Improving Weight Loss Maintenance by Using Digital Data Sharing to Provide Responsive Support and Accountability

摘要 在生活方式改变计划中，与干预者(例如，减肥教练)接触会产生一种 支持性的责任，可以促进行为改变和减肥。保持着强烈的 面对面干预接触结束后的支持性问责有可能改善结果 在声名狼藉的减肥维持期。一种促进支持的创新方式 问责制为参与者提供了数字工具，可以客观地测量体重和PA并跟踪食物 实时摄取，使来自这些工具的数据自动且连续地提供给教练，以及 设计干预联系的时间和内容，以使它们响应共享数据。 尽管允许从传感器和基于互联网的应用程序共享数据的工具很容易获得， 在生活方式改变计划中，他们被整合到干预接触者中的方式还没有 数据共享对行为的影响还没有得到系统的评估。超重 肥胖参与者(n=90)将从社区招募进行小型随机对照试验，以测试 改善生活方式干预的可行性、可接受性、有效性和作用机制 通过数据共享。在计划的第1-12周(即第一阶段)，所有参与者将每周参加12次面对面的 面对面，基于群体的行为治疗会话，以诱导体重减轻。参赛者将获得一个 无线体重秤、PA传感器和数字食物记录应用程序，并指示将它们用于日常使用 自我监控目的。在第二阶段(第13-52周)，参与者将被随机分配到标准 (LM)或远程生活方式调整的增强版本(LM+SHARE)。两种情况都不会有面对面的- 第二阶段的面部干预接触；远程干预接触将包括简短的电话和短信 学员教练提供的信息。这两种情况下的参与者将继续接受每日处方 三个自我监控装置的使用。在标准的LM条件下，不会有来自这些设备的数字数据 直接与教练分享；干预接触将仅由不频繁、延迟的自我通知 参与者的报告(这是目前长期肥胖护理的标准)，以及短信的时间安排将 被修好。在LM+Share中，数字工具将自动和连续地传输体重、PA和 将食物记录数据发送给教练。在LM+Share中，支持性责任将通过三种方式得到加强：1) 参与者将在教练查看他们的数据后收到自动警报，2)个性化文本的计时 来自教练的信息将对临床上显著的体重、PA、卡路里摄入量或使用 秤、PA传感器或食品记录工具，以及3)短信和电话的内容将通过以下方式通知 教练已查看的数字数据，以及教练将继续查看数据的预期 以提供持续的支持。评估将在0周、12周、26周、40周和52周完成。

Abstract In a lifestyle modification program, contact with an interventionist (e.g., weight loss coach) creates a sense of supportive accountability that can facilitate behavior change and weight loss. Sustaining a strong sense of supportive accountability after face-to-face intervention contact ends has the potential to improve outcomes during the notoriously difficult weight loss maintenance period. One innovative way of facilitating supportive accountability is providing participants with digital tools that objectively measure weight and PA and track food intake in real-time, making the data from those tools automatically and continuously available to coaches, and designing the timing and content of intervention contacts such that they are responsive to the shared data. Although tools that allow for data sharing from sensors and Internet-based applications are readily available, the ways in which they are integrated into intervention contacts in a lifestyle modification program are not yet optimized, and research has not systematically evaluated the effect of data sharing on behavior. Overweight and obese participants (n = 90) will be recruited from the community for a small RCT in order to test the feasibility, acceptability, efficacy, and mechanisms of action of a lifestyle modification intervention enhanced with data sharing. In weeks 1-12 of the program (i.e., Phase I), all participants will attend 12 weekly, face-to- face, group-based behavioral treatment sessions to induce weight loss. Participants will be provided with a wireless body weight scale, PA sensor, and digital food record app and instructed to use them daily use for self-monitoring purposes. In Phase II (weeks 13-52), participants will be randomly assigned to the standard (LM) or enhanced version of remote lifestyle modification (LM+SHARE). Neither condition will have face-to- face intervention contact during Phase II; remote intervention contact will consist of brief phone calls and text messages provided by the participant's coach. Participants in both conditions will be prescribed continued daily use of the three self-monitoring devices. In the standard LM condition, no digital data from these devices will be directly shared with coaches; intervention encounters will be informed only by the infrequent, delayed self- report of participants (which is the current standard of long-term obesity care), and timing of text messages will be fixed. In LM+SHARE, the digital tools will automatically and continuously transmit body weight, PA, and food record data to the coach. In LM+SHARE, supportive accountability will be enhanced in three ways: 1) participants will receive automated alerts after coaches view their data, 2) timing of personalized text messages from coaches will be responsive to clinically notable change in weight, PA, calorie intake, or use of scale, PA sensor, or food record tool, and 3) content of the text messages and phone calls will be informed by the digital data the coach has viewed, as well as the expectation that the coach will continue viewing data in order to provide ongoing support. Assessments will be completed at 0, 12, 26, 40, and 52 weeks.