Examination of the relationship between lapses and weight loss in a smartphone-based just-in time adaptive intervention
Examination of the relationship between lapses and weight loss in a smartphone-based just-in time adaptive intervention
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DOI：
10.1093/tbm/ibaa097
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发表时间：
2021-04-01
影响因子：
3.6
通讯作者：
Forman，Evan M.
中科院分区：
文献类型：
--
作者：
Goldstein，Stephanie P.;Brick，Leslie A.;Forman，Evan M.
我们开发了一种基于智能手机的即时适应性干预（JITAI），称为OnTrack，它提供个性化干预以防止饮食失误（即，不遵守行为减肥干预饮食）。OnTrack利用生态瞬时评估（EMA;重复电子调查）进行自我报告的失误触发，使用机器学习预测失误，并提供简短的干预以防止失误。我们已经建立了OnTrack的初步可行性，可接受性和有效性，但没有研究已经检查了我们假设的作用机制：减少失误频率将与使用OnTrack时更大的体重减轻相关。这项二次分析调查了失误频率与每周体重减轻百分比之间的关联。事后分析评估了OnTrack参与对这种关联的调节作用。超重/肥胖的参与者（N= 121）（MBMI= 34.51; 84.3%女性; 69.4%白色）使用OnTrack和数字减肥计划10周。参与OnTrack（即，EMA完成和干预访问）自动记录，参与者通过EMA自我报告饮食失误，并使用蓝牙秤每周称重。受试者的随机效应和时间的固定效应的线性混合模型显示，每周失误和体重减轻的百分比之间无显着关联。事后分析显示，OnTrack参与具有统计学显著的调节作用，因此完成的EMA和干预措施较少，从而实现了失误和体重减轻之间的预期关联。在这项研究中，失误与体重减轻无关，一种解释可能是参与程度对这种关系的影响。未来的研究应调查的参与在评估JITAIs的作用。
We developed a smartphone-based just-in-time adaptive intervention (JITAI), called OnTrack, that provides personalized intervention to prevent dietary lapses (i.e., nonadherence from the behavioral weight loss intervention diet). OnTrack utilizes ecological momentary assessment (EMA; repeated electronic surveys) for self-reporting lapse triggers, predicts lapses using machine learning, and provides brief intervention to prevent lapse. We have established preliminary feasibility, acceptability, and efficacy of OnTrack, but no study has examined our hypothesized mechanism of action: reduced lapse frequency will be associated with greater weight loss while using OnTrack. This secondary analysis investigated the association between lapse frequency and the weekly percentage of weight loss. Post hoc analyses evaluated the moderating effect of OnTrack engagement on this association. Participants (N= 121) with overweight/obesity (MBMI= 34.51; 84.3% female; 69.4% White) used OnTrack with a digital weight loss program for 10 weeks. Engagement with OnTrack (i.e., EMA completed and interventions accessed) was recorded automatically, participants self-reported dietary lapses via EMA, and weighed weekly using Bluetooth scales. Linear mixed models with a random effect of subject and fixed effect of time revealed a nonsignificant association between weekly lapses and the percentage of weight loss. Post hoc analyses revealed a statistically significant moderation effect of OnTrack engagement such that fewer EMA and interventions completed conferred the expected associations between lapses and weight loss. Lapses were not associated with weight loss in this study and one explanation may be the influence of engagement levels on this relationship. Future research should investigate the role of engagement in evaluating JITAIs.