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Pagoto S, Lueders N, Palmer L, Idiong C, Bannor R, Xu R, Ingels S. Best Practices for Designing and Testing Behavioral and Health Communication Interventions for Delivery in Private Facebook Groups: Tutorial. JMIR Form Res 2024; 8:e58627. [PMID: 39231426 PMCID: PMC11411228 DOI: 10.2196/58627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 06/14/2024] [Accepted: 06/19/2024] [Indexed: 09/06/2024] Open
Abstract
Facebook, the most popular social media platform in the United States, is used by 239 million US adults, which represents 71% of the population. Not only do most US adults use Facebook but they also spend an average of 40 minutes per day on the platform. Due to Facebook's reach and ease of use, it is increasingly being used as a modality for delivering behavioral and health communication interventions. Typically, a Facebook-delivered intervention involves creating a private group to deliver intervention content for participants to engage with asynchronously. In many interventions, a counselor is present to facilitate discussions and provide feedback and support. Studies of Facebook-delivered interventions have been conducted on a variety of topics, and they vary widely in terms of the intervention content used in the group, use of human counselors, group size, engagement, and other characteristics. In addition, results vary widely and may depend on how well the intervention was executed and the degree to which it elicited engagement among participants. Best practices for designing and delivering behavioral intervention content for asynchronous delivery in Facebook groups are lacking, as are best practices for engaging participants via this modality. In this tutorial, we propose best practices for the use of private Facebook groups for delivery and testing the efficacy of behavioral or health communication interventions, including converting traditional intervention content into Facebook posts; creating protocols for onboarding, counseling, engagement, and data management; designing and branding intervention content; and using engagement data to optimize engagement and outcomes.
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Affiliation(s)
- Sherry Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | | | - Lindsay Palmer
- University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Christie Idiong
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
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Pagoto SL, Goetz JM, Xu R, Wang ML, Palmer L, Lemon SC. Randomized non-inferiority trial comparing an asynchronous remotely-delivered versus clinic-delivered lifestyle intervention. Int J Obes (Lond) 2024:10.1038/s41366-024-01617-0. [PMID: 39191926 DOI: 10.1038/s41366-024-01617-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 07/30/2024] [Accepted: 08/09/2024] [Indexed: 08/29/2024]
Abstract
OBJECTIVE Lifestyle interventions are effective, but those delivered via in-person group meetings have poor scalability and reach. Research is needed to establish if remotely delivered lifestyle interventions are non-inferior to in-person delivered lifestyle interventions. METHODS We conducted a randomized non-inferiority trial (N = 329) to compare a lifestyle intervention delivered remotely and asynchronously via an online social network (Get Social condition) to one delivered via in-person groups (Traditional condition). We hypothesized that the Get Social condition would result in a mean percent weight loss at 12 months that was not inferior to the Traditional condition. Additional outcomes included intervention delivery costs per pound lost and acceptability (e.g., convenience, support, modality preferences). RESULTS At 12 months, no significant difference in percent weight change was observed between the Get Social and Traditional conditions (2.7% vs. 3.7%, p = 0.17) however, criteria for non-inferiority were not met. The Get Social condition costs $21.45 per pound lost versus $26.24 for the Traditional condition. A greater percentage of Get Social condition participants rated participation as convenient (65% vs 44%; p = 0.001). CONCLUSIONS Results revealed a remotely-delivered asynchronous lifestyle intervention resulted in slightly less weight loss than an in-person version but may be more economical and convenient. TRIAL REGISTRATION ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 .
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Affiliation(s)
- Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
| | - Jared M Goetz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Ran Xu
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Monica L Wang
- Boston University School of Public Health, Boston, MA, USA
| | - Lindsay Palmer
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, Worcester, MA, USA
| | - Stephenie C Lemon
- University of Massachusetts Chan Medical School, Department of Population and Quantitative Health Sciences, Worcester, MA, USA
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Karampatakis GD, Wood HE, Griffiths CJ, Lea NC, Ashcroft RE, Day B, Walker N, Coulson NS, De Simoni A. Ethical and Information Governance Considerations for Promoting Digital Social Interventions in Primary Care. J Med Internet Res 2023; 25:e44886. [PMID: 37756051 PMCID: PMC10568391 DOI: 10.2196/44886] [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: 12/07/2022] [Revised: 04/28/2023] [Accepted: 07/31/2023] [Indexed: 09/28/2023] Open
Abstract
Promoting online peer support beyond the informal sector to statutory health services requires ethical considerations and evidence-based knowledge about its impact on patients, health care professionals, and the wider health care system. Evidence on the effectiveness of digital interventions in primary care is sparse, and definitive guidance is lacking on the ethical concerns arising from the use of social media as a means for health-related interventions and research. Existing literature examining ethical issues with digital interventions in health care mainly focuses on apps, electronic health records, wearables, and telephone or video consultations, without necessarily covering digital social interventions, and does not always account for primary care settings specifically. Here we address the ethical and information governance aspects of undertaking research on the promotion of online peer support to patients by primary care clinicians, related to medical and public health ethics.
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Affiliation(s)
- Georgios Dimitrios Karampatakis
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Helen E Wood
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Chris J Griffiths
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Nathan C Lea
- Department of Medical Informatics & Statistics, The European Institute for Innovation through Health Data, Ghent University Hospital, Ghent, Belgium
| | | | - Bill Day
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil Walker
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
| | - Neil S Coulson
- Medical School, Nottingham City Hospital, Nottingham, United Kingdom
| | - Anna De Simoni
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Asthma UK Centre for Applied Research, Queen Mary University of London, London, United Kingdom
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Jake-Schoffman DE, Waring ME, DiVito J, Goetz JM, Pan C, Pagoto SL. The Relationship Between How Participants Articulate Their Goals and Accomplishments and Weight Loss Outcomes: Secondary Analysis of a Pilot of a Web-Based Weight Loss Intervention. JMIR Mhealth Uhealth 2023; 11:e41275. [PMID: 36927569 PMCID: PMC10131988 DOI: 10.2196/41275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/15/2022] [Accepted: 01/25/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND In behavioral weight loss interventions, participants are asked to set weekly goals to support long-term habits that lead to weight loss. Although participants are asked to set and accomplish weekly goals, we do not know how often they do this and whether doing so is associated with weight loss. Web-based weight loss interventions allow for the analysis of participant engagement data, including how participants articulate their goals and accomplishments. OBJECTIVE Using engagement data from a web-based weight loss intervention, we examined whether participants articulating their goals and accomplishments in measurable and repeating terms were associated with greater weight loss. METHODS Adults with overweight or obesity received a 12-week Facebook-delivered weight loss intervention based on the Diabetes Prevention Program Lifestyle Intervention. Participants replied to conversation threads that queried about their goals and accomplishments. Two independent coders classified participants' posts that articulated goals or accomplishments as measurable or repeating. Crude and age-adjusted linear regression models were used to examine the relationship between the frequency of post type and percent weight loss. RESULTS Participants (N=53; n=48, 91% female; n=48, 91% non-Hispanic White) were on average 46.2 (SD 10.5) years old with a mean BMI of 32.4 (SD 4.8) kg/m2. Over 12 weeks, participants shared a median of 4 (IQR 1-8) posts that reported goals and 10 (IQR 4-24) posts that reported accomplishments. Most participants shared ≥1 post with a goal (n=43, 81%) and ≥1 post with an accomplishment (n=47, 89%). Each post reporting a goal was associated with 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing ≥1 post with a repeating goal was associated with an average of 2.2% greater weight loss (95% CI -3.9% to -0.4%). Each post with a repeating goal was associated with an average of 0.5% greater weight loss (95% CI -1.0% to 0.0%). Sharing ≥1 post with measurable and repeating goals was associated with an average of 1.9% greater weight loss (95% CI -3.7% to -0.2%). Sharing each post with an accomplishment was associated with an average of 0.1% greater weight loss (95% CI -0.1% to 0.0%). Every post with an accomplishment that was repeating was associated with an average of 0.2% greater weight loss (95% CI -0.3% to 0.0%). Sharing other types of goals and accomplishments was not associated with weight loss. CONCLUSIONS In a web-based weight loss intervention, stating goals in repeating or both measurable and repeating terms was associated with greater weight loss, but simply stating them in measurable terms was not. For accomplishments, only those articulated in repeating terms were associated with greater weight loss. Posts about one-time goals and accomplishments represent an opportunity to encourage planning for future behaviors. Future research should examine if stating goals and accomplishments in repeating terms signals habit formation.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, United States
- Center for Integrative Cardiovascular and Metabolic Disease, University of Florida, Gainesville, FL, United States
| | - Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Joseph DiVito
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Cindy Pan
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, United States
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Waring ME, Moore Simas TA, Heersping GE, Rudin LR, Balakrishnan K, Burdick AR, Pagoto SL. Development and feasibility of a web-based gestational weight gain intervention for women with pre-pregnancy overweight or obesity. Mhealth 2023; 9:13. [PMID: 37089268 PMCID: PMC10119439 DOI: 10.21037/mhealth-22-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/06/2023] [Indexed: 02/25/2023] Open
Abstract
Background Excessive gestational weight gain is associated with negative maternal and infant health outcomes. Digital health approaches may help overcome barriers to participating in lifestyle interventions requiring in-person visits. The purpose of this study was to develop and examine the feasibility of a web-based gestational weight gain intervention. Methods Intervention development included feedback and input from pregnant women. We conducted a 12-week one-arm pilot study during which participants engaged in an online discussion board with coaches and other pregnant women, tracked their weight gain with an interactive graph, and accessed a list of online resources for pregnancy health. Feasibility outcomes were recruitment, retention, engagement and sustained participation, intervention acceptability, and website usability. Gestational weight gain was an exploratory outcome. Results Participants (n=12) were on average 16.8 [standard deviation (SD): 2.0] weeks gestation with average pre-pregnancy body mass index of 30.5 (SD: 4.8) kg/m2. Participant retention was 92% (n=11). Participants logged into the website a median of 21 times [interquartile range (IQR), 8-37; range, 2-98] over 12 weeks, and 58% (n=7) logged into the website during the last week of the intervention. All participants said they would be very likely or likely to participate again, and 100% said they would be very likely or likely to recommend the intervention to a pregnant friend. In post-intervention interviews, 64% (n=7) explicitly said that the website was easy to use, but 100% (n=11) mentioned usability issues. When asked their preferred intervention platform, 18% (n=2) somewhat or strongly preferred a private website, 18% (n=2) had no preference, and 64% (n=7) somewhat or strongly preferred Facebook. Seventy percent (n=7) had excessive gestational weight gain, 10% (n=1) inadequate gestational weight gain, and 20% (n=2) gained within recommended ranges. Conclusions Additional development work is needed before moving to efficacy testing. Most notably, usability issues with the investigator-developed website and participant preference suggest a switch to a commercial social media platform.
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Affiliation(s)
- Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Tiffany A. Moore Simas
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Obstetrics & Gynecology, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
- Department of Psychiatry, University of Massachusetts Chan Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Grace E. Heersping
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Lauren R. Rudin
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Kavitha Balakrishnan
- Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Abigail R. Burdick
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Sherry L. Pagoto
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
- UConn Center for mHealth & Social Media, University of Connecticut, Storrs, CT, USA
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Remotely delivered and clinic-delivered lifestyle interventions produced similar effects on the diet quality of participants. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01835-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
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McVay MA, Cooper KB, Donahue ML, Seoane MC, Shah NR, Webb F, Perri M, Jake‐Schoffman DE. Engaging primary care patients with existing online tools for weight loss: A pilot trial. Obes Sci Pract 2022; 8:569-584. [PMID: 36238223 PMCID: PMC9535672 DOI: 10.1002/osp4.592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/29/2021] [Accepted: 01/18/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Free online tools show potential for promoting weight loss at a low cost, but there is limited evidence about how to effectively engage patients with them. To address this, a low-dose, flexible intervention was developed that aims to enhance weight-related discussions with primary care providers (PCPs) and engage patients with an organic (i.e., not researcher-created) weight loss-focused social media community and online self-monitoring tool. Feasibility and acceptability of the intervention was evaluated in a single-arm, 12-week pilot. Methods PCPs were recruited at two clinics, then PCP's patients with upcoming appointments were identified and recruited. Patients received an interactive online kickoff before their scheduled primary care appointment, then 8 follow-up messages over 12 weeks via email or their electronic health record patient portal. Patients completed assessments at baseline, post-appointment, and week 12. Primary care providers and patients completed semi-structured interviews. Results All PCPs approached enrolled (n = 6); patient recruitment was on track to meet the study goal prior to COVID-19 restrictions, and n = 27 patients enrolled. Patient satisfaction with the pre-appointment kickoff was high. Twenty-four patients reported discussing weight-related topics at their primary care appointment and all were satisfied with the discussion. Twenty-two patients completed 12-week assessments. Of these, 15 reported engaging with the self-monitoring tool and 9 with the social media community. Patient interviews revealed reasons for low social media community engagement, including perceived lack of fit. On average, patients with available data (n = 21) lost 2.4 ± 4.1% of baseline weight, and 28.6% of these patients lost ≥3% of baseline weight. Primary care providers reported high intervention satisfaction. Conclusions The intervention and trial design show potential, although additional strategies are needed to promote tool engagement.
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Affiliation(s)
- Megan A. McVay
- Department of Health Education & BehaviorUniversity of FloridaGainesvilleFloridaUSA
| | - Kellie B. Cooper
- Department of Health Education & BehaviorUniversity of FloridaGainesvilleFloridaUSA
| | | | | | - Nipa R. Shah
- Department of Community Health and Family MedicineUniversity of FloridaCollege of MedicineJacksonvilleFloridaUSA
| | - Fern Webb
- Department of SurgeryUniversity of FloridaJacksonvilleFloridaUSA
| | - Michael Perri
- College of Public Health and Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
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Xu R, Divito J, Bannor R, Schroeder M, Pagoto S. Predicting Participant Engagement in a Social Media-Delivered Lifestyle Intervention Using Microlevel Conversational Data: Secondary Analysis of Data From a Pilot Randomized Controlled Trial. JMIR Form Res 2022; 6:e38068. [PMID: 35900824 PMCID: PMC9377444 DOI: 10.2196/38068] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Social media-delivered lifestyle interventions have shown promising outcomes, often generating modest but significant weight loss. Participant engagement appears to be an important predictor of weight loss outcomes; however, engagement generally declines over time and is highly variable both within and across studies. Research on factors that influence participant engagement remains scant in the context of social media-delivered lifestyle interventions. OBJECTIVE This study aimed to identify predictors of participant engagement from the content generated during a social media-delivered lifestyle intervention, including characteristics of the posts, the conversation that followed the post, and participants' previous engagement patterns. METHODS We performed secondary analyses using data from a pilot randomized trial that delivered 2 lifestyle interventions via Facebook. We analyzed 80 participants' engagement data over a 16-week intervention period and linked them to predictors, including characteristics of the posts, conversations that followed the post, and participants' previous engagement, using a mixed-effects model. We also performed machine learning-based classification to confirm the importance of the significant predictors previously identified and explore how well these measures can predict whether participants will engage with a specific post. RESULTS The probability of participants' engagement with each post decreased by 0.28% each week (P<.001; 95% CI 0.16%-0.4%). The probability of participants engaging with posts generated by interventionists was 6.3% (P<.001; 95% CI 5.1%-7.5%) higher than posts generated by other participants. Participants also had a 6.5% (P<.001; 95% CI 4.9%-8.1%) and 6.1% (P<.001; 95% CI 4.1%-8.1%) higher probability of engaging with posts that directly mentioned weight and goals, respectively, than other types of posts. Participants were 44.8% (P<.001; 95% CI 42.8%-46.9%) and 46% (P<.001; 95% CI 44.1%-48.0%) more likely to engage with a post when they were replied to by other participants and by interventionists, respectively. A 1 SD decrease in the sentiment of the conversation on a specific post was associated with a 5.4% (P<.001; 95% CI 4.9%-5.9%) increase in the probability of participants' subsequent engagement with the post. Participants' engagement in previous posts was also a predictor of engagement in subsequent posts (P<.001; 95% CI 0.74%-0.79%). Moreover, using a machine learning approach, we confirmed the importance of the predictors previously identified and achieved an accuracy of 90.9% in terms of predicting participants' engagement using a balanced testing sample with 1600 observations. CONCLUSIONS Findings revealed several predictors of engagement derived from the content generated by interventionists and other participants. Results have implications for increasing engagement in asynchronous, remotely delivered lifestyle interventions, which could improve outcomes. Our results also point to the potential of data science and natural language processing to analyze microlevel conversational data and identify factors influencing participant engagement. Future studies should validate these results in larger trials. TRIAL REGISTRATION ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Joseph Divito
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Matthew Schroeder
- Center for Aging Research, Indiana University, Indianapolis, IN, United States
| | - Sherry Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
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Jake-Schoffman DE, Carrera Seoane M, Cooper K, Rajoria M, McVay MA. Engaging adults with obesity in organic online communities to support weight loss: a mixed methods pilot study. Psychol Health 2022:1-20. [PMID: 35726546 DOI: 10.1080/08870446.2022.2087073] [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: 09/01/2021] [Revised: 04/20/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Organic online communities have shown potential for aiding weight loss, but few adults use them. We sought to test strategies to encourage adults to select and engage in online communities for weight loss. DESIGN 4-week single-arm, mixed-methods pilot. MAIN OUTCOME MEASURES Quantitative and qualitative data on selection of online community, engagement with community, and engagement and satisfaction with tasks. RESULTS On average, participants (n = 25) were female (80.0%) and white (68.0%), 45.2 ± 18.1 years old, with a BMI of 36.2 ± 6.5 kg/m2. Selection of online community varied across participants (13 MyFitnessPal, 5 Facebook, 5 Reddit). In qualitative analyses, reasons for selection included experience with community, privacy considerations, and seeking people similar to them. Most tasks were fully or partially completed by a majority of participants (>80.0%). For most tasks, ∼50% of participants felt the task helped them with weight loss support. Variability in response was observed, especially between tasks that requested reading compared to posting/commenting in the community. Frequent reading of community content throughout the study was reported by >70.0% of participants, though posting/commenting was less frequent. Barriers to further engagement included concerns about privacy, judgement, and misinformation. CONCLUSIONS This study provides insights about strategies for engaging individuals in online health communities.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Montserrat Carrera Seoane
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Kellie Cooper
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Melinda Rajoria
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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Waring ME, Pagoto SL, Moore Simas TA, Heersping G, Rudin LR, Arcangel K. Feedback on Instagram posts for a gestational weight gain intervention. Transl Behav Med 2022; 12:568-575. [PMID: 35191497 PMCID: PMC9150071 DOI: 10.1093/tbm/ibac001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Lifestyle interventions can facilitate healthy gestational weight gain but attending in-person meetings can be challenging. High rates of use and the popularity of pregnancy content suggests Instagram as a possible platform for delivering gestational weight gain interventions. We assessed the logistics and acceptability of creating a private Instagram group and to obtain feedback on intervention posts. We conducted a 2-week study with pregnant women with pre-pregnancy overweight or obesity who use Instagram daily. Participants created a private Instagram account and followed other participants and a moderator who shared twice-daily posts about physical activity and healthy eating during pregnancy. Participants provided feedback through a follow-up survey and focus group/interviews. Engagement data was abstracted from Instagram. Participants (N = 11) were on average 26.3 (SD: 7.4) weeks gestation and 54% had obesity pre-pregnancy. All participants followed the moderator's account, 73% followed all other participants, participants engaged with 100% of study posts, 82% felt comfortable sharing in the group, and 73% would participate in a similar group if pregnant in the future. While participants felt the posts were visually attractive and included helpful information, they wanted more personalized content and felt reluctant to post photos they felt were not "Instagram worthy." Moderators should foster an environment in which participants feel comfortable posting unedited, authentic photos of their lives, perhaps by sharing personal photos that are relatable and represent their own imperfect lives. Results will inform further development and testing of an Instagram-delivered gestational weight gain intervention.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Tiffany A Moore Simas
- Departments of Obstetrics and Gynecology, Pediatrics, Psychiatry, and Population and Quantitative Health Sciences, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, USA
| | - Grace Heersping
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Lauren R Rudin
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
| | - Kaylei Arcangel
- Department of Allied Health Sciences and UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, USA
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Pagoto SL, Schroeder MW, Xu R, Waring ME, Groshon L, Goetz JM, Idiong C, Troy H, DiVito J, Bannor R. A Facebook-Delivered Weight Loss Intervention Using Open Enrollment: Randomized Pilot Feasibility Trial. JMIR Form Res 2022; 6:e33663. [PMID: 35522466 PMCID: PMC9123537 DOI: 10.2196/33663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/05/2022] [Accepted: 03/07/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Behavioral weight loss programs typically enroll 12-40 people into groups that then suffer from declining engagement over time. Web-based patient communities, on the other hand, typically offer no limits on capacity and membership is fluid. This model may be useful for boosting engagement in behavioral weight loss interventions, which could lead to better outcomes. OBJECTIVE In this study, we aimed to examine the feasibility and acceptability of continuously enrolling participants into a Facebook-delivered weight loss intervention for the first 8 of 16 weeks relative to the same intervention where no new participants were enrolled after randomization. METHODS We conducted a randomized pilot trial to compare a Facebook weight loss group that used open enrollment with a group that used closed enrollment on feasibility and acceptability in adults with BMI 27-45 kg/m2. The feasibility outcomes included retention, engagement, and diet tracking adherence. We described the percentage loss of ≥5% weight in both groups as an exploratory outcome. We also explored the relationship between total volume of activity in the group and weight loss. The participants provided feedback via web-based surveys and focus groups. RESULTS Randomized participants (68/80, 85% women) were on average, aged 40.2 (SD 11.2) years with a mean BMI of 34.4 (SD 4.98) kg/m2. We enrolled an additional 54 participants (50/54, 93% female) in the open enrollment condition between weeks 1 and 8, resulting in a total group size of 94. Retention was 88% and 98% under the open and closed conditions, respectively. Randomized participants across conditions did not differ in engagement (P=.72), or diet tracking adherence (P=.42). Participant feedback in both conditions revealed that sense of community was what they liked most about the program and not enough individualized feedback was what they liked the least. Weight loss of ≥5% was achieved by 30% (12/40) of the participants randomized to the open enrollment condition and 18% (7/40) of the participants in the closed enrollment condition. Exploratory analyses revealed that the open condition (median 385, IQR 228-536.5) had a greater volume of engagement than the closed condition (median 215, IQR 145.5-292; P=.007). Furthermore, an increase of 100 in the total volume of engagement in the Facebook group each week was associated with an additional 0.1% weekly weight loss among the randomized participants (P=.02), which was independent of time, individual participant engagement, and sociodemographic characteristics. CONCLUSIONS Open enrollment was as feasible and acceptable as closed enrollment. A greater volume of engagement in the Facebook group was associated with weight loss, suggesting that larger groups that produce more engagement overall may be beneficial. Future research should examine the efficacy of the open enrollment approach for weight loss in a fully powered randomized trial. TRIAL REGISTRATION ClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680.
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Affiliation(s)
- Sherry L Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Matthew W Schroeder
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Ran Xu
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Molly E Waring
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Laurie Groshon
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Christie Idiong
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Haley Troy
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Joseph DiVito
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
| | - Richard Bannor
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, University of Connecticut, Storrs, CT, United States
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12
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Skoda EM, Steinbach J, Robitzsch A, Pfeiffer C, Schüren L, Tomaszewski J, Niedergethman M, Schweda A, Bäuerle A, Teufel M. Metabolic Surgery Supporting Aftercare via Group-Intervention (MeSSAGES): study protocol of a randomised controlled trial. BMJ Open 2021; 11:e053839. [PMID: 34937721 PMCID: PMC8705074 DOI: 10.1136/bmjopen-2021-053839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Obesity is a constantly rising and cost-intensive medical issue worldwide. Severe obesity often needs surgery to promote weight loss, but due to the rapid therapeutic success after the surgery, many patients lack the awareness of the need to consistently maintain the postoperative care. However, therapeutic success and psychological well-being can be increased through group interventions and social support of the group members. Therefore, aftercare via group intervention is a promising approach. In this prospective randomised controlled study, the self-efficacy in a social media-based interactive, psychoeducational intervention is to be tested. METHODS AND ANALYSIS The intervention group will complete a social media-supported group intervention for 6 weeks with weekly postings of educative contents and the possibility to exchange in groups via anonymous avatars. The control group will receive treatment as usual (TAU) after the obesity surgery as recommended in the German S3-guidelines Obesity Surgery and Metabolic Surgery. We will examine the effectiveness of a social media-supported intervention group, and therefore, the change in self-efficacy expectation. For the primary outcome, we will perform a mixed analysis of variance with time as the within-subject factor (times of measurement T0-T4) and the group assignment as the between-subject factor (intervention +TAU vs TAU group). ETHICS AND DISSEMINATION The study was approved by the Medical Association North Rhine (Ärztekammer Nordrhein, 2020031) and the patient enrolment will begin in July 2021. TRIAL REGISTRATION NUMBER DRKS00018089.
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Affiliation(s)
- Eva-Maria Skoda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Jasmin Steinbach
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Anita Robitzsch
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Corinna Pfeiffer
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lynik Schüren
- Department of Surgery, Alfried Krupp Klinikum Essen, Essen, Germany
| | | | | | - Adam Schweda
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Essen, Germany
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13
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Cavallo DN, Martinez R, Webb Hooper M, Flocke S. Feasibility of a social media-based weight loss intervention designed for low-SES adults. Transl Behav Med 2021; 11:981-992. [PMID: 32716040 DOI: 10.1093/tbm/ibaa070] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Low-socioeconomic status (SES) individuals have higher rates of obesity. Social media platforms are used frequently by low-SES individuals and facilitate important weight loss program components including social support. Very few social media-based weight loss interventions, however, have enrolled or been tailored to low-SES participants. The purpose of this article is to examine the feasibility of a social media-based weight loss intervention among low-SES adults. We conducted a one-group pretest post-test pilot intervention study with two groups (group 1, n = 39, group 2, n = 16) of low-SES overweight/obese adults who were enrolled in a 12-week social media-based weight loss intervention including self-monitoring via Fitbits and participation in a private Facebook group. A moderator provided educational content and encouraged social support via Facebook. Descriptive statistics were used to assess intervention acceptability and engagement. Exploratory analyses were conducted to examine changes in study outcomes and engagement patterns. The study had good retention (86%). Among 55 total participants enrolled, there were 9,175 participant interactions within the Facebook group. Among completers (n = 47), 96% indicated they would recommend the intervention to a friend. Mean weight loss was 1.07 kg (SD = 3.96, p = .0498), and participants reported increases in positive dietary social support (mean = 2.47, SD = 5.09, p = .0007). Engagement in this social media-based pilot intervention was high and exceeded results from previous studies using similar formats. Participants evaluated the intervention favorably. Changes in weight loss and several theoretical mediators were in the desired direction. Overall, our results indicate social media groups as a platform for weight loss intervention delivery among low-SES adults are feasible and should be studied in larger randomized trials.
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Affiliation(s)
- David N Cavallo
- Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
| | - Rogelio Martinez
- University of the Incarnate Word School of Osteopathic Medicine, San Antonio, TX, USA
| | - Monica Webb Hooper
- Office of Cancer Disparities Research, Case Comprehensive Cancer Center, Cleveland, OH, USA
| | - Susan Flocke
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
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14
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Harfield S, Elliott S, Ramsey L, Housen T, Ward J. Using social networking sites to recruit participants: methods of an online survey of sexual health, knowledge and behaviour of young South Australians. Aust N Z J Public Health 2021; 45:348-354. [PMID: 34097339 DOI: 10.1111/1753-6405.13117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVE To describe the methods of recruitment and demographic results of an online sexual health survey using social networking sites (SNS) to recruit people aged 16-29 years in the state of South Australia (SA) during 2019. METHODS A crosssectional online survey titled 'Let's Talk About It' using SNS (Facebook and Instagram) was administered between July and August 2019, targeting Aboriginal and Torres Strait Islander and non-Indigenous young people. The survey comprised questions on demographics information, sexual health knowledge, behaviours and healthcare access. RESULTS During the data collection period, the study team closely monitored the demographics of participants and adjusted SNS messaging through paid advertising to increase the recruitment of under-represented population groups, especially Aboriginal people, males and regional and remote residents of SA. A total of 2,724 people accessed the survey predominately via Facebook during a six-week period between July and August 2019; 2,380 people were eligible and included in the analysis. Conclusions and implications for public health: Even though SNS have been used previously in recruitment for sexual health issues, small adjustments to the study during recruitment were specifically made to include under-represented populations in the final study. Using SNS is an effective method for recruiting survey participants; during recruitment phases, additional strategies may be required to be inclusive of diverse and under-represented populations.
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Affiliation(s)
- Stephen Harfield
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, South Australia.,National Centre for Epidemiology & Population Health, The Australian National University, Australian Capital Territory
| | - Salenna Elliott
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, South Australia
| | - Liam Ramsey
- College of Medicine and Public Health, Flinders University, South Australia
| | - Tambri Housen
- National Centre for Epidemiology & Population Health, The Australian National University, Australian Capital Territory
| | - James Ward
- Wardliparingga Aboriginal Health Equity, South Australian Health and Medical Research Institute, South Australia.,School of Public Health, The University of Queensland.,UQ Poche Centre for Indigenous Health, The University of Queensland
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15
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Xu R, Cavallo D. Social Network Analysis of the Effects of a Social Media-Based Weight Loss Intervention Targeting Adults of Low Socioeconomic Status: Single-Arm Intervention Trial. J Med Internet Res 2021; 23:e24690. [PMID: 33835033 PMCID: PMC8065555 DOI: 10.2196/24690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/19/2020] [Accepted: 03/12/2021] [Indexed: 12/28/2022] Open
Abstract
Background Obesity is a known risk factor for cardiovascular disease risk factors, including hypertension and type II diabetes. Although numerous weight loss interventions have demonstrated efficacy, there is considerably less evidence about the theoretical mechanisms through which they work. Delivering lifestyle behavior change interventions via social media provides unique opportunities for understanding mechanisms of intervention effects. Server data collected directly from web-based platforms can provide detailed, real-time behavioral information over the course of intervention programs that can be used to understand how interventions work. Objective The objective of this study was to demonstrate how social network analysis can facilitate our understanding of the mechanisms underlying a social media–based weight loss intervention. Methods We performed secondary analysis by using data from a pilot study that delivered a dietary and physical activity intervention to a group of participants via Facebook. We mapped out participants’ interaction networks over the 12-week intervention period and linked participants’ network characteristics (eg, in-degree, out-degree, network constraint) to participants’ changes in theoretical mediators (ie, dietary knowledge, perceived social support, self-efficacy) and weight loss by using regression analysis. We also performed mediation analyses to explore how the effects of social network measures on weight loss could be mediated by the aforementioned theoretical mediators. Results In this analysis, 47 participants from 2 waves completed the study and were included. We found that increases in the number of posts, comments, and reactions significantly predicted weight loss (β=–.94, P=.04); receiving comments positively predicted changes in self-efficacy (β=7.81, P=.009), and the degree to which one’s network neighbors are tightly connected with each other weakly predicted changes in perceived social support (β=7.70, P=.08). In addition, change in self-efficacy mediated the relationship between receiving comments and weight loss (β=–.89, P=.02). Conclusions Our analyses using data from this pilot study linked participants’ network characteristics with changes in several important study outcomes of interest such as self-efficacy, social support, and weight. Our results point to the potential of using social network analysis to understand the social processes and mechanisms through which web-based behavioral interventions affect participants’ psychological and behavioral outcomes. Future studies are warranted to validate our results and to further explore the relationship between network dynamics and study outcomes in similar and larger trials.
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Affiliation(s)
- Ran Xu
- Department of Allied Health Sciences, College of Agriculture, Health and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - David Cavallo
- Department of Nutrition, School of Medicine, Case Western Reserve University, Cleveland, OH, United States
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16
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Waring ME, Libby BA, Moore Simas TA, Bracken ML, Bibeau JL, Herrera V, Wang J, Pagoto SL. Delivering a Post-Partum Weight Loss Intervention via Facebook or In-Person Groups: Protocol for a Randomized Feasibility Pilot Trial. JMIR Res Protoc 2019; 8:e15530. [PMID: 31778116 PMCID: PMC6908979 DOI: 10.2196/15530] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/25/2019] [Accepted: 09/26/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Postpartum weight retention contributes to long-term weight gain and obesity for many women. Lifestyle interventions with numerous visits are logistically challenging for many postpartum women. Delivering a lifestyle intervention via social media may overcome logistic challenges to participation in in-person weight loss programs. OBJECTIVE The objective of this study is to conduct a randomized feasibility pilot trial of a 6-month postpartum weight loss intervention delivered via Facebook or in-person groups with 72 postpartum women with overweight or obesity. METHODS Women with overweight or obesity who are 8 weeks to 12 months postpartum (N=72) will be recruited from the Hartford, Connecticut community. Eligible participants must also own an iPhone or Android smartphone and be an active Facebook user. Participants will receive a 6-month postpartum weight loss intervention based on the Diabetes Prevention Program lifestyle intervention and adapted for postpartum women. Participants will be randomized to receive the intervention via a private Facebook group or in-person group meetings. Assessments will occur at baseline, weekly during the intervention, at 6 months (at the end of the intervention), and at 12 months. Primary feasibility outcomes are recruitment, sustained participation, contamination, retention, and feasibility of assessment procedures including measurement of costs to deliver and receive the intervention. We will describe 6- and 12-month weight loss as an exploratory outcome. RESULTS Recruitment began in September 2018. The first wave of the intervention began in February 2019, and the second wave of the intervention is expected to begin in fall 2019. We anticipate completing follow-up assessments in fall 2020, and results will be analyzed at that time. CONCLUSIONS Results will inform the design of a large randomized controlled trial to assess whether delivering a postpartum weight loss intervention via Facebook is noninferior for weight loss and more cost-effective than delivering the intervention via traditional in-person groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15530.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Brooke A Libby
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Tiffany A Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Pediatrics, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Psychiatry, University of Massachusetts Medical School/UMass Memorial Health Care, Worcester, MA, United States
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, United States
| | - Madison L Bracken
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States
| | - Jessica L Bibeau
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Valeria Herrera
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
| | - Justin Wang
- Social Sciences Department, Community College of Rhode Island, Warwick, RI, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, UConn Center for mHealth and Social Media, University of Connecticut, Storrs, CT, United States
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17
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Brown MM, Arigo D, Pasko K, Gupta A. Perceptions of social support for weight loss among patients in primary care. Obes Res Clin Pract 2019; 13:594-598. [PMID: 31744757 DOI: 10.1016/j.orcp.2019.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 10/26/2019] [Indexed: 10/25/2022]
Abstract
This study examined primary care patients' experiences with support for weight loss efforts. Adult patients (N = 106) were recruited through primary care clinics and completed an electronic survey pertaining to their weight loss efforts. The majority (76%) received support from their existing social network (e.g., family members, professionals); 59% had used apps and <20% had used social media for support. Findings reveal differences in satisfaction with support between men and women and between support sources, which will be useful for informing weight loss interventions in primary care.
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Affiliation(s)
- Megan M Brown
- Department of Psychology, Rowan University, United States
| | - Danielle Arigo
- Department of Psychology, Rowan University, United States; Department of Family Medicine, Rowan School of Osteopathic Medicine, United States.
| | - Kristen Pasko
- Department of Psychology, Rowan University, United States
| | - Adarsh Gupta
- Department of Family Medicine, Rowan School of Osteopathic Medicine, United States
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18
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Ogden J, Maxwell H, Wong A. Development and feasibility study of an app (Ladle) for weight loss and behaviour change. PeerJ 2019; 7:e6907. [PMID: 31143540 PMCID: PMC6525583 DOI: 10.7717/peerj.6907] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/04/2019] [Indexed: 12/26/2022] Open
Abstract
Background Weight management interventions involving behaviour change often utilise face to face interventions which include evidence based behaviour change strategies yet are costly and time intensive. In contrast, digital interventions cost less and have a wider reach yet tend to lack an evidence base and are less effective. Aims The present study therefore aimed to develop an evidence based behaviour change low cost app for weight management and to provide a preliminary analysis of its effectiveness. Methods The Ladle app was developed through evidence review and feedback from health care professionals and patients and consists of a 12 week course focusing on six habits and weight loss facilitated through 36 audio psychological lessons and 12 lessons specifically on the six habits. Each lesson was between 2-5 min (approx. 168 min of lessons). It was evaluated in terms of completion rate, weight loss, adoption of the six habits and participant feedback. Results The results showed a completion rate of 44%, that 52% of Completers showed weight loss of at least 5%, 79% showed weight loss of at least 3%, the median % weight lost was -5% and the median weight loss was -3.8 kg. Further, by the end of 12 weeks the majority (>80%) of participants had adopted four of the six habits for at least 5 days a week and nearly half (45%) had adopted the remaining two habits for at least 4 days out of 7. Feedback comments were mainly positive (n = 80) focusing mostly on the content of the lessons. Some comments were neutral (n = 56) and involved a statement of commitment or a description of a challenge and a minority were negative (n = 23) describing some technical issues which were addressed as the evaluation progressed. Conclusion The new Ladle app offers an evidenced based alternative to more intensive face to face interventions. On preliminary analysis it would seem to have lower completion rates than some more intensive interventions but comparable effectiveness for weight loss. It can also improve habits and is less time-intensive and costly to deliver. Participant feedback was generally positive.
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Affiliation(s)
- Jane Ogden
- School of Psychology, University of Surrey, Guildford, Surrey, United Kingdom
| | - Hazel Maxwell
- Fittle App Limited (trading as Ladle), London, United Kingdom
| | - Adrian Wong
- Fittle App Limited (trading as Ladle), London, United Kingdom
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19
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Wisk LE, Nelson EB, Magane KM, Weitzman ER. Clinical Trial Recruitment and Retention of College Students with Type 1 Diabetes via Social Media: An Implementation Case Study. J Diabetes Sci Technol 2019; 13:445-456. [PMID: 31010315 PMCID: PMC6501540 DOI: 10.1177/1932296819839503] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND We sought to quantify the efficiency and acceptability of Internet-based recruitment for engaging an especially hard-to-reach cohort (college-students with type 1 diabetes, T1D) and to describe the approach used for implementing a health-related trial entirely online using off-the-shelf tools inclusive of participant safety and validity concerns. METHOD We recruited youth (ages 17-25 years) with T1D via a variety of social media platforms and other outreach channels. We quantified response rate and participant characteristics across channels with engagement metrics tracked via Google Analytics and participant survey data. We developed decision rules to identify invalid (duplicative/false) records (N = 89) and compared them to valid cases (N = 138). RESULTS Facebook was the highest yield recruitment source; demographics differed by platform. Invalid records were prevalent; invalid records were more likely to be recruited from Twitter or Instagram and differed from valid cases across most demographics. Valid cases closely resembled characteristics obtained from Google Analytics and from prior data on platform user-base. Retention was high, with complete follow-up for 88.4%. There were no safety concerns and participants reported high acceptability for future recruitment via social media. CONCLUSIONS We demonstrate that recruitment of college students with T1D into a longitudinal intervention trial via social media is feasible, efficient, acceptable, and yields a sample representative of the user-base from which they were drawn. Given observed differences in characteristics across recruitment channels, recruiting across multiple platforms is recommended to optimize sample diversity. Trial implementation, engagement tracking, and retention are feasible with off-the-shelf tools using preexisting platforms.
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Affiliation(s)
- Lauren E. Wisk
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard
Medical School, Boston, MA, USA
- Division of General Internal Medicine
& Health Services Research, David Geffen School of Medicine at the University of
California, Los Angeles, Los Angeles, CA, USA
- Lauren E. Wisk, PhD, Division of General
Internal Medicine & Health Services Research, David Geffen School of
Medicine at the University of California, Los Angeles, 1100 Glendon Ave, Ste
850, Los Angeles, CA 90024, USA.
| | - Eliza B. Nelson
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Kara M. Magane
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Elissa R. Weitzman
- Division of Adolescent/Young Adult
Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard
Medical School, Boston, MA, USA
- Computational Health Informatics
Program, Boston Children’s Hospital, Boston, MA, USA
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20
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Kwasnicka D, Dombrowski SU, White M, Sniehotta FF. 'It's not a diet, it's a lifestyle': a longitudinal, data-prompted interview study of weight loss maintenance. Psychol Health 2019; 34:963-982. [PMID: 30905184 DOI: 10.1080/08870446.2019.1579913] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: To advance understanding of the individual and environmental factors underpinning weight loss maintenance. Design: Semi-structured, data-prompted interviews were conducted with twelve overweight adult participants (three men, nine women) who had lost over 5% of their body weight in the year before baseline. Participants gathered daily data through wireless scales, activity monitors (Fitbit™), ecological momentary assessment and experience sampling (taking photographs, writing notes). They were interviewed at 3- and 6-months post baseline. Interview stimuli included personal data of weight and activity graphs, correlations of psychological factors, and self-generated notes and photographs. Interview data were analysed using the Framework Method, applying pre-specified maintenance-relevant theoretical themes. Results: The theoretical Framework provided a good fit for the narratives, with five main themes underpinning successful weight loss maintenance: sustained motivation, effective self-regulation, plentiful resources, habit formation and a supportive environment. Additionally, participants reported an identity shift from being a dieter to accepting a new healthy lifestyle. Goal prioritising and allowing for occasional controlled lapses enhanced weight loss maintenance. Conclusions: This study successfully used the novel method of data-prompted interviews to explore weight loss maintenance experiences with new explanations emerging from the data. Future research should further develop behaviour change maintenance theory and data-prompted interview method.
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Affiliation(s)
- Dominika Kwasnicka
- a School of Psychology , Curtin University , Perth , Australia.,b SWPS University of Social Sciences and Humanities , Wroclaw , Poland.,c Institute of Health and Society , Newcastle University, Newcastle upon Tyne, and Fuse, UKCRC Centre for Translational Research in Public Health , Newcastle , UK
| | - Stephan U Dombrowski
- c Institute of Health and Society , Newcastle University, Newcastle upon Tyne, and Fuse, UKCRC Centre for Translational Research in Public Health , Newcastle , UK.,d Faculty of Kinesiology , University of New Brunswick , Fredericton , NB , Canada
| | - Martin White
- c Institute of Health and Society , Newcastle University, Newcastle upon Tyne, and Fuse, UKCRC Centre for Translational Research in Public Health , Newcastle , UK.,e UKCRC Centre for Diet and Activity Research (CEDAR) and MRC Epidemiology Unit , School of Clinical Medicine, University of Cambridge , Cambridge , UK
| | - Falko F Sniehotta
- c Institute of Health and Society , Newcastle University, Newcastle upon Tyne, and Fuse, UKCRC Centre for Translational Research in Public Health , Newcastle , UK
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Arigo D, Jake-Schoffman DE, Wolin K, Beckjord E, Hekler EB, Pagoto SL. The history and future of digital health in the field of behavioral medicine. J Behav Med 2019; 42:67-83. [PMID: 30825090 PMCID: PMC6644720 DOI: 10.1007/s10865-018-9966-z] [Citation(s) in RCA: 89] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 08/23/2018] [Indexed: 01/03/2023]
Abstract
Since its earliest days, the field of behavioral medicine has leveraged technology to increase the reach and effectiveness of its interventions. Here, we highlight key areas of opportunity and recommend next steps to further advance intervention development, evaluation, and commercialization with a focus on three technologies: mobile applications (apps), social media, and wearable devices. Ultimately, we argue that future of digital health behavioral science research lies in finding ways to advance more robust academic-industry partnerships. These include academics consciously working towards preparing and training the work force of the twenty first century for digital health, actively working towards advancing methods that can balance the needs for efficiency in industry with the desire for rigor and reproducibility in academia, and the need to advance common practices and procedures that support more ethical practices for promoting healthy behavior.
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Affiliation(s)
- Danielle Arigo
- Department of Psychology, Rowan University, Glassboro, USA.
| | | | | | - Ellen Beckjord
- Population Health and Clinical Affairs, University of Pittsburgh Medical Center Health Plan, Pittsburgh, USA
| | - Eric B Hekler
- Department of Family Medicine Public Health, Center for Wireless and Population Health Systems, University of California, San Diego, San Diego, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, Institute for Collaboration in Health, Interventions, and Policy, Center for mHealth and Social Media, University of Connecticut, Storrs, USA
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Silfee VJ, Lopez-Cepero A, Lemon SC, Estabrook B, Nguyen O, Wang ML, Rosal MC. Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women. JMIR Form Res 2018; 2:e18. [PMID: 30684423 PMCID: PMC6334676 DOI: 10.2196/formative.9597] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 06/28/2018] [Accepted: 07/17/2018] [Indexed: 11/20/2022] Open
Abstract
Background Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income postpartum women have resulted in poor intervention attendance and high attrition. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions. Objective The objective of this study was to adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. Methods This study comprised 3 single-group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program for Facebook delivery by translating the protocol to a content library of Facebook posts with additional posts from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, Massachusetts. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first 8 weeks, Facebook intervention posts were delivered 2 times per day, with additional posts from coaches aiming to stimulate interaction among participants or respond to participants’ questions and challenges. For the following 8 weeks, posts were delivered once per day without additional coaching. Feasibility outcomes were engagement (defined by number of likes, comments, and posts measured throughout intervention delivery), acceptability, and retention (survey at follow-up and assessment completion rate, respectively). Changes in weight were also assessed at baseline and follow-up. Results Pilot 1 had a retention rate of 89% (24/27), and on average, 62% (17/27) of women actively engaged with the group each week during the 8-week coached phase. Mean weight loss was 2.6 (SD 8.64) pounds, and 79% (19/27) would recommend the program to a friend. Pilot 2 had a retention rate of 83% (20/24), and on average, 55% (13/24) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 2.5 (SD 9.23) pounds, and 80% (16/24) would recommend the program to a friend. Pilot 3 had a retention rate of 88% (14/16), and on average, 67% (11/16) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 7.0 (SD 11.6) pounds, and 100% (16/16) would recommend the program to a friend. Conclusions Our findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to low-income postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.
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Affiliation(s)
- Valerie J Silfee
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Barbara Estabrook
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Oanh Nguyen
- Family Health Center of Worcester, Inc, Worcester, MA, United States
| | - Monica L Wang
- Department of Community Health Sciences, School of Public Health, Boston University, Boston, MA, United States
| | - Milagros C Rosal
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Pagoto S, Tulu B, Agu E, Waring ME, Oleski JL, Jake-Schoffman DE. Using the Habit App for Weight Loss Problem Solving: Development and Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e145. [PMID: 29925496 PMCID: PMC6031896 DOI: 10.2196/mhealth.9801] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/09/2018] [Accepted: 03/09/2018] [Indexed: 12/19/2022] Open
Abstract
Background Reviews of weight loss mobile apps have revealed they include very few evidence-based features, relying mostly on self-monitoring. Unfortunately, adherence to self-monitoring is often low, especially among patients with motivational challenges. One behavioral strategy that is leveraged in virtually every visit of behavioral weight loss interventions and is specifically used to deal with adherence and motivational issues is problem solving. Problem solving has been successfully implemented in depression mobile apps, but not yet in weight loss apps. Objective This study describes the development and feasibility testing of the Habit app, which was designed to automate problem-solving therapy for weight loss. Methods Two iterative single-arm pilot studies were conducted to evaluate the feasibility and acceptability of the Habit app. In each pilot study, adults who were overweight or obese were enrolled in an 8-week intervention that included the Habit app plus support via a private Facebook group. Feasibility outcomes included retention, app usage, usability, and acceptability. Changes in problem-solving skills and weight over 8 weeks are described, as well as app usage and weight change at 16 weeks. Results Results from both pilots show acceptable use of the Habit app over 8 weeks with on average two to three uses per week, the recommended rate of use. Acceptability ratings were mixed such that 54% (13/24) and 73% (11/15) of participants found the diet solutions helpful and 71% (17/24) and 80% (12/15) found setting reminders for habits helpful in pilots 1 and 2, respectively. In both pilots, participants lost significant weight (P=.005 and P=.03, respectively). In neither pilot was an effect on problem-solving skills observed (P=.62 and P=.27, respectively). Conclusions Problem-solving therapy for weight loss is feasible to implement in a mobile app environment; however, automated delivery may not impact problem-solving skills as has been observed previously via human delivery. Trial Registration ClinicalTrials.gov NCT02192905; https://clinicaltrials.gov/ct2/show/NCT02192905 (Archived by WebCite at http://www.webcitation.org/6zPQmvOF2)
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Affiliation(s)
- Sherry Pagoto
- Institute for Collaboration on Health, Intervention, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Bengisu Tulu
- Foisie Business School, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Emmanuel Agu
- Computer Science Department, Worcester Polytechnic Institute, Worcester, MA, United States
| | - Molly E Waring
- Institute for Collaboration on Health, Intervention, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Jessica L Oleski
- Institute for Collaboration on Health, Intervention, and Policy, Department of Allied Health Sciences, University of Connecticut, Storrs, CT, United States
| | - Danielle E Jake-Schoffman
- Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
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Saez L, Langlois J, Legrand K, Quinet MH, Lecomte E, Omorou AY, Briançon S. Reach and Acceptability of a Mobile Reminder Strategy and Facebook Group Intervention for Weight Management in Less Advantaged Adolescents: Insights From the PRALIMAP-INÈS Trial. JMIR Mhealth Uhealth 2018; 6:e110. [PMID: 29776897 PMCID: PMC5984273 DOI: 10.2196/mhealth.7657] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 09/20/2017] [Accepted: 02/03/2018] [Indexed: 01/01/2023] Open
Abstract
Background Although information and communication technology interventions appear to be a promising means of reducing the health inequality gap in overweight and obesity prevention, research on information and communication technology interventions is lacking outside the Anglo-Saxon world. Objective The aim of this study was to assess the reach and acceptability of 2 information and communication technology interventions delivered as part of a French nutritional program: an SMS text messaging (short message service, SMS) attendance-reminder for collective sessions strategy and a Facebook challenge group. Methods This study sample comprised 262 socially less advantaged overweight adolescents aged between 13 and 18 years. The information and communication technology interventions were carried out during the 2013-2014 academic year in 33 French state-run schools. For the SMS attendance-reminder for collective sessions strategy, at the start of the academic year, adolescents were asked to give their mobile number. SMS attendance-reminders were sent shortly before each of the 5 collective sessions. For the Facebook challenge group, adolescents were invited to join a closed Facebook group in which challenges on physical activity and on diet were posted weekly. Process data and 2 sets of face-to-face interviews were also used to interpret participation rates and access to Facebook. Appreciation for both interventions was evaluated by a questionnaire at the end of the academic year. Results Of the recruited adolescents, 79.0% (207/262) gave their mobile number, reflecting high access to a mobile phone. Giving a number was significantly more likely for girls (odds ratio [OR] 2.1, 95% CI 1.1-3.9; P=.02) and adolescents in a vocational or general high school as opposed to middle school (OR 1.0, 95% CI 0.4-2.7; OR 0.2, 95% CI 0.1-0.5; P<.001). Indicating a mobile number at the start of the year was not significantly associated with participation in collective sessions. Of the adolescents seen at the start-of-year face-to-face interviews, 78.1% (153/196) declared an interest in the Facebook challenge group, which implies having a Facebook account or being able to have access to one. However, only 21 adolescents went through the process of joining the group. Although there was satisfaction with the Facebook group among the participants, the low participation rate in the Facebook group does not allow conclusions to be drawn with confidence. Conclusions The results are in line with the claim that using information and communication technologies in health programs is unlikely to widen health inequalities. However, in this population of French adolescents, mobile phone strategies seem more adapted to a high school context, and caution should be exercised with a younger audience. Although there is positive appreciation of the SMS attendance-reminders and a Facebook intervention is initially highly appealing to less advantaged adolescents, no evidence of impact could be demonstrated. These results highlight the difficulty in assessing the impact of specific interventions in complex health programs. Trial Registration Clinicaltrials.gov NCT01688453; https://clinicaltrials.gov/ct2/show/NCT01688453 (Archived by WebCite at http://www.webcitation.org/6yy6EQ0SM)
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Affiliation(s)
- Laura Saez
- APEMAC EA4360, University of Lorraine, Nancy, France
| | - Johanne Langlois
- APEMAC EA4360, University of Lorraine, Nancy, France.,National Conservatory of Arts and Crafts, Nancy, France
| | - Karine Legrand
- APEMAC EA4360, University of Lorraine, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France
| | | | - Edith Lecomte
- National Conservatory of Arts and Crafts, Nancy, France
| | - Abdou Y Omorou
- APEMAC EA4360, University of Lorraine, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France
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- APEMAC EA4360, University of Lorraine, Nancy, France.,National Conservatory of Arts and Crafts, Nancy, France.,Clinical Epidemiology, Clinical Investigation Center, National Institute for Health and Medical Research, University Hospital Regional Center, Nancy, France.,Academy Rector of Nancy and Metz, Nancy, France.,APEMAC EA4360, University of Lorraine, Metz, France
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Waring ME, Jake-Schoffman DE, Holovatska MM, Mejia C, Williams JC, Pagoto SL. Social Media and Obesity in Adults: a Review of Recent Research and Future Directions. Curr Diab Rep 2018; 18:34. [PMID: 29671135 DOI: 10.1007/s11892-018-1001-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW Social media is widely used and has potential to connect adults with obesity with information and social support for weight loss and to deliver lifestyle interventions. The purpose of this review is to summarize recent observational and intervention research on social media and obesity. RECENT FINDINGS Online patient communities for weight loss abound but may include misinformation. Systematic reviews and meta-analyses suggest that social media-delivered lifestyle interventions modestly impact weight, yet how social media was used and participant engagement varies widely. The rapidly changing social media landscape poses challenges for patients, clinicians, and researchers. Research is needed on how patients can establish supportive communities for weight loss and the role of clinicians in these communities. Emerging research on meaningful engagement in, and the efficacy and cost-effectiveness of, social media-delivered lifestyle interventions should provide insights into how to leverage social media to address the obesity epidemic.
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Affiliation(s)
- Molly E Waring
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA.
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Marta M Holovatska
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
| | - Claudia Mejia
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
| | - Jamasia C Williams
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Sherry L Pagoto
- Department of Allied Health Sciences, University of Connecticut, 358 Mansfield Road, Unit 1101, Storrs, CT, 06269-1101, USA
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26
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Haughton CF, Silfee VJ, Wang ML, Lopez-Cepero AC, Estabrook DP, Frisard C, Rosal MC, Pagoto SL, Lemon SC. Racial/ethnic representation in lifestyle weight loss intervention studies in the United States: A systematic review. Prev Med Rep 2018; 9:131-137. [PMID: 29616185 PMCID: PMC5880332 DOI: 10.1016/j.pmedr.2018.01.012] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/21/2022] Open
Abstract
Obesity remains a persistent public health and health disparity concern in the United States. Eliminating health disparities, particularly among racial/ethnic minority groups, is a major health priority in the US. The primary aim of this review was to evaluate representation of racial/ethnic sub-group members in behavioral weight loss interventions conducted among adults in the United States. The secondary aims were to assess recruitment and study design approaches to include racial/ethnic groups and the extent of racial/ethnic sub-group analyses conducted in these studies. PubMed, PsycInfo, Medline, and CINAHL were searched for behavioral weight loss intervention trials conducted in 2009–2015 using keywords: weight, loss, overweight, obese, intervention and trial. Most of the 94 studies included a majority of White participants compared to any other racial/ethnic group. Across the included studies, 58.9% of participants were White, 18.2% were African American, 8.7% were Hispanic/Latino, 5.0% were Asian and 1.0% were Native Americans. An additional 8.2% were categorized as “Other”. Nine of the 94 studies exclusively included minority samples. Lack of adequate representation of racial and ethnic minority populations in behavioral trials limits the generalizability and potential public health impact of these interventions to groups that might most benefit from weight loss. Given racial/ethnic disparities in obesity rates and the burden of obesity and obesity-related diseases among minority groups in the United States, greater inclusion in weight loss intervention studies is warranted. Describes racial/ethnic minority inclusion in behavioral weight loss studies Majority of studies continue to include a majority white sample. Modest increases in the representation of some racial/ethnic minority groups. Lack of adequate representation of minority groups limits generalizability. Greater racial/ethnic inclusion in weight loss intervention studies is warranted.
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Affiliation(s)
| | | | - Monica L. Wang
- Boston University School of Public Health, Boston, MA, USA
| | | | | | | | | | - Sherry L. Pagoto
- University of Massachusetts Medical School, Worcester, MA, USA
- University of Connecticut, Storrs, CT, USA
| | - Stephenie C. Lemon
- University of Massachusetts Medical School, Worcester, MA, USA
- Corresponding author at: UMass Worcester Prevention Research Center, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA.UMass Worcester Prevention Research CenterDivision of Preventive and Behavioral MedicineUniversity of Massachusetts Medical School55 Lake Avenue NorthWorcesterMA01655USA
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Arigo D, Pagoto S, Carter-Harris L, Lillie SE, Nebeker C. Using social media for health research: Methodological and ethical considerations for recruitment and intervention delivery. Digit Health 2018; 4:2055207618771757. [PMID: 29942634 PMCID: PMC6016568 DOI: 10.1177/2055207618771757] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 03/21/2018] [Indexed: 12/21/2022] Open
Abstract
As the popularity and diversity of social media platforms increases so does their utility for health research. Using social media for recruitment into clinical studies and/or delivering health behavior interventions may increase reach to a broader audience. However, evidence supporting the efficacy of these approaches is limited, and key questions remain with respect to optimal benchmarks, intervention development and methodology, participant engagement, informed consent, privacy, and data management. Little methodological guidance is available to researchers interested in using social media for health research. In this Tutorial, we summarize the content of the 2017 Society for Behavioral Medicine Pre-Conference Course entitled 'Using Social Media for Research,' at which the authors presented their experiences with methodological and ethical issues relating to social media-enabled research recruitment and intervention delivery. We identify common pitfalls and provide recommendations for recruitment and intervention via social media. We also discuss the ethical and responsible conduct of research using social media for each of these purposes.
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Affiliation(s)
- Danielle Arigo
- The University of Scranton, USA
- Center for Integrated Healthcare, Syracuse VA Medical Center, USA
| | | | - Lisa Carter-Harris
- Indiana University School of Nursing, USA
- Indiana University Simon Cancer Center, USA
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Wang ML, Waring ME, Jake-Schoffman DE, Oleski JL, Michaels Z, Goetz JM, Lemon SC, Ma Y, Pagoto SL. Clinic Versus Online Social Network-Delivered Lifestyle Interventions: Protocol for the Get Social Noninferiority Randomized Controlled Trial. JMIR Res Protoc 2017; 6:e243. [PMID: 29229591 PMCID: PMC5742659 DOI: 10.2196/resprot.8068] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 09/22/2017] [Accepted: 09/23/2017] [Indexed: 11/25/2022] Open
Abstract
Background Online social networks may be a promising modality to deliver lifestyle interventions by reducing cost and burden. Although online social networks have been integrated as one component of multimodality lifestyle interventions, no randomized trials to date have compared a lifestyle intervention delivered entirely via online social network with a traditional clinic-delivered intervention. Objective This paper describes the design and methods of a noninferiority randomized controlled trial, testing (1) whether a lifestyle intervention delivered entirely through an online social network would produce weight loss that would not be appreciably worse than that induced by a traditional clinic-based lifestyle intervention among overweight and obese adults and (2) whether the former would do so at a lower cost. Methods Adults with body mass index (BMI) between 27 and 45 kg/m2 (N=328) will be recruited from the communities in central Massachusetts. These overweight or obese adults will be randomized to two conditions: a lifestyle intervention delivered entirely via the online social network Twitter (Get Social condition) and an in-person group-based lifestyle intervention (Traditional condition) among overweight and obese adults. Measures will be obtained at baseline, 6 months, and 12 months after randomization. The primary noninferiority outcome is percentage weight loss at 12 months. Secondary noninferiority outcomes include dietary intake and moderate intensity physical activity at 12 months. Our secondary aim is to compare the conditions on cost. Exploratory outcomes include treatment retention, acceptability, and burden. Finally, we will explore predictors of weight loss in the online social network condition. Results The final wave of data collection is expected to conclude in June 2019. Data analysis will take place in the months following and is expected to be complete in September 2019. Conclusions Findings will extend the literature by revealing whether delivering a lifestyle intervention via an online social network is an effective alternative to the traditional modality of clinic visits, given the former might be more scalable and feasible to implement in settings that cannot support clinic-based models. Trial Registration ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 (Archived by WebCite at http://www.webcitation.org/6v20waTFW)
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Affiliation(s)
- Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, United States
| | - Molly E Waring
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Danielle E Jake-Schoffman
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jessica L Oleski
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Zachary Michaels
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Jared M Goetz
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
| | - Stephenie C Lemon
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Yunsheng Ma
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, United States
| | - Sherry L Pagoto
- Department of Allied Health Sciences, College of Agriculture, Health, and Natural Resources, University of Connecticut, Storrs, CT, United States
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He C, Wu S, Zhao Y, Li Z, Zhang Y, Le J, Wang L, Wan S, Li C, Li Y, Sun X. Social Media-Promoted Weight Loss Among an Occupational Population: Cohort Study Using a WeChat Mobile Phone App-Based Campaign. J Med Internet Res 2017; 19:e357. [PMID: 29061555 PMCID: PMC5673881 DOI: 10.2196/jmir.7861] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Revised: 07/15/2017] [Accepted: 08/27/2017] [Indexed: 12/22/2022] Open
Abstract
Background Being overweight and obese are major risk factors for noncommunicable diseases such as cardiovascular diseases. The prevalence of overweight and obesity is high throughout the world and these issues are very serious in the Shunyi District in China. As mobile technologies have rapidly developed, mobile apps such as WeChat are well accepted and have the potential to improve health behaviors. Objective This study aims to evaluate the effectiveness of a mobile app (WeChat) as an intervention on weight loss behavior. Methods This study was conducted among an occupational population from August 2015 to February 2016 in the Shunyi District of Beijing. Before the intervention, the Shunyi District Government released an official document for weight loss to all 134 government agencies and enterprises in Shunyi District. Participants willing to use our official WeChat account were enrolled in a WeChat group and received 6 months of interventions for weight loss; those who were not willing to use the account were in a control group given routine publicity on weight loss. Results In total, 15,310 occupational participants including 3467 participants (22.65%) in the control group and 11,843 participants (77.35%) in the WeChat group were enrolled. Participants in the WeChat group lost more weight (mean 2.09, SD 3.43 kg) than people in the control group (mean 1.78, SD 2.96 kg), and the difference in mean weight loss between the two groups for males was significant based on the stratification of age and educational level. To control for confounding factors and to explore the effects of WeChat on weight loss, the propensity score method with a multinominal logistic regression was utilized. For males, this showed that the WeChat group (with both active and inactive subgroups) had a higher probability of maintaining weight, weight loss from 1 to 2 kg, or weight loss more than 2 kg than the control group. However, the control group had higher probability of weight loss from 0 to 1 kg. Being active in WeChat was likely to be associated with weight loss. The more active participants were in the weight loss program via WeChat, the more weight they lost. Conclusions The weight loss intervention campaign based on an official WeChat account focused on an occupation-based population in Shunyi District was effective for males. The more active male participants were in using WeChat, the more weight they lost. There might be no effect or there may even be a negative effect on weight loss for females. Future research should focus on how to improve adherence to the WeChat weight loss interventions, to improve and refine the WeChat content such as developing a variety of materials to attract interest, and to protect personal privacy, especially for females.
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Affiliation(s)
- Chao He
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Shiyan Wu
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yingying Zhao
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Zheng Li
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Yanyan Zhang
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Jia Le
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Lei Wang
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Siyang Wan
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Changqing Li
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Yindong Li
- Department of Health Education, Shunyi Center for Disease Prevention and Control, Beijing, China
| | - Xinying Sun
- Department of Social Medicine and Health Education, School of Public Health, Peking University Health Science Center, Beijing, China
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Weight loss support seeking on twitter: the impact of weight on follow back rates and interactions. Transl Behav Med 2017; 7:84-91. [PMID: 27443643 DOI: 10.1007/s13142-016-0429-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
People seek weight loss support on online social networks, but little is known about how to build a supportive community. We created four Twitter accounts portraying women interested in weight loss (two obese, two normal weight/overweight) and followed health care professional and peer accounts for 2-5 weeks. We examined follow back rates, interactions, and organic follows from professionals and peers by weight status. Follow back rates did not differ by weight status when following professionals (6.8 % normal weight/overweight vs 11.0 % for obese; p = 0.4167) or peers (6.7 % for normal weight/overweight vs 10.8 % for obese; p = 0.1548). Number of interactions and organic followers also did not differ by weight status. Peers interacted with study accounts significantly more than professionals (p = 0.0138), but interactions were infrequent. Women seeking weight loss support on Twitter may need to be present for more than 5 weeks to build an interactive weight loss community.
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Waring ME, Schneider KL, Appelhans BM, Simas TAM, Xiao RS, Whited MC, Busch AM, Evans MM, Pagoto SL. Interest in a Twitter-delivered weight loss program among women of childbearing age. Transl Behav Med 2017; 6:277-84. [PMID: 27356998 DOI: 10.1007/s13142-015-0382-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Weight management through the childbearing years is important, yet few women have access to efficacious weight loss programs. Online social network-delivered programs may increase reach and thus impact. The aim of this study was to gauge interest in a Twitter-based weight loss intervention among women of childbearing age and the feasibility of recruitment via Twitter. We recruited English-speaking women aged 18-45 years (N = 63) from Twitter to complete an anonymous online survey including open-ended questions about program advantages and concerns. Forty percent of participants were obese and 83 % were trying to lose weight. Eighty-one percent were interested in a Twitter-delivered weight loss program. Interest was high in all subgroups (62-100 %). Participants (59 %) cited program advantages, including convenience, support/accountability, and privacy. Concerns (59 %) included questions about privacy, support/accountability, engagement, efficacy, and technology barriers. Research is needed to develop and evaluate social media-delivered interventions, and to develop methods for recruiting participants directly from Twitter.
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Affiliation(s)
- Molly E Waring
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, AS8-1077, Worcester, MA, 01605, USA. .,Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Kristin L Schneider
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL, USA
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Tiffany A Moore Simas
- Department of Obstetrics & Gynecology, University of Massachusetts Medical School, Worcester, MA, USA.,Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA
| | - Rui S Xiao
- Division of Epidemiology of Chronic Diseases and Vulnerable Populations, Department of Quantitative Health Sciences, University of Massachusetts Medical School, 368 Plantation Street, AS8-1077, Worcester, MA, 01605, USA
| | - Matthew C Whited
- Department of Psychology, East Carolina University, Greenville, NC, USA
| | - Andrew M Busch
- Department of Psychiatry & Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Martinus M Evans
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Sherry L Pagoto
- Division of Behavioral and Preventive Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
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Joiner KL, Nam S, Whittemore R. Lifestyle interventions based on the diabetes prevention program delivered via eHealth: A systematic review and meta-analysis. Prev Med 2017; 100:194-207. [PMID: 28456513 PMCID: PMC5699208 DOI: 10.1016/j.ypmed.2017.04.033] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/26/2017] [Accepted: 04/23/2017] [Indexed: 01/05/2023]
Abstract
The objective was to describe Diabetes Prevention Program (DPP)-based lifestyle interventions delivered via electronic, mobile, and certain types of telehealth (eHealth) and estimate the magnitude of the effect on weight loss. A systematic review was conducted. PubMed and EMBASE were searched for studies published between January 2003 and February 2016 that met inclusion and exclusion criteria. An overall estimate of the effect on mean percentage weight loss across all the interventions was initially conducted. A stratified meta-analysis was also conducted to determine estimates of the effect across the interventions classified according to whether behavioral support by counselors post-baseline was not provided, provided remotely with communication technology, or face-to-face. Twenty-two studies met the inclusion/exclusion criteria, in which 26 interventions were evaluated. Samples were primarily white and college educated. Interventions included Web-based applications, mobile phone applications, text messages, DVDs, interactive voice response telephone calls, telehealth video conferencing, and video on-demand programing. Nine interventions were stand-alone, delivered post-baseline exclusively via eHealth. Seventeen interventions included additional behavioral support provided by counselors post-baseline remotely with communication technology or face-to-face. The estimated overall effect on mean percentage weight loss from baseline to up to 15months of follow-up across all the interventions was -3.98%. The subtotal estimate across the stand-alone eHealth interventions (-3.34%) was less than the estimate across interventions with behavioral support given by a counselor remotely (-4.31%), and the estimate across interventions with behavioral support given by a counselor in-person (-4.65%). There is promising evidence of the efficacy of DPP-based eHealth interventions on weight loss. Further studies are needed particularly in racially and ethnically diverse populations with limited levels of educational attainment. Future research should also focus on ways to optimize behavioral support.
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Affiliation(s)
- Kevin L Joiner
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States.
| | - Soohyun Nam
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States.
| | - Robin Whittemore
- Yale University, School of Nursing, 400 West Campus Drive, Orange, CT 06477, United States.
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Napolitano MA, Whiteley JA, Mavredes MN, Faro J, DiPietro L, Hayman LL, Neighbors CJ, Simmens S. Using social media to deliver weight loss programming to young adults: Design and rationale for the Healthy Body Healthy U (HBHU) trial. Contemp Clin Trials 2017; 60:1-13. [PMID: 28611007 DOI: 10.1016/j.cct.2017.06.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 05/18/2017] [Accepted: 06/09/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND The transitional period from late adolescence to early adulthood is a vulnerable period for weight gain, with a twofold increase in overweight/obesity during this life transition. In the United States, approximately one-third of young adults have obesity and are at a high risk for weight gain. PURPOSE To describe the design and rationale of a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) sponsored randomized, controlled clinical trial, the Healthy Body Healthy U (HBHU) study, which compares the differential efficacy of three interventions on weight loss among young adults aged 18-35years. METHODS The intervention is delivered via Facebook and SMS Text Messaging (text messaging) and includes: 1) targeted content (Targeted); 2) tailored or personalized feedback (Tailored); or 3) contact control (Control). Recruitment is on-going at two campus sites, with the intervention delivery conducted by the parent site. A total of 450 students will be randomly-assigned to receive one of three programs for 18months. We hypothesize that: a) the Tailored group will lose significantly more weight at the 6, 12, 18month follow-ups compared with the Targeted group; and that b) both the Tailored and Targeted groups will have greater weight loss at the 6, 12, 18month follow-ups than the Control group. We also hypothesize that participants who achieve a 5% weight loss at 6 and 18months will have greater improvements in their cardiometabolic risk factors than those who do not achieve this target. We will examine intervention costs to inform implementation and sustainability other universities. Expected study completion date is 2019. CONCLUSIONS This project has significant public health impact, as the successful translation could reach as many as 20 million university students each year, and change the current standard of practice for promoting weight management within university campus communities. ClinicalTrial.gov: NCT02342912.
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Affiliation(s)
- Melissa A Napolitano
- Department of Prevention and Community Health, The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave NW, Suite 300, Washington, DC 20052, USA; Department of Exercise and Nutrition Sciences, The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave NW, Suite 200, Washington, DC 20052, USA.
| | - Jessica A Whiteley
- College of Nursing and Health Sciences, University of Massachusetts Boston, Exercise and Health Sciences Program, 100 Morrissey Blvd, Science Center, 2(nd) Floor, Boston, MA 02125-3393, USA.
| | - Meghan N Mavredes
- Department of Prevention and Community Health, The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave NW, Suite 300, Washington, DC 20052, USA.
| | - Jamie Faro
- College of Nursing and Health Sciences, University of Massachusetts Boston, Exercise and Health Sciences Program, 100 Morrissey Blvd, Science Center, 2(nd) Floor, Boston, MA 02125-3393, USA.
| | - Loretta DiPietro
- Department of Exercise and Nutrition Sciences, The George Washington University, Milken Institute School of Public Health, 950 New Hampshire Ave NW, Suite 200, Washington, DC 20052, USA.
| | - Laura L Hayman
- University of Massachusetts Boston, Department of Nursing, 100 Morrissey Blvd, Quinn Administration-01-01, Boston, MA 02125-3393, USA.
| | - Charles J Neighbors
- Columbia University, The National Center on Addiction and Substance Abuse, Health Services Research, 633 Third Avenue, 19th Floor, New York, NY 10017, USA.
| | - Samuel Simmens
- The George Washington University, Milken Institute School of Public Health, Department of Epidemiology and Biostatistics, Science & Engineering Hall, 800 22nd St NW, Floor 7, Washington, DC 20052, USA.
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Willis EA, Szabo‐Reed AN, Ptomey LT, Steger FL, Honas JJ, Al‐Hihi EM, Lee R, Lee J, Oh Y, Washburn RA, Donnelly JE. Distance learning strategies for weight management utilizing online social networks versus group phone conference call. Obes Sci Pract 2017; 3:134-142. [PMID: 28713582 PMCID: PMC5478801 DOI: 10.1002/osp4.96] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/12/2016] [Accepted: 11/28/2016] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE The increase in technology and online social networks (OSNs) may present healthcare providers with an innovative modality for delivering weight management programmes that could have an impact on health care at the population level. The objective of this study was to evaluate the feasibility and efficacy of using an OSN to deliver a weight loss programme to inform future, large-scale trials. METHODS Seventy individuals (age = 47 ± 12.4, minority = 24.3%) with obesity (BMI = 36.2 ± 4.0) completed a 6-month weight loss intervention and were randomized to either a conference call or OSN delivery group. Weight loss was achieved by reducing energy intake by 500-700 kcal·d-1 below estimated total daily energy expenditure and progressing physical activity to 300 min/week. Behavioural weight loss strategies were delivered weekly throughout the intervention. RESULTS Conference call and OSN groups produced clinically meaningful weight loss of ≥5% from baseline to 6 months (phone = -6.3 ± 6.4%, OSN = -5.8 ± 6.7%). There was no significant difference in weight change between groups (p = 0.765). CONCLUSION The phone and OSN groups met the American Heart Association/American College of Cardiology/The Obesity Society's Guidelines by reducing baseline weight by 5-10% within 6 months. OSNs appear to be a viable delivery platform for weight loss interventions; however, larger scale adequately powered trials are needed.
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Affiliation(s)
- Erik A. Willis
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Amanda N. Szabo‐Reed
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Lauren T. Ptomey
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Felicia L. Steger
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Jeffery J. Honas
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Eyad M. Al‐Hihi
- General and Geriatric Medicine, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Robert Lee
- Department of Health Policy and ManagementUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Jaehoon Lee
- Institute for Measurement, Methodology, Analysis, and PolicyTexas Tech UniversityLubbockTXUSA
| | - Youngha Oh
- Institute for Measurement, Methodology, Analysis, and PolicyTexas Tech UniversityLubbockTXUSA
| | - Richard A. Washburn
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
- General and Geriatric Medicine, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
| | - Joseph E. Donnelly
- Cardiovascular Research Institute, Department of Internal MedicineUniversity of Kansas Medical CenterKansas CityKSUSA
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Integrating Personalized Technology in Toxicology: Sensors, Smart Glass, and Social Media Applications in Toxicology Research. J Med Toxicol 2017; 13:166-172. [PMID: 28405896 DOI: 10.1007/s13181-017-0611-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/07/2017] [Accepted: 03/15/2017] [Indexed: 02/04/2023] Open
Abstract
Rapid proliferation of mobile technologies in social and healthcare spaces create an opportunity for advancement in research and clinical practice. The application of mobile, personalized technology in healthcare, referred to as mHealth, has not yet become routine in toxicology. However, key features of our practice environment, such as frequent need for remote evaluation, unreliable historical data from patients, and sensitive subject matter, make mHealth tools appealing solutions in comparison to traditional methods that collect retrospective or indirect data. This manuscript describes the features, uses, and costs associated with several of common sectors of mHealth research including wearable biosensors, ingestible biosensors, head-mounted devices, and social media applications. The benefits and novel challenges associated with the study and use of these applications are then discussed. Finally, opportunities for further research and integration are explored with a particular focus on toxicology-based applications.
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36
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Willis EA, Szabo-Reed AN, Ptomey LT, Steger FL, Honas JJ, Washburn RA, Donnelly JE. Do weight management interventions delivered by online social networks effectively improve body weight, body composition, and chronic disease risk factors? A systematic review. J Telemed Telecare 2017; 23:263-272. [PMID: 26880695 PMCID: PMC4985486 DOI: 10.1177/1357633x16630846] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990-November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.
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Affiliation(s)
- Erik A Willis
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Amanda N Szabo-Reed
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Lauren T Ptomey
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Felicia L Steger
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Jeffery J Honas
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Richard A Washburn
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
| | - Joseph E Donnelly
- Cardiovascular Research Institute, Division of Internal Medicine, Kansas City, USA
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37
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Pagoto S, Waring ME, May CN, Ding EY, Kunz WH, Hayes R, Oleski JL. Adapting Behavioral Interventions for Social Media Delivery. J Med Internet Res 2016; 18:e24. [PMID: 26825969 PMCID: PMC4752690 DOI: 10.2196/jmir.5086] [Citation(s) in RCA: 76] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/14/2015] [Accepted: 11/09/2015] [Indexed: 12/29/2022] Open
Abstract
Patients are increasingly using online social networks (ie, social media) to connect with other patients and health care professionals--a trend called peer-to-peer health care. Because online social networks provide a means for health care professionals to communicate with patients, and for patients to communicate with each other, an opportunity exists to use social media as a modality to deliver behavioral interventions. Social media-delivered behavioral interventions have the potential to reduce the expense of behavioral interventions by eliminating visits, as well as increase our access to patients by becoming embedded in their social media feeds. Trials of online social network-delivered behavioral interventions have shown promise, but much is unknown about intervention development and methodology. In this paper, we discuss the process by which investigators can translate behavioral interventions for social media delivery. We present a model that describes the steps and decision points in this process, including the necessary training and reporting requirements. We also discuss issues pertinent to social media-delivered interventions, including cost, scalability, and privacy. Finally, we identify areas of research that are needed to optimize this emerging behavioral intervention modality.
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Affiliation(s)
- Sherry Pagoto
- Department of Medicine, Division of Preventive and Behavioral Medicine, University of Massachusetts Medical School, Worcester, MA, United States.
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