used as adjuncts to other treatments, there are currently no randomized controlled trials (RCT) of a stand-alone smartphone application for weight loss that focuses primarily on self-monitoring of diet and physical activity.OBJECTIVE: The aim of this pilot study was to collect acceptability and feasibility outcomes of a self-monitoring weight management intervention delivered by a smartphone app, compared to a website and paper diary.METHODS: A sample of 128 overweight volunteers were randomized to receive a weight management intervention delivered by smartphone app, website, or paper diary. The smartphone app intervention, My Meal Mate (MMM), was developed by the research team using an evidence-based behavioral approach. The app incorporates goal setting, self-monitoring of diet and activity, and feedback via weekly text message. The website group used an existing commercially available slimming website from a company called Weight Loss Resources who also provided the paper diaries. The comparator groups delivered a similar self-monitoring intervention to the app, but by different modes of delivery. Participants were recruited by email, intranet, newsletters, and posters from large local employers. Trial duration was 6 months. The intervention and comparator groups were self-directed with no ongoing human input from the research team. The only face-to-face components were at baseline enrollment and brief follow-up sessions at 6 weeks and 6 months to take anthropometric measures and administer questionnaires.RESULTS: Trial retention was 40/43 (93%) in the smartphone group, 19/42 (55%) in the website group, and 20/43 (53%) in the diary group at 6 months. Adherence was statistically significantly higher in the smartphone group with a mean of 92 days (SD 67) of dietary recording compared with 35 days (SD 44) in the website group and 29 days (SD 39) in the diary group (P<.001). Self-monitoring declined over time in all groups. In an intention-to-treat analysis using baseline observation carried forward for missing data, mean weight change at 6 months was -4.6 kg (95% CI -6.2 to -3.0) in the smartphone app group, -2.9 kg (95% CI -4.7 to -1.1) in the diary group, and -1.3 kg (95% CI -2.7 to 0.1) in the website group. BMI change at 6 months was -1.6 kg/m(2) (95% CI -2.2 to -1.1) in the smartphone group, -1.0 kg/m(2) (95% CI -1.6 to -0.4) in the diary group, and -0.5 kg/m(2) (95% CI -0.9 to 0.0) in the website group. Change in body fat was -1.3% (95% CI -1.7 to -0.8) in the smartphone group, -0.9% (95% CI -1.5 to -0.4) in the diary group, and -0.5% (95% CI -0.9 to 0.0) in the website group.CONCLUSIONS: The MMM app is an acceptable and feasible weight loss intervention and a full RCT of this approach is warranted.TRIAL REGISTRATION: ClinicalTrials.gov NCT01744535; http://clinicaltrials.gov/ct2/show/NCT01744535 (Archived by WebCite at http://www.webcitation.org/6FEtc3PVB).

Resumo Limpo

ckground grow interest use inform communic technolog treat obes intervent deliv smartphon conveni potenti costeffect widereach weight manag strategi although studi textingbas intervent smartphon applic app use adjunct treatment current random control trial rct standalon smartphon applic weight loss focus primarili selfmonitor diet physic activityobject aim pilot studi collect accept feasibl outcom selfmonitor weight manag intervent deliv smartphon app compar websit paper diarymethod sampl overweight volunt random receiv weight manag intervent deliv smartphon app websit paper diari smartphon app intervent meal mate mmm develop research team use evidencebas behavior approach app incorpor goal set selfmonitor diet activ feedback via week text messag websit group use exist commerci avail slim websit compani call weight loss resourc also provid paper diari compar group deliv similar selfmonitor intervent app differ mode deliveri particip recruit email intranet newslett poster larg local employ trial durat month intervent compar group selfdirect ongo human input research team facetofac compon baselin enrol brief followup session week month take anthropometr measur administ questionnairesresult trial retent smartphon group websit group diari group month adher statist signific higher smartphon group mean day sd dietari record compar day sd websit group day sd diari group p selfmonitor declin time group intentiontotreat analysi use baselin observ carri forward miss data mean weight chang month kg ci smartphon app group kg ci diari group kg ci websit group bmi chang month kgm ci smartphon group kgm ci diari group kgm ci websit group chang bodi fat ci smartphon group ci diari group ci websit groupconclus mmm app accept feasibl weight loss intervent full rct approach warrantedtri registr clinicaltrialsgov nct httpclinicaltrialsgovctshownct archiv webcit httpwwwwebcitationorgfetcpvb

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