mDiet: A Text Message Intervention for Weight Loss

描述(由申请人提供)： 我们提出了一项随机对照试验，以评估主要基于发送/接收手机短信的减肥干预措施在多大程度上促进了21至60岁超重和肥胖男性和女性的减肥和减肥保持。这项研究基于有希望的形成性研究和最近在NCI R21的支持下对75名超重/肥胖男性和女性(平均年龄：49.9岁)进行的试点随机对照试验(RCT)。据我们所知，mDIET试点研究是第一个通过主要基于短信(短信)的干预来解决超重/肥胖的随机对照试验。在16周时，我们发现mDIET组之间的体重差异显着，mDIET使用者的体重比对照组多3.16%(2.88公斤)，而且可接受性非常高。短信正变得越来越普遍，基本上可以在所有移动电话平台上查看。因此，使用这种方法的行为干预的人群覆盖范围可能很广。在这个项目中，我们将扩展和加强mDIET背后的专家系统逻辑，加强针对有助于减肥的能量摄入行为的内容，并开发与体力活动和久坐行为相关的额外内容--所有这些变化都旨在使mDIET能够促进和维持12个月后5%-10%的体重减轻。我们将在母语为西班牙语的人中进行更多的形成性研究，并为说英语和西班牙语的男性和女性开发mDIET。然后，309名超重/肥胖(BMI 25.1-39.9)的21-60岁的女性和男性将被随机分为三组，每组为期12个月：a)纯短信版本的mDIET；b)短信+手机版本的mDIET，其中包括训练有素的减肥专家打来的定期简短咨询电话；或c)普通护理标准印刷型体重干预。我们将招收大约30%的人参加西班牙语优先选项组，以确保我们有能力在这一人群中进行有意义的探索性分析。MDIET以行为理论为基础，可以支持向每个用户传递定制的消息。主要结果将是mDIET对12个月后体重减轻百分比的影响。次要结果将包括在6个月和12个月时评估mDIET对每个组中初始体重至少下降5%的比例、行为和心理社会结构、生活质量和抑郁、对干预的满意度以及与使用干预元素相关的过程措施的评估。 公共卫生相关性： 该项目探索一个主要基于自动发送和接收手机短信的程序是否可以帮助超重/肥胖的人减肥。根据专家系统规则，每天发送几次消息，并促进对减肥和减肥保持至关重要的改进行为。一些消息要求回复，鼓励继续参与和与该计划的互动。由于短信的广泛使用，如果被发现有效，这一计划对公众健康的影响可能会很大。

DESCRIPTION (provided by applicant): We propose a randomized controlled trial to evaluate how well a weight loss intervention based primarily on text messages sent to/from mobile phones, mDIET, promotes weight loss and weight loss maintenance in overweight and obese men and women age 21 through 60. This study is based on promising formative research and a pilot randomized controlled trial (RCT) recently concluded among 75 overweight/obese men and women (mean age: 49.9) with the support of an NCI R21. To our knowledge the mDIET pilot study was the first RCT to address overweight/obesity with an intervention that is based primarily on the use of text (SMS) messages. At 16 weeks we found a significant between-group difference in weight with mDIET users losing 3.16% more weight (2.88 kg) than controls and very high acceptability. SMS messaging is becoming increasingly common and can be viewed on essentially all mobile phone platforms. Thus, the population reach of behavioral interventions using this approach can be extensive. In this project we will expand and strengthen the expert system logic underlying mDIET, strengthen content targeted at energy intake behaviors that contribute to weight loss and develop additional content related to physical activity and sedentary behavior -- all changes aimed at enabling mDIET to promote and sustain a 5-10% weight loss at 12 months. We will conduct additional formative research among those whose first language is Spanish, and develop mDIET for both English and Spanish-language speaking men and women. Then, 309 overweight/obese (BMI 25.1-39.9) women and men, age 21-60 will be randomized to one of three 12-month conditions: a) an SMS only version of mDIET; b) An SMS+Phone version of mDIET that includes regular brief counseling calls from a trained weight loss specialist; or c) a usual care Standard Print-based weight intervention. We will enroll approximately 30% in the Spanish language preference group to assure our ability to perform meaningful exploratory analyses in this population. mDIET is based in behavioral theory and can support delivery of tailored messages to each user. The primary outcome will be the effect of mDIET on percent weight loss at 12 months. Secondary outcomes will include assessments at 6 and 12 months of mDIET effects on proportion of each group that lose at least 5% of initial body weight, behavioral, and psychosocial constructs, quality of life & depression, satisfaction with the intervention and process measures related to use of intervention elements. PUBLIC HEALTH RELEVANCE: This project explores whether a program based mainly on the use of automated text messages sent to and from a person's mobile phone can help overweight/obese people lose weight. Messages are sent a few times each day based upon expert system rules and promote improved behaviors important to weight loss and weight loss maintenance. Some messages request a reply encouraging continued engagement and interaction with the program. Because of the widespread use of text messages, if found efficacious the public health impact of this program could be great.