Social Mobile Approaches to Reduce Weight (SMART) 2.0

摘要 在20至39岁的人群中，约有60.3%的人超重或肥胖， 成年与未来体重增加、心血管疾病风险因素和心理困扰有关。 因此，有人建议，治疗年轻人的超重和肥胖可能会预防慢性 中年的疾病关于如何在这一人群中促进体重减轻而不 使用昂贵的可扩展性有限的亲自程序。几年来，我们小组调查了 依靠无处不在的技术在虚拟空间中与年轻人见面的干预措施的有效性， 经常居住和使用这些场所，通过体育活动和健康饮食促进减肥。我们 现在建议在642名超重/肥胖大学生中进行平行组随机对照试验， 圣地亚哥18-35岁的学生。受试者将被随机分配至1）SMART 2.0， 技术和个人健康教练; 2）SMART 2.0仅与技术;或3）对照组。的 干预措施将持续24个月，旨在以可扩展的方式最大限度地提高功效。 将使用完全集成的模式系统提供干预内容：1）Fitbit，2）MyFitnessBit，3） SMS，4）多个社交媒体流，5）具有博客的网站，以及6）电子邮件。消费级设备和应用程序 将被用于自我监控行为，他们的数据将被实时被动获取。算法将 用于自动传送交互式文本消息以支持个性化定制的目标设置， 绩效反馈和目标回顾，以高度动态的方式反映参与者的行为进展 达到最低减肥5%的目标。将鼓励参与者分享他们的数据， 通过应用程序中内置的社交网络工具与他人进行行为改进。社会网络机制 影响力将在研究空间内使用，以引起参与者对参与者和健康教练对 参与者的支持，以及外部的研究空间，以调用社会支持和问责制，从强大的 对长期行为改变很重要的联系。此外，一个小组将每月收到 以技术为媒介的、基于理论和证据的实时个人健康指导。我们的主要目的 旨在确定SMART 2.0干预措施在24个月内改善体重的有效性。我们的次要 目的是评价1）6、12、18和24个月时组间的人体测量差异 和生理结果，身体活动，饮食，睡眠，自尊，身体形象，焦虑，抑郁， 参与者关于体重相关行为的在线交流的频率和组成; 2） 剂量反应（即，量化的参与方式）的干预措施; 3）可用性和 干预的可接受性; 4）干预效果的潜在中介者和调节者（例如，社会 网络连接、污染等）; 5）身体活动、饮食和睡眠的变化模式。

ABSTRACT Approximately 60.3% of those aged 20 to 39 years are overweight or obese, and excess weight gain in young adulthood is associated with future weight gain, cardiovascular disease risk factors, and psychological distress. Consequently, it has been suggested that treating overweight and obesity in young adults may prevent chronic disease in middle age. Relatively little is known about how to promote weight loss in this population without using costly in-person programs that have limited scalability. For several years, our group has investigated the efficacy of interventions that rely on ubiquitous technologies to meet young adults in the virtual spaces they frequently inhabit and use these venues to promote weight loss through physical activity and healthy diet. We now propose to conduct a parallel-group randomized controlled trial among 642 overweight/obese university students aged 18-35 years in San Diego. Participants will be randomly allocated to either 1) SMART 2.0 with technology and personal health coaching; 2) SMART 2.0 with technology alone; or 3) a control group. The interventions will be delivered for 24 months, and they are designed to maximize efficacy in a scalable manner. Intervention content will be delivered using a fully integrated system of modalities: 1) Fitbit, 2) MyFitnessPal, 3) SMS, 4) multiple social media streams, 5) a website with blog, and 6) email. Consumer-level devices and apps will be used to self-monitor behavior, and their data will be passively acquired in real-time. Algorithms will be used to automatically deliver interactive text messages to support individually tailored goal setting, performance feedback, and goal review in a highly dynamic style that reflects participants' behavioral progress towards achieving a minimum goal of 5% weight loss. Participants will be encouraged to share their data and behavioral progress with others via social networking tools built into the apps. Social network mechanisms of influence will be used both within the study-space, to elicit participant-to-participant and health coach-to- participant support, as well as outside the study-space, to invoke social support and accountability from strong ties known to be important for long-term behavior change. Additionally, one group will receive monthly technology-mediated, real-time personal health coaching that is theory- and evidence-based. Our primary aim is to determine the efficacy of the SMART 2.0 interventions to improve weight over 24 months. Our secondary aims are to evaluate to evaluate 1) differences between groups at 6, 12, 18, and 24 months in anthropometric and physiological outcomes, physical activity, diet, sleep, self-esteem, body image, anxiety, depression, and the frequency and composition of participants' online communication about weight-related behaviors; 2) the dose response (i.e., quantified engagement with modalities) of the interventions; 3) the usability and acceptability of the intervention; 4) potential mediators and moderators of the intervention effects (e.g., social network connectivity, contamination, etc.); and 5) patterns of change in physical activity, diet, and sleep.