Consistency With and Disengagement From Self-monitoring of Weight, Dietary Intake, and Physical Activity in a Technology-Based Weight Loss Program: Exploratory Study.
Consistency With and Disengagement From Self-monitoring of Weight, Dietary Intake, and Physical Activity in a Technology-Based Weight Loss Program: Exploratory Study.
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在基于技术的减肥计划中，与体重，饮食摄入和体育活动的自我监控的一致性和脱离关系：探索性研究。
DOI：
10.2196/33603
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发表时间：
2022-02-18
影响因子：
2.2
通讯作者：
Ross KM
中科院分区：
文献类型：
--
作者：
Carpenter CA;Eastman A;Ross KM
数字自我监测工具提供了改善体重和体重相关行为的自我监测的承诺;然而，关于参与者一致性和脱离这些工具的模式知之甚少。这项研究描述了在6个月的减肥干预期间使用数字自我监测工具的一致性和脱离时间，并调查了提供基于电话的干预是否改善了自我监测的依从性。参与者是54名超重或肥胖的成年人（平均年龄49.6岁，SD 12.4岁;平均BMI 32.6 kg/m2，SD 3.2 kg/m2），参加了一项试点试验，评估自我监测技术（Fitbit Zip，Aria量表和智能手机应用程序）的影响，有和没有额外的干预联系，对体重减轻。所有参与者都接受了减肥教育，并被要求在6个月的计划中每天自我监测体重，饮食摄入量和身体活动。一致性被定义为参与者遵守自我监测建议的周数（7天中的7天）。脱离被定义为连续2周未达到7天自我监测依从性目标的第一周。Wilcoxon符号秩检验用于检查行为目标的一致性和脱离的差异。t检验（双尾）和考克斯比例风险模型被用来检查是否提供额外的干预联系会导致显着改善的一致性和时间脱离自我监测工具，分别。线性回归用于检查一致性、脱离时间和体重减轻之间的关联。参与者持续自我监测身体活动的周数（平均17.4周，SD 8.5周）比体重（平均11.1周，SD 8.5周）或饮食摄入（平均10.8周，SD 8.7周; P<0.05）多。同样，参与者从身体活动的自我监测中脱离的时间（中位数为19.5周）比体重（4周）或饮食摄入（10周; P<0.001）要长得多。随机接受额外干预接触的参与者与未接受干预接触的参与者相比，饮食摄入自我监测的一致性显著更高，脱离时间更长（P= 0.006）;然而，两组之间体重或体力活动自我监测无统计学显著差异（分别为P= 0.24和P= 0.25）。更大的一致性和更长的脱离时间与自我监测体重和饮食摄入量的体重减轻有关（分别为P<0.001和P= 0.004），但与体力活动无关（P= 0.57）。结果表明，自我监测的坚持不同的行为目标，更大的一致性和更长的时间来脱离与低负担的工具（即，自我监测的身体活动）。与支持性责任理论相一致，额外的干预接触改善了一致性，延长了脱离饮食摄入自我监测的时间。鉴于观察到的一致性，脱离和减肥结果之间的关联，重要的是要确定增加数字自我监测工具的一致性和参与度的其他方法。
Digital self-monitoring tools offer promise to improve adherence to self-monitoring of weight and weight-related behaviors; however, less is known regarding the patterns of participant consistency and disengagement with these tools. This study characterizes the consistency of use and time to disengagement with digital self-monitoring tools during a 6-month weight loss intervention and investigates whether the provision of phone-based intervention improved self-monitoring adherence. Participants were 54 adults with overweight or obesity (mean age 49.6 years, SD 12.4 years; mean BMI 32.6 kg/m2, SD 3.2 kg/m2) enrolled in a pilot trial assessing the impact of self-monitoring technology (Fitbit Zip, Aria scale, and smartphone app), with and without additional interventionist contact, on weight loss. All participants received weight loss education and were asked to self-monitor weight, dietary intake, and physical activity daily throughout the 6-month program. Consistency was defined as the number of weeks that participants adhered to self-monitoring recommendations (7 out of 7 days). Disengagement was defined as the first of 2 consecutive weeks that the 7-day self-monitoring adherence goal was not met. Wilcoxon signed-rank tests were used to examine differences in consistency and disengagement by behavioral targets. t tests (2-tailed) and Cox proportional hazards models were used to examine whether providing additional interventionist contact would lead to significant improvements in consistency and time to disengagement from self-monitoring tools, respectively. Linear regressions were used to examine associations between consistency, time to disengagement, and weight loss. Participants consistently self-monitored physical activity for more weeks (mean 17.4 weeks, SD 8.5 weeks) than weight (mean 11.1 weeks, SD 8.5 weeks) or dietary intake (mean 10.8 weeks, SD 8.7 weeks; P<.05). Similarly, participants had a significantly longer time to disengagement from self-monitoring of physical activity (median 19.5 weeks) than weight (4 weeks) or dietary intake (10 weeks; P<.001). Participants randomized to receive additional interventionist contact had significantly greater consistency and longer time to disengagement for self-monitoring of dietary intake compared with participants who did not (P=.006); however, there were no statistically significant differences between groups for self-monitoring of weight or physical activity (P=.24 and P=.25, respectively). Greater consistency and longer time to disengagement were associated with greater weight loss for self-monitoring of weight and dietary intake (P<.001 and P=.004, respectively) but not for physical activity (P=.57). Results demonstrated that self-monitoring adherence differed by behavioral target, with greater consistency and longer time to disengagement associated with lower-burden tools (ie, self-monitoring of physical activity). Consistent with supportive accountability theory, additional interventionist contact improved consistency and lengthened time to disengagement from self-monitoring of dietary intake. Given the observed associations between consistency, disengagement, and weight loss outcomes, it is important to identify additional methods of increasing consistency and engagement with digital self-monitoring tools.
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