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Pinto da Costa M. An Intervention to Connect Patients With Psychosis and Volunteers via Smartphone (the Phone Pal): Development Study. JMIR Form Res 2022; 6:e35086. [PMID: 35653171 PMCID: PMC9204578 DOI: 10.2196/35086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intervention development is a critical stage. However, evidence indicates that the substandard reporting of intervention details is widespread. OBJECTIVE This study aimed to provide an overview of the guiding frameworks, methodology, and stages for the design and construction of a new complex intervention-the Phone Pal. METHODS The intervention development process followed the Medical Research Council framework for developing complex interventions as well as the person-based approach. The intervention was developed following the evidence synthesis of a literature review, a focus group study, and a survey after consultation and input from advisory groups with a range of stakeholders, including patients, volunteers, clinicians, and academics. RESULTS The developed logic model outlines the contextual factors, intervention, mechanisms of change, and short- and long-term outcomes. The operationalized intervention required matching 1 patient with 1 volunteer to communicate with each other through a smartphone via SMS text messages, WhatsApp messages or email, and audio or video calls. Each participant was encouraged to communicate with their match at least once per week for a 12-week period using informal conversation. CONCLUSIONS The systematic process and theoretically sound strategy through which this intervention was developed can provide insights to future researchers on the reality of developing and preparing the operationalization of a digital intervention using multiple components.
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Affiliation(s)
- Mariana Pinto da Costa
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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- Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
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Langan A, Bader A, Goedkoop S, Cummings S, Tsikitas M, Nogueira I, Campoverde Reyes KJ, Stanford FC. A longitudinal study to investigate the effects of a 12-week comprehensive lifestyle weight management program on body weight and quality of life. Clin Nutr ESPEN 2020; 40:125-132. [PMID: 33183525 DOI: 10.1016/j.clnesp.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS The majority of Americans now have overweight or obesity. With limited resources to treat all patients, group programs are emerging as an efficient method for dissemination of evidence-based lifestyle information. The objective of this study was to evaluate change in body weight, biochemical parameters, and quality of life among individuals after completion of a 12-week comprehensive group weight management program at an obesity medicine clinic. METHODS 204 patients were recruited for the study after enrolling in the Healthy Habits for Life program at the Massachusetts General Hospital Weight Center in Boston and Danvers, MA. Prior to the program, patients met individually with a dietitian and baseline data was collected. Primary outcome measures collected were weight and BMI change over the course of the program. Secondary measures collected included biochemical parameters and quality of life. Weekly group visits consisted of primary outcome collection and 1.5 h of instruction on various lifestyle- and nutrition-related topics. Secondary outcome measures were reassessed at an individual visit with the dietitian after the program concluded. RESULTS 142 participants were adherent to the protocol (attended 9 out of 12 classes). On average, patients lost 6.4 kg (14.1 lbs.), representing a percent total body weight loss of over 5%. Average BMI decrease was significant at 5.35 ± 4.61%. Improvements were seen in physical function, self-esteem, and sexual life; total QOL scores also improved by a significant 5.79% on average. There were also significant improvements in total cholesterol, triglycerides, and HbA1c. CONCLUSIONS The Healthy Habits for Life group program was an effective treatment for obesity and related health concerns, including overall quality of life. Group programs of this style may be a more efficient was to disseminate evidence-based lifestyle information and affect change for patients with overweight or obesity.
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Affiliation(s)
- Annette Langan
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Abeer Bader
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA.
| | - Sonja Goedkoop
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Susan Cummings
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Marianne Tsikitas
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Isadora Nogueira
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA
| | - Karen J Campoverde Reyes
- Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 101 Merrimac Street, Suite 615, Boston, MA, 02114, USA; Liver Research Center, Beth Israel Deaconess Medical Center, 110 Francis Street, Suite 4A, Boston, MA, 02215, USA
| | - Fatima Cody Stanford
- MGH Weight Center, Massachusetts General Hospital, 50 Staniford St #430, Boston, MA, 02114, USA; Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 101 Merrimac Street, Suite 615, Boston, MA, 02114, USA; Pediatric Endocrinology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street #6C, Boston, MA, 02114, USA
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Martins C, Dutton GR, Hunter GR, Gower BA. Revisiting the Compensatory Theory as an explanatory model for relapse in obesity management. Am J Clin Nutr 2020; 112:1170-1179. [PMID: 32936896 PMCID: PMC7657332 DOI: 10.1093/ajcn/nqaa243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/04/2020] [Indexed: 12/21/2022] Open
Abstract
Weight regain remains the main challenge in obesity management, and its etiology remains elusive. The aim of the present review was to revise the available evidence regarding the "Compensatory Theory," which is an explanatory model of relapse in obesity treatment, and to propose alternative mechanisms that can contribute to weight regain. It has been proposed, and generally accepted as true, that when a person loses weight the body fights back, with physiological adaptations on both sides of the energy balance equation that try to bring body weight back to its original state: this is the Compensatory Theory. This theory proposes that the increased orexigenic drive to eat and the reduced energy expenditure that follow weight loss are the main drivers of relapse. However, evidence showing a link between these physiological adaptations to weight loss and weight regain is lacking. Here, we propose that the physiological adaptations to weight loss, both at the level of the homeostatic appetite control system and energy expenditure, are in fact a normalization to a lower body weight and not drivers of weight regain. In light of this we explore other potential mechanisms, both physiological and behavioral, that can contribute to the high incidence of relapse in obesity management. More research is needed to clearly ascertain whether the changes in energy expenditure and homeostatic appetite markers seen in reduced-obese individuals are a compensatory mechanism that drives relapse or a normalization towards a lower body weight, and to explore alternative hypotheses that explain relapse in obesity management.
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Affiliation(s)
| | - Gareth R Dutton
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Gary R Hunter
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL
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Webb VL, Wadden TA. Intensive Lifestyle Intervention for Obesity: Principles, Practices, and Results. Gastroenterology 2017; 152:1752-1764. [PMID: 28192109 DOI: 10.1053/j.gastro.2017.01.045] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 01/03/2017] [Accepted: 01/03/2017] [Indexed: 01/25/2023]
Abstract
Using the Guidelines for the Management of Overweight and Obesity in Adults as a framework, this article reviews intensive lifestyle interventions for weight loss. The Guidelines recommend a minimum of 6 months of high-intensity, comprehensive lifestyle intervention, consisting of a reduced-calorie diet, increased physical activity, and behavior therapy. Persons with obesity typically lose approximately 8 kg (approximately 8% of initial weight) with this approach, accompanied by improvements in health and quality of life. To prevent weight regain, the Guidelines recommend a 1-year weight loss maintenance program that includes at least monthly counseling with a trained interventionist. Lifestyle interventions usually are delivered in-person; however, treatment increasingly is being disseminated through community- and commercial-based programs, as well as delivered by telephone, Internet, and smartphone platforms. These latter modalities expand treatment reach but usually produce smaller weight losses than in-person interventions. The review concludes with an examination of challenges in weight management.
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Affiliation(s)
- Victoria L Webb
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
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Trilk JL, Kennedy AB. Using lifestyle medicine in U.S. health care to treat obesity: too many bariatric surgeries? Curr Sports Med Rep 2015; 14:96-9. [PMID: 25757003 DOI: 10.1249/jsr.0000000000000138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
More than one-third of Americans are classified as obese. Many clinicians perform bariatric surgery (BSx) when it is said that lifestyle intervention failed. However, BSx is medically complex, with extremely variable success, certain failures, major complications, and sometimes death. Although many studies declare BSx as more effective for producing weight loss than nonsurgical lifestyle management, these conclusions are flawed when lifestyle management between cohorts are not identical. Lifestyle behavior change is essential to success for both surgical and nonsurgical weight loss, as over 50% of BSx patients regain weight without lifestyle modification. Indeed, programs that include self-reward and reinforcement are extremely effective. It is therefore possible that successful BSx is simply an intrinsic reward for an intensive change in lifestyle behavior. Accounting for the costs and risks associated with BSx, providing state and federal resources for lifestyle behavior change programs could provide a key opportunity for the war against obesity.
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Affiliation(s)
- Jennifer L Trilk
- 1Department of Biomedical Sciences, University of South Carolina School of Medicine, Greenville, SC; and 2Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
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