Targeting important behaviors for weight loss through the use of social gaming and points: The Social Pounds Off Digitally (Social POD) study

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Overweight and obesity are linked to a number of chronic diseases, including type 2 diabetes mellitus (T2DM). Weight loss has been shown to help with the prevention of T2DM. Behavioral weight loss programs that provide, encourage, or facilitate social support are associated with greater adherence to treatment. Social support can also help to encourage consistent dietary self-monitoring, which is considered the cornerstone of weight loss treatment and an important component of interventions targeting T2DM prevention and management. Few studies have focused specifically on ways to target areas of social support that have proven to be effective in face-to-face delivery settings. The Social Pounds Off Digitally (Social POD) study was a three-month randomized weight loss intervention with content delivered remotely via twice-weekly podcasts (same for both intervention arms). Overweight adults (N=51) were recruited and randomly assigned to either the experimental group (n= 26; Social POD app that received points for self-monitoring and social support)) or the comparison group (n=25; standard diet tracking app with no points). Social POD group participants lost significantly more weight (-5.3 kg; 95%CI: -7.5, -3.0) than those in the standard app group (-2.2 kg; 95%CI: -3.6, -1.0; p=0.02) and total points earned significantly predicted % weight loss (B=-0.02, p=0.01). This study, with 39% of the participants being African American, represents one of the more diverse study samples for a digital weight loss intervention. The goal of the present proposal is to examine the Social POD intervention in a longer-term study (12 months) to ensure that use of social gaming leads to sustainable behavior changes and continued weight loss. Our study has the following aims: Aim 1) Determine if the Social POD app plus points intervention (SocialPOD+points; points for provision and receipt of social support) produces significantly more weight loss at 12 months than the Social POD without points (SocialPOD-) among 240 adults with overweight or obesity and ≥3 T2DM risk factors. Hypothesis: The SocialPOD+points group will lose more weight than the SocialPOD- group. Aim 2) Examine the differences in social support provision and receipt between groups at 12 months. Hypothesis: That the SocialPOD+points group will have greater levels of social support provision and receipt than the SocialPOD-. Secondary Aims) Examine usage patterns over time [e.g., do points sustain engagement and promote weight loss maintenance?], potential mediators and moderators [engagement (e.g., frequency of self-monitoring)], demographic factors (e.g., sex, race, age)], the usability and acceptability of the interventions, and the association of social support provision/receipt and psychosocial factors (e.g., motivation, enjoyment) with weight loss. This approach has considerable public health appeal since, if the social gaming approach proves to be successful in promoting and maintaining weight loss, it could be greatly scaled up for widespread dissemination.