Engaging men in weight loss with a game-based mHealth and neurotraining program

摘要 在美国，男性超重和肥胖的比例非常高，即71.3%， 42%的男性目前正在尝试减肥。然而，男性的体重却严重偏低。 损失计划。男性发现传统的减肥计划(即基于团体的、教育和咨询-- 注重饮食/卡路里)没有吸引力，因为它们涉及到接受咨询，专注于替换 “男性”食物(如肉类)和“女性”食物(如沙拉)，并提供最低限度的个性化或 自主。因此，已经尝试通过有针对性地增加招聘和呼吁 招募和适应标准的减肥计划。然而，这些努力一直是 令人失望。移动应用程序(mHealth应用程序)具有吸引人的功能，但男性注册率较低， 以常规方式提供的效果不佳。游戏化的mHealth计划提供了吸引男性的可能性 并提高功效，因为(1)视频游戏对男性非常有吸引力；(2)游戏化特征(例如， 众所周知，获得连胜和里程碑(竞争)的数字奖励会增加乐趣和 激励和促进期望的行为；以及(3)以重复动作为特色的“神经训练”视频游戏 机械、适应难度和反馈可以训练抑制控制，这是大脑抑制的基本能力 内在产生的进场反应，与身体质量和高- 卡路里食物。抑制控制训练(ICT)游戏已经成功地减少了有针对性的消耗 食物/饮料和改善短期减肥。例如，在我们的前期工作中，我们展示了 减肥研讨会加上每天短时间的ICT可以为那些拥有更高体重的人带来更大的减肥效果- 与强健的注意力控制相比，高糖食物的内隐偏好高于平均水平(即 研讨会加假培训)，我们发现加入游戏化元素(例如，故事、音乐、关卡) 一个基本的游戏为男性带来了额外的8周体重减轻(4.1%比2.5%)。这个项目延伸了 之前的工作，通过评估游戏化和ICT对长期参与和 结果。因此，将招募243名体重指数≥为25的男性，其中15人参与可用性测试，228人 分配给为期12个月的mHealth减肥计划，该计划规定数字自我监测和饮食和 体力活动目标。利用有效的2x2析因设计，参与者将被随机分配到 一个标准的或完全游戏化的计划，由一个以团队为特色的行为改变计划组成 比赛，以及数字增强器，以实现连胜和里程碑，并随机获得 要么是假的，要么是主动抑制性控制神经训练。目标包括评估游戏化的效果和 ICTon关于12个月后的体重减轻、饮食和体力活动以及评估假设的中介因素 (参与和抑制控制)和主持人(玩视频游戏的基准频率和隐含的 对以信通技术为目标的食物的偏好)。

Abstract Men in the United States have an exceptionally high prevalence of overweight and obesity, i.e., 71.3%, and 42% of men are currently attempting weight loss. However, men are dramatically underrepresented in weight loss programs. Men find conventional weight loss program (i.e., group-based, education and counseling- orientated, dietary/calorie-focused) unappealing because they involve receiving counseling, focus on replacing “masculine” foods (e.g., meat) with “feminine” ones (e.g., salad), and provide minimal personalization or autonomy. As such, attempts have been made to increase recruitment and appeal through targeted recruitment and adaptations to standard weight loss programs. However, these efforts have been disappointing. Mobile applications (mHealth apps) have attractive features, but have low male enrollment and poor efficacy as conventionally delivered. A gamified mHealth program offers the possibility of engaging men and enhancing efficacy given that (1) video gaming is highly appealing to men; (2) gamification features (e.g., digital rewards for attaining “streaks” and milestones, competition) are known enhance enjoyment and motivation and facilitate desired behaviors; and (3) “neurotraining” video games featuring repetitive action mechanics, adaptive difficulty, and feedback can train inhibitory control, a basic brain capacity to inhibit intrinsically-generated approach responses that is strongly linked to body mass and the consumption of high- calorie foods. Inhibitory control training (ICT) games have been successful at reducing consumption of targeted foods/beverages and improving short-term weight loss. For instance, in our preliminary work we demonstrated that a weight loss workshop plus a short, daily ICT produced greater weight loss for individuals with higher- than-average implicit preferences for high-sugar foods, compared to a robust attention control (i.e., the workshop plus a sham training), and we found that adding gamification elements (e.g., story, music, levels) to a rudimentary game produced additional 8-week weight loss for men (4.1% vs 2.5%). This project extends previous work by evaluating the independent effects of gamification and ICT on long-term engagement and outcomes. As such, 243 men with BMI ≥ 25 will be recruited, with 15 participating in usability testing and 228 assigned to a 12-month mHealth weight loss program that prescribes digital self-monitoring and dietary and physical activity targets. Utilizing an efficient 2 x 2 factorial design, participants will be randomized to receive either a standard or fully-gamified program, comprised of a behavior change program featuring team-based competition, and digital reinforcers for attainment of streaks and milestones, and also randomized to receive either sham or active inhibitory control neurotraining. Aims include evaluating the efficacy of gamification and ICTon weight loss, diet and physical activity at 12 months, as well as evaluating hypothesized mediators (engagement and inhibitory control) and moderators (baseline frequency of video game play and implicit preferences for ICT-targeted foods).