Adherence to a Smartphone Application for Weight Loss Compared to Website and Paper Diary: Pilot Randomized Controlled Trial
By Michelle Carter, V. Burley, C. Nykjaer, J. Cade. Journal of Medical Internet Research, 2013
708 citations recorded by the source corpus.
Background 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/m2 (95% CI –2.2 to –1.1) in the smartphone group, –1.0 kg/m2 (95% CI –1.6 to –0.4) in the diary group, and –0.5 kg/m2 (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)
Subfields: Applied Psychology, General Health Professions, Physiology
View Paper: https://www.semanticscholar.org/paper/fa721cf0d677f5f6676eee159023d5377123adca
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Citations in the corpus
- The Rise of Consumer Health Wearables: Promises and Barriers (2016, background): “Despite their widespread use, these solutions result in a high level of patient attrition [27], which might be a result of requiring patients to delay self-report until they are next able to use their home computer [28].”
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- Smartphones and Health Promotion: A Review of the Evidence (2013, positive): “He found very positive effects of smartphone app intervention compared with a control group using a paper diary [37].”
- Behavioral Functionality of Mobile Apps in Health Interventions: A Systematic Review of the Literature (2015, methodology): “Carter et al [40] reported that users found the apps convenient and easier to use than other methods of tracking diet.”
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- A smartphone app reveals erratic diurnal eating patterns in humans that can be modulated for health benefits (2015, background): “Although such apps improve adherence relative to the traditional diary log (Carter et al., 2013), data logging can be cumbersome for mixed meals, and consequently, users may not bother to log small snacks.”
- Smartphones for Smarter Delivery of Mental Health Programs: A Systematic Review (2013, background): “Advantages of mHealth include the improvement of treatment accessibility and participant retention, real-time symptom and activity monitoring and tracking of treatment progress through ecological momentary assessment (EMA), provision of personalized feedback and motivational support, portability and”
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