Feasibility Trial of a Problem-Solving Weight Loss Mobile Application

描述（由申请人提供）：生活方式干预，虽然在减少体重和糖尿病风险方面有效，但是密集的（即需要16次或更多的面对面访问），这阻碍了广泛实施。移动技术可能会降低干预强度，同时通过协助提供行为策略来保持结果，但很少有研究对此进行探讨。在公开市场上，减肥手机应用激增；然而，我们的研究和其他研究表明，这些应用程序解决的基于证据的策略范围很窄，主要包括自我监控、提示、目标设定，有时还包括社交网络在市场和研究中，应用程序缺少的一个关键策略是解决问题，这是行为减肥干预的重要组成部分我们建议开发和测试Smart Coach的可行性，这是一款减肥手机应用程序，它包括自我监控、目标设定和社交网络等常见功能，但更重要的是，它具有虚拟形象便利、具体的问题解决功能，可以智能地处理信息，帮助患者找到减肥问题的解决方案。我们假设智能教练与低强度（一半的疗程）减肥干预相结合将比单独进行低强度减肥干预更有效，在面对面访问结束后观察到最大的差异。使用“众包”模型，我们将通过以下方式填充问题和解决方案数据库：1)专家提供的问题解决会议，其中包括试图减肥的肥胖参与者样本；2)应用程序的预试点测试。使用“人工智能”原理，我们将转换问题解决算法

DESCRIPTION (provided by applicant): Lifestyle interventions, while effective at reducing weight and diabetes risk, are intensive (i.e., requiring 16 or more face-to-face visits) which has prevented widespread implementation. Mobile technology may reduce intervention intensity while preserving outcomes by assisting in the delivery of behavioral strategies, but very little research has explored this. Weight loss mobile applications are proliferating in the open market; however our work and others2 show that the range of evidence-based strategies addressed by these apps is narrow, primarily including self-monitoring, prompts, goal-setting, and sometimes a social network.3 A key strategy missing across apps in both the market and research is problem solving, an essential component of behavioral weight loss interventions.4 We propose to develop and test the feasibility of Smart Coach, a weight loss mobile application that includes common features such as self-monitoring, goal setting, and a social network, but even more importantly, an avatar-facilitated, idiographic problem solving feature that processes information intelligently to help patients identify solutions to their weight loss problems. We hypothesize tha Smart Coach when combined with a lower intensity (half the sessions) weight loss intervention will be more effective than a lower intensity weight loss intervention alone, with biggest differences observable after face-to- face visits end. Using a "crowd-sourcing" model, we will populate a database with problems and solutions via 1) expert-delivered problem solving sessions with a sample of obese participants trying to lose weight and 2) a pre-pilot test of the app. Using principles of "artificial intelligence" we will convert the algorithm of problem solving counseling into the mobile application so that it may perform this strategy on its own, but based on expert and crowd-sourced information. We will then use a series of iterative steps involving qualitative research methods (usability testing, focus groups, and pre-piloting) to refine the tool A randomized pilot feasibility trial will test the feasibility and initial effects of the Smart Coah mobile application when paired with a shortened (8- week) behavioral weight loss intervention relative to a shortened behavioral weight intervention alone. Feasibility outcomes include frequency and duration of usage of the mobile app and each feature, recruitment, and retention. We will also do exploratory analyses comparing conditions on problem solving skills and weight loss at 8- and 16-weeks. Data will support a larger efficacy trial of a Smart Coach-assisted brief behavioral weight loss intervention relative to a brief behavioral weight loss intervention alone. Our overarching goal is to develop mobile technology that reduces the intensity of lifestyle interventions as far as possible while preserving weight loss outcomes, to ultimately broaden the reach to people and settings that currently have little access.