Building Habits Together: Feasibility trial of an integrated mobile and social network weight loss intervention

摘要 肥胖是心血管疾病的一个严重危险因素，但很少有人能够获得行为干预。 治疗。技术提供的减肥计划有可能增加覆盖范围和早期研究 影响不大。商业减肥移动的应用程序产生的结果不那么令人印象深刻 也许是因为他们主要关注自我监控，尽管这是一个重要的组成部分， 行为减肥干预，作为一个独立的干预措施，效果不佳。生成技术 这可以帮助更广泛的行为策略，特别是在减轻负担的方式可能会增加 技术支持的干预措施的有效性。我们以前的工作主要集中在开发技术上- 支持的工具，帮助参与者实施刺激控制和解决问题，两个行为改变 在传统的行为减肥干预措施中大量利用的策略。此应用程序的目标是 测试一个全面的技术交付的减肥干预的可行性和可接受性， 系统地帮助用户实施3个基本的行为减肥策略（自我监测， 刺激控制，解决问题），并使用同伴指导培训，让同伴互相帮助， 实施这些战略。为了最大限度地降低成本并最大限度地发挥传播潜力，我们利用了这两个方面 可商购的技术（例如，MyFitness和Facebook）和我们的本土技术， 完成这个。拟议中的技术交付计划包括1）用于饮食和锻炼的MyFitnessList 自我监控，2）我们的Building Habits Together应用程序，其中包括我们以前开发的两个功能， 帮助参与者控制刺激和解决问题的行为策略，3）Facebook提供 一个平台，传递干预信息，提供咨询，并吸引参与者，以及4）简要的同行 导师培训，以增加与行为策略有关的同行互动。一旦精炼和预- 在为期6周的单组试验中，我们将评估构建的可行性和可接受性 在6个月的试点中，与标准技术提供的减肥干预措施相比， 随机试验可行性结果包括使用移动的应用程序功能（饮食自我监测、滑动 跟踪器和问题解决），保留，参与（问题解决，同行指导），可接受性，权重 与损失相关的问题解决技能、负担、污染和咨询时间。结果将提供初步 数据来支持一项随机试验，测试共同培养习惯的干预措施是否能改善体重 与标准技术提供的减肥干预相比，1年内的减肥结果。结果 将是一种低成本、低用户负担、完全远程传递的行为减肥干预， 可以很容易地在各种环境中采用。

Abstract Obesity is a serious risk factor for cardiovascular disease but few people have access to behavioral treatments. Technology-delivered weight loss programs have the potential to increase reach and early studies reveal modest impact. Less impressive outcomes have been produced by commercial weight loss mobile apps perhaps because they focus mostly on self-monitoring which in spite of being an essential component of behavioral weight loss interventions, has poor efficacy as a standalone intervention. Generating technology that can assist in a wider range of behavioral strategies, particularly in ways that reduce burden could increase the efficacy of technology-supported interventions. Our previous work has focused on developing technology- supported tools that help participants implement stimulus control and problem solving, two behavior change strategies heavily leveraged in traditional behavioral weight loss interventions. The goal of this application is to test the feasibility and acceptability of a comprehensive technology-delivered weight loss intervention that systematically assists users in implementing 3 essential behavioral weight loss strategies (self-monitoring, stimulus control, problem solving) and uses peer mentoring training to engage peers to assist each other in implementing these strategies. To minimize costs and maximize dissemination potential, we leverage both commercially available technologies (e.g., MyFitnessPal and Facebook) and our home grown technologies to accomplish this. The proposed technology-delivered program includes 1) MyFitnessPal for diet and exercise self-monitoring, 2) our Building Habits Together app, which includes two features we previously developed to assist participants in the behavioral strategies of stimulus control and problem solving, 3) Facebook to provide a platform to deliver intervention messages, provide counseling, and engage participants, and 4) brief peer mentor training to increase peer-to-peer interactions relating to behavioral strategies. Once refined and pre- piloted in a single arm trial of a 6-week version, we will evaluate the feasibility and acceptability of Building Habits Together relative to a standard technology-delivered weight loss intervention in a 6-month pilot randomized trial. Feasibility outcomes include use of the mobile app features (dietary self-monitoring, slip tracker, and problem solving), retention, engagement (problem solving, peer mentoring), acceptability, weight loss-related problem solving skills, burden, contamination, and counselor time. Results will provide preliminary data to support a randomized trial testing whether the Building Habits Together intervention improves weight loss outcomes over 1 year relative to a standard technology-delivered weight loss intervention. The result would then be a low cost, low user burden, entirely remotely-delivered behavioral weight loss intervention that could be readily adopted in a variety of settings.