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

超重和肥胖与包括2型糖尿病在内的多种慢性疾病有关 （T2DM）。减肥已被证明有助于预防T2 DM。行为减肥计划 提供、鼓励或促进社会支持与更大的治疗依从性相关。社会 支持还有助于鼓励持续的饮食自我监测，这被认为是 减肥治疗和针对T2 DM预防的干预措施的重要组成部分， 管理很少有研究专门关注如何针对社会支持领域，这些领域已经证明 to be effective有效in face面对to face面对delivery交付settings设置. 社交减肥（Social Pounds Off Digitally）研究是一项为期三个月的随机减肥研究， 通过每周两次播客远程提供内容的干预（两个干预组相同）。 招募超重成年人（N=51）并随机分配到实验组（n= 26; 接受自我监控和社会支持积分的社交POD应用程序）或对照组（n=25; 标准的饮食跟踪应用程序，没有积分）。社交POD组的参与者体重减轻明显更多（-5.3 kg; 95%CI：-7.5，-3.0）比标准app组（-2.2 kg; 95%CI：-3.6，-1.0; p=0.02）和总分 获得了显著的预测体重减轻%（B=-0.02，p=0.01）。这项研究中，39%的参与者 非裔美国人是数字减肥干预的更多样化的研究样本之一。的 本提案的目标是在一项长期研究（12个月）中检查社会POD干预， 确保使用社交游戏导致可持续的行为改变和持续的减肥。 我们的研究有以下目的：目的1）确定社交POD应用程序是否加点干预 （SocialPOD+积分;提供和接受社会支持的积分）产生显著更多的减肥效果 在240名超重或肥胖的成年人中，12个月时的社交POD比不得分（SocialPOD-） ≥3个T2 DM危险因素。假设：SocialPOD+积分组将比 SocialPOD-组。目标2）审查不同群体在社会支助提供和接受方面的差异， 12个月假设：SocialPOD+积分组将获得更高水平的社会支持 和收据比SocialPOD-。次要目的）检查随时间推移的使用模式[例如，点是否维持 参与和促进减肥维持？]，潜在的调解人和主持人[参与（例如， 自我监测的频率）]，人口统计学因素（例如，性别、种族、年龄）]、 干预措施，以及社会支持的提供/接受与心理社会因素（例如，动机， 享受减肥。这种方法具有相当大的公共卫生吸引力，因为如果社交游戏 这种方法被证明是成功的，在促进和维持减肥，它可以大大扩大， 广泛传播。

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.