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，与干预者联系（例如，减肥教练）创建一个感觉， 支持性问责制，可以促进行为改变和减肥。保持强烈的 面对面干预接触结束后的支持性问责制有可能改善结果 在臭名昭著的减肥维持期。一种促进支持性的创新方法 问责制为参与者提供客观测量体重和PA并跟踪食物的数字化工具 实时摄入，使这些工具的数据自动并持续提供给教练，以及 设计干预联系的时间和内容，使得它们响应于所述共享数据。 虽然允许从传感器和基于互联网的应用程序共享数据的工具是现成的， 在生活方式改变计划中，他们被纳入干预联系的方式还没有 研究还没有系统地评估数据共享对行为的影响。超重 和肥胖参与者（n = 90）将从社区招募进行小型RCT，以测试 提高生活方式改变干预的可行性、可接受性、有效性和作用机制 数据共享。在项目的第1-12周（即，第一阶段），所有参与者将参加12周，面对面- 面对，基于群体的行为治疗会议，以诱导减肥。参加者将获得一份 无线体重秤，PA传感器和数字食物记录应用程序，并指示每天使用它们， 自我监控的目的。在第二阶段（第13-52周），参与者将被随机分配到标准 (LM)或远程生活方式改变的增强版本（LM+SHARE）。两种情况都不会有面对面的-- 第二阶段的面对面干预联系;远程干预联系将包括简短的电话和短信 由学员的教练提供的信息。在这两种情况下的参与者将被规定继续每天 使用三个自我监控设备。在标准LM条件下，来自这些设备的数字数据不会 直接与教练分享;干预遭遇只会被不经常的，延迟的自我告知， 参与者的报告（这是目前长期肥胖护理的标准），短信的时间将 被固定。在LM+SHARE中，数字化工具将自动连续传输体重、PA和 食物记录数据给教练。在LM+SHARE中，支持性问责制将通过三种方式得到加强： 参与者将在教练查看他们的数据后收到自动警报，2）个性化文本的时间 来自教练的消息将对体重、PA、卡路里摄入量或使用 体重秤、PA传感器或食物记录工具，以及3）短信和电话的内容将由 教练已经查看的数字数据，以及教练将继续查看数据的期望， 以提供持续的支持。将在第0、12、26、40和52周完成评估。

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.