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

描述(由申请人提供)：本申请涉及广泛的挑战领域(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针对有心脏代谢风险因素的成年人的黄金标准减肥治疗。尽管有效，但民进党并未被广泛采用，因为它与专家进行的16次个人面对面培训被认为负担太大，成本太高，无法成为一个可持续的项目。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，行为上对饮食和活动目标的遵守就会下降，体重通常会开始恢复。民进党实施过程中仍未解决的挑战是，如何在不影响常规社会支持、问责和反馈的情况下，降低治疗强度，而这些都是维持承诺所必需的。我们假设，通过使用手持技术来保存反馈、责任和定期的社会支持，实施DPP强化生活方式治疗是可行的，但效率是两倍。被测试的基于智能手机的技术系统是以卡弗和谢尔的自我调节控制系统理论为指导的。最初的形成性研究将升级智能手机，提供引人入胜的功能，鼓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。最终工具的使用将与肥胖成年人初步2组随机对照试验中纸质记录上的常规记录进行比较。通过在为期6个月的干预期内持续提供同伴支持、问责和关于饮食、体力活动和减肥目标的反馈，参与式系统有望增强(1)行为坚持[通过(A)自我监测饮食和活动以及(B)实现饮食和活动目标]，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使能技术可以通过提高有效的DPP生活方式干预的效率、可行性和覆盖面来帮助遏制肥胖流行。。长期的面对面治疗对于保持成功减肥所需的饮食和活动目标是必要的。这项名为Engine的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，帮助人们与支持行为坚持减肥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.