Optimizing a standalone text messaging-based weight loss intervention

优化基于独立短信的减肥干预

• 批准号: 9245464
• 负责人: Gary G Bennett
• 金额: $ 70.38万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-02-01 至 2021-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9245464
• 关键词: Address; Adult; Affect; Body Weight Changes; Body Weight decreased; Categories; Characteristics; Community Healthcare; Counseling; Diet; Epidemic; Feedback; Frequencies; Future; Goals; Individual; Intervention; Literature; Logistics; Maintenance; Mediator of activation protein; Minor; Modeling; Monitor; Motivation; Obesity; Outcome; Participant; Phase; Physical activity; Population; Positioning Attribute; Provider; Randomized; Recording of previous events; Reporting; Schedule; Self Efficacy; Standardization; Structure; Subgroup; Technology; Testing; Text; Time; Work; base; behavior change; cost; cost effectiveness; design; evidence base; incremental cost-effectiveness; mHealth; multi-component intervention; novel; novel strategies; obesity treatment; personalized intervention; response; skills training; theories; therapy design; treatment strategy; weight loss intervention; weight maintenance

The overarching goal of our proposed project is to develop an efficacious standalone text messaging obesity intervention. We focus on standalone approaches -- treatments that can be wholly delivered via text messaging -- because of their dissemination potential. Standalone treatments are readily scalable, can be used modularly, and several such interventions (e.g., Text4baby) have achieved population reach. Despite their translational potential, no trials have yet tested a fully standalone texting intervention for weight loss. To accomplish this goal, we propose to use the multiphase optimization strategy (MOST) to identify which intervention components should optimally be included in our standalone texting weight loss intervention. MOST guides the randomized experimentation of intervention components so that we might assemble a treatment package comprised only of components that make a meaningful impact on weight loss. We will conduct a 12-month experimental trial among 592 obese adults. All study participants will receive a core 6-month weight loss texting intervention (based on our iOTA approach) that includes tailored behavior change goals, interactive self-monitoring, automated feedback, and skills training. Using a fractional factorial design, we will randomize participants to one of 16 experimental conditions (37 in each condition) that will test the text messaging components (and levels). We will follow participants at months 1, 3, 6, and 12. We will experimentally determine which text messaging components (and component levels) produce a meaningful contribution to 6- month weight change and 6-month change in diet, physical activity, and the proportion of participants who achieve > 5% weight loss at 6 months and maintenance at 12 months. We will examine associations of engagement and non-usage attrition with weight change, model trajectories of change in engagement and non- usage attrition over time, and test theoretically-driven mediators of engagement, self-efficacy, and the Technology Acceptance Model constructs: perceived ease of use and perceived usefulness. We will also determine the cost of the intervention’s implementation and its incremental cost effectiveness. Finally, we explore whether combinations of intervention component are differentially efficacious by participant characteristics; this will allow us to ultimately tailor intervention structures for optimal outcomes. This study will demonstrate how to best assemble a low cost, high reach standalone texting weight loss intervention.

我们提出的项目的总体目标是开发一个有效的独立短信肥胖 干预我们专注于独立的方法--完全可以通过短信传递的治疗方法 因为它的传播潜力。独立的治疗方法易于扩展，可以模块化使用， 以及几种这样的干预（例如，Text 4 baby）已经实现了人口覆盖。尽管他们的翻译 潜在的，还没有试验测试了一个完全独立的短信干预减肥。为了实现这一 目标，我们建议使用多阶段优化策略（MOST），以确定哪些干预 成分最好应该包括在我们的独立短信减肥干预。MOST指导 随机实验干预成分，这样我们就可以组装一个治疗包， 仅由对减肥产生有意义影响的成分组成。我们将进行为期12个月的 在592名肥胖成年人中进行的实验性研究。所有研究参与者将接受为期6个月的核心减肥 短信干预（基于我们的iOTA方法），包括量身定制的行为改变目标，互动 自我监控、自动反馈和技能培训。使用部分析因设计，我们将随机 16个实验条件之一（每个条件37人），将测试短信 水平（Level）。我们将在第1、3、6和12个月随访参与者。我们将实验性地 确定哪些文本消息传递组件（和组件级别）对6- 一个月的体重变化和6个月的饮食变化，身体活动，以及参与者的比例， 6个月时体重减轻> 5%，12个月时保持不变。我们将研究 参与度和非使用损耗与权重变化，参与度和非使用损耗变化的模型轨迹， 随着时间的推移，使用磨损，并测试理论驱动的参与，自我效能感和 技术接受模型的结构：感知易用性和感知有用性。我们还将 确定实施干预措施的成本及其增量成本效益。最后我们 探索干预成分的组合是否因参与者而异 这将使我们能够最终调整干预结构，以取得最佳成果。本研究将 演示如何最好地组装一个低成本，高覆盖率的独立短信减肥干预。