ENGAGED: E-Networks Guiding Adherence to Goals for Exercise and Diet

描述（由申请人提供）：本申请涉及广泛挑战领域（06）使能技术和特定挑战主题06-OD（OBSSR）-101*，“使用新技术提高依从性”糖尿病预防计划（DPP）强化生活方式干预是具有心脏代谢风险因素的成人的金标准减肥治疗。尽管DPP很有效，但它并没有被广泛采用，因为它与专家进行的16次单独的面对面会议被认为过于繁重和昂贵，不适合作为一个可持续的计划。通过减少疗程次数来降低成本的尝试已经大大减少了体重减轻。一旦频繁的面对面会议停止，对饮食和活动目标的行为坚持就会下降，体重会经常反弹。DPP实施尚未解决的挑战是如何在不削减对维持依从性至关重要的定期社会支持、问责制和反馈的情况下降低治疗强度。我们假设，通过使用手持技术来保持反馈、问责制和定期的社会支持，实施DPP强化生活方式治疗是可行的，但效率是两倍。待测试的基于智能手机的技术系统由Carver和Scheier的自我调节控制系统理论指导。初步的形成性研究将升级智能手机，使其具有吸引人的功能，激励参与者使用该设备进行自我监控，并与教练和同伴支持小组互动。在一项涉及64名肥胖成年人的初步2组随机对照试验（RCT）中，将最终工具的使用与通常的纸质记录进行比较。通过在6个月的干预期内持续实现同伴支持、问责制和对饮食、身体活动和减肥目标的反馈，ENGAGED系统预计将增强（1）行为依从性[通过（a）饮食和活动的自我监测和（B）饮食和活动目标的实现来操作]，以及（2）减肥。整合专家和同行支持资源以提高治疗依从性的技术可以通过提高有效DPP生活方式干预的效率，可行性和范围来帮助减少肥胖流行。.简单总结现在有必要由专业人士进行长期面对面治疗，以维持成功减肥所需的饮食和活动目标的坚持。ENGAGED研究测试了一种降低成本的方法，方法是将面对面治疗的次数减少一半，并使用专门设计的智能手机，帮助人们与支持减肥行为的顾问和同龄人进行虚拟互动。

DESCRIPTION (provided by applicant): This application addresses Broad Challenge Area (06) Enabling Technologies and Specific Challenge Topic 06-OD(OBSSR)-101*, "Using new technologies to improve adherence" The Diabetes Prevention Program (DPP) intensive lifestyle intervention is the gold standard weight loss treatment for adults with cardiometabolic risk factors. Despite its efficacy, the DPP has not been widely adopted, because its 16 individual, face-to-face sessions with a specialist are considered too burdensome and expensive to be a sustainable program. Attempts to reduce cost by decreasing session number have yielded greatly diminished weight loss. Behavioral adherence to diet and activity goals declines and weight regain routinely begins once frequent face-to-face meetings cease. The still unmet challenge of DPP implementation is how to reduce treatment intensity without excising the regular social support, accountability, and feedback that are essential to maintain adherence. We hypothesize that it is feasible to implement DPP Intensive Lifestyle Treatment as effectively but twice as efficiently by using hand held technology to preserve feedback, accountability, and regular social support. The smartphone-based technology system to be tested is guided by Carver and Scheier's control systems theory of self-regulation. Initial formative research will upgrade the smartphone with engaging features that motivate participants to use the device to self- monitor and interact with a coach and peer support group. Use of the finalized tool will be compared to usual recording on paper records in a preliminary 2-group randomized controlled trial (RCT) involving 64 obese adults. By enabling peer support, accountability, and feedback on diet, physical activity, and weight loss goals continuously through the 6-month intervention period, the ENGAGED system is expected to enhance (1) behavioral adherence [operationalized by (a) self-monitoring of diet and activity and (b) attainment of diet and activity goals], and (2) weight loss. An enabling technology that integrates specialist and peer support resources to improve treatment adherence could help to curtail the obesity epidemic by increasing the efficiency, feasibility, and reach of effective DPP lifestyle intervention. . Lay Summary Long in-person treatment with a professional is now necessary to maintain the adherence to diet and activity goals that is needed for successful weight loss. The ENGAGED study tests a way to reduce cost by having half as many in-person treatment sessions and using specially designed smart phones that help people engage virtually with a counselor and peers who support behavioral adherence to weight loss.