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Huntriss R, Salimgaraev R, Nikogosov D, Powell J, Varady KA. The effectiveness of mobile app usage in facilitating weight loss: An observational study. Obes Sci Pract 2024; 10:e757. [PMID: 38745944 PMCID: PMC11091450 DOI: 10.1002/osp4.757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 03/26/2024] [Accepted: 04/12/2024] [Indexed: 05/16/2024] Open
Abstract
Aim With increasing rates of global obesity and associated health issues, there is an ever-increasing need for weight management solutions to be more accessible. Mobile applications offer accessible support systems and have the potential to offer a viable and effective weight management solution as an alternative to traditional healthcare models. Objective To evaluate the effectiveness of the SIMPLE mobile application for time-restricted eating in achieving weight loss (WL). Methods User data were analyzed between January 2021 and January 2023. In-app activity was calculated as the proportion of active days over 12, 26 and 52 weeks. A day is considered active if it contains at least one in-app action (e.g., logging weight, food, fasting, or physical activity). Users were categorized into four in-app activity levels: inactive (in-app activity <33%), medium activity (33%-66%), high activity (66%-99%), and maximal activity (100%). Weight change among in-app activity groups was assessed at 12, 26, and 52 weeks. Results Out of 53,482 users, a positive association was found between the use of the SIMPLE app and WL. Active app users lost more weight than their less active counterparts. Active users had a median WL of 4.20%, 5.04%, and 3.86% at 12, 26, and 52 weeks, respectively. A larger percentage of active users-up to 50.26%-achieved clinically significant WL (≥5%) when compared to inactive users. A dose-response relationship between WL and app usage was found after adjusting for gender, age, and initial Body Mass Index; a 10% increase in app activity correlated with increased WL by 0.43, 0.66 and 0.69 kg at 12, 26, and 52 weeks, respectively. Conclusions The study demonstrates that the SIMPLE app enables effective WL directly associated with the level of app engagement. Mobile health applications offer an accessible and effective weight management solution and should be considered when supporting adults to lose weight.
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Affiliation(s)
| | | | | | - John Powell
- Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordOxfordshireUK
| | - Krista A. Varady
- Department of Kinesiology and NutritionUniversity of IllinoisChicagoIllinoisUSA
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Liu H, Feng J, Shi Z, Su J, Sun J, Wu F, Zhu Z. Effects of a Novel Applet-Based Personalized Dietary Intervention on Dietary Intakes: A Randomized Controlled Trial in a Real-World Scenario. Nutrients 2024; 16:565. [PMID: 38398889 PMCID: PMC10892066 DOI: 10.3390/nu16040565] [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: 01/24/2024] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 02/25/2024] Open
Abstract
The objective of this study was to assess the feasibility and effectiveness of a novel WeChat applet-based personalized dietary intervention aimed at promoting healthier dietary intakes. A two-arm parallel, randomized, controlled trial was conducted in a real-world scenario and involved a total of 153 participants (the intervention group, n = 76; the control group, n = 77), lasting for 4 months in Shanghai, China. The intervention group had access to visualized nutrition evaluations through the applet during workday lunch time, while the control group received no interventions. A total of 3413 lunch dietary intake records were captured through the applet. Linear mixed models were utilized to assess the intervention effects over time. At baseline, the participants' lunchtime dietary intakes were characterized by insufficient consumption of plant foods (86.9% of the participants) and excessive intake of animal foods (79.7% of the participants). Following the commencement of the intervention, the intervention group showed a significant decrease in the animal/plant food ratio (β = -0.03/week, p = 0.024) and the consumption of livestock and poultry meat (β = -1.80 g/week, p = 0.035), as well as a borderline significant increase in the consumption of vegetables and fruits (β = 3.22 g/week, p = 0.055) and plant foods (β = 3.26 g/week, p = 0.057) over time at lunch compared to the control group. The applet-based personalized dietary intervention was feasible and effective in improving dietary intakes and, consequently, possibly may manage body weight issues in real-world scenarios.
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Affiliation(s)
- Hongwei Liu
- School of Public Health, Fudan University, Shanghai 200032, China; (H.L.); (J.F.)
| | - Jingyuan Feng
- School of Public Health, Fudan University, Shanghai 200032, China; (H.L.); (J.F.)
| | - Zehuan Shi
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; (Z.S.); (J.S.)
| | - Jin Su
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; (Z.S.); (J.S.)
| | - Jing Sun
- National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China;
| | - Fan Wu
- School of Public Health, Fudan University, Shanghai 200032, China; (H.L.); (J.F.)
| | - Zhenni Zhu
- Division of Health Risk Factors Monitoring and Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China; (Z.S.); (J.S.)
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Earl S, Burnette JL, Ho AS. Exploring the benefits and costs of a growth mindset in a digital app weight management program. J Health Psychol 2024:13591053241226610. [PMID: 38312005 DOI: 10.1177/13591053241226610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
We explored the potential benefits and costs of believing one can change their weight (i.e. growth mindset) in the context of a digital weight management program. We investigated mechanisms by which growth mindsets relate to weight loss achievement and body shame. Among participants seeking to lose weight (N = 1626; 74.7% female; 77.9% White; Mage = 45.7), stronger growth mindsets indirectly predicted greater weight loss achievement through positive offset expectations and subsequent increased program engagement. Additionally, stronger growth mindsets predicted less body shame through positive offset expectations but predicted more body shame through increased onset responsibility, replicating the double-edged sword model of growth mindsets. We conclude with applications that leverage growth mindsets for optimal behavior change while mitigating costs such as body shame.
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Sewpaul R, Resnicow K, Crutzen R, Dukhi N, Ellahebokus A, Reddy P. A Tailored mHealth Intervention for Improving Antenatal Care Seeking and Health Behavioral Determinants During Pregnancy Among Adolescent Girls and Young Women in South Africa: Development and Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e43654. [PMID: 37703092 PMCID: PMC10534293 DOI: 10.2196/43654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 06/30/2023] [Accepted: 07/17/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND South Africa, a middle-income country, has an adolescent fertility rate far higher than that of high-income countries. Adolescent girls and young women have an increased risk of pregnancy-related complications and lower antenatal appointment attendance rates than older adult pregnant women. Mobile health (mHealth) interventions to improve health behaviors among pregnant adolescent girls and young women in low- and middle-income countries are scarce. OBJECTIVE This paper describes the development and components of an mHealth intervention to improve antenatal appointment attendance and health behavioral determinants among pregnant adolescent girls and young women in South Africa and details the protocol for a pilot randomized controlled trial that evaluated the intervention's efficacy and user acceptability. METHODS The intervention, Teen MomConnect, sent tailored motivational behavior change and behavioral reinforcement SMS text messages to participants about antenatal appointment keeping and pregnancy behaviors. The delivery methodology of the intervention was adapted from MomConnect, an mHealth education program for pregnant women in South Africa that has nationwide coverage. In addition, participants received a face-to-face motivational interviewing session delivered by a trained research assistant. Pregnant adolescent girls and young women aged 13 to 20 years were recruited from health facilities and community networks. Participants were randomized into the control group that received the standard MomConnect health SMS text messages or the experimental group that received the Teen MomConnect intervention. Participants completed a baseline questionnaire upon enrollment in the study and a follow-up questionnaire after the end of their pregnancy. The questionnaires assessed demographic characteristics, pregnancy behaviors, and the psychosocial determinants of antenatal appointment attendance (knowledge, attitudes, social support, risk perceptions, self-efficacy, intention, and action planning). Feasibility was assessed using descriptive analyses of acceptability, study implementation processes, and perceived satisfaction with the intervention. The number of appointments attended was obtained from the participants' clinic records. Appointment attendance was compared between the control and experimental groups, as were awareness of HIV status and the psychosocial determinants of antenatal appointment attendance. RESULTS Participant recruitment was conducted from May 2018 to December 2018, and the questionnaire-based data collection was completed by December 2019. Overall, 412 participants were enrolled. CONCLUSIONS This paper describes the Teen MomConnect intervention to improve antenatal appointment attendance and pregnancy health behaviors among adolescent girls and young women. The results on the intervention's preliminary efficacy and user acceptability will inform policy makers and health program officers on how tailored, age-appropriate, and motivational health behavior messages can be delivered via mobile phone to pregnant adolescent girls and young women. TRIAL REGISTRATION Pan African Clinical Trial Registry (PACTR) PACTR201912734889796; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=9565. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/43654.
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Affiliation(s)
- Ronel Sewpaul
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
- Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Rik Crutzen
- Department of Health Promotion, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Natisha Dukhi
- Public Health, Societies and Belonging, Human Sciences Research Council, Pretoria, South Africa
| | | | - Priscilla Reddy
- College of Humanities, University of KwaZulu-Natal, Durban, South Africa
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Mitchell ES, Fabry A, Ho AS, May CN, Baldwin M, Blanco P, Smith K, Michaelides A, Shokoohi M, West M, Gotera K, El Massad O, Zhou A. The Impact of a Digital Weight Loss Intervention on Health Care Resource Utilization and Costs Compared Between Users and Nonusers With Overweight and Obesity: Retrospective Analysis Study. JMIR Mhealth Uhealth 2023; 11:e47473. [PMID: 37616049 PMCID: PMC10485704 DOI: 10.2196/47473] [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: 03/22/2023] [Revised: 05/15/2023] [Accepted: 07/12/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND The Noom Weight program is a smartphone-based weight management program that uses cognitive behavioral therapy techniques to motivate users to achieve weight loss through a comprehensive lifestyle intervention. OBJECTIVE This retrospective database analysis aimed to evaluate the impact of Noom Weight use on health care resource utilization (HRU) and health care costs among individuals with overweight and obesity. METHODS Electronic health record data, insurance claims data, and Noom Weight program data were used to conduct the analysis. The study included 43,047 Noom Weight users and 14,555 non-Noom Weight users aged between 18 and 80 years with a BMI of ≥25 kg/m² and residing in the United States. The index date was defined as the first day of a 3-month treatment window during which Noom Weight was used at least once per week on average. Inverse probability treatment weighting was used to balance sociodemographic covariates between the 2 cohorts. HRU and costs for inpatient visits, outpatient visits, telehealth visits, surgeries, and prescriptions were analyzed. RESULTS Within 12 months after the index date, Noom Weight users had less inpatient costs (mean difference [MD] -US $20.10, 95% CI -US $30.08 to -US $10.12), less outpatient costs (MD -US $124.33, 95% CI -US $159.76 to -US $88.89), less overall prescription costs (MD -US $313.82, 95% CI -US $565.42 to -US $62.21), and less overall health care costs (MD -US $450.39, 95% CI -US $706.28 to -US $194.50) per user than non-Noom Weight users. In terms of HRU, Noom Weight users had fewer inpatient visits (MD -0.03, 95% CI -0.04 to -0.03), fewer outpatient visits (MD -0.78, 95% CI -0.93 to -0.62), fewer surgeries (MD -0.01, 95% CI -0.01 to 0.00), and fewer prescriptions (MD -1.39, 95% CI -1.76 to -1.03) per user than non-Noom Weight users. Among a subset of individuals with 24-month follow-up data, Noom Weight users incurred lower overall prescription costs (MD -US $1139.52, 95% CI -US $1972.21 to -US $306.83) and lower overall health care costs (MD -US $1219.06, 95% CI -US $2061.56 to -US $376.55) per user than non-Noom Weight users. The key differences were associated with reduced prescription use. CONCLUSIONS Noom Weight use is associated with lower HRU and costs than non-Noom Weight use, with potential cost savings of up to US $1219.06 per user at 24 months after the index date. These findings suggest that Noom Weight could be a cost-effective weight management program for individuals with overweight and obesity. This study provides valuable evidence for health care providers and payers in evaluating the potential benefits of digital weight loss interventions such as Noom Weight.
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Affiliation(s)
| | - Alexander Fabry
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Annabell Suh Ho
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Christine N May
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Matthew Baldwin
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Paige Blanco
- Academic Research, Noom, Inc, New York City, NY, United States
| | - Kyle Smith
- Academic Research, Noom, Inc, New York City, NY, United States
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Bielsky AR, Foley CB. Nutritional Wellness for the Busy Health Care Provider: Small Everyday Wins. Anesthesiol Clin 2022; 40:349-357. [PMID: 35659406 DOI: 10.1016/j.anclin.2022.01.008] [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] [Indexed: 06/15/2023]
Abstract
When describing health care provider wellness, diet and nutrition are typically not addressed. This, in combination with the lack of decent food and diet resources typically available to the typically busy health care provider, exposes a significant gap in the road to advancing clinician wellness. This article aims to describe the relationship between nutrition and well-being, and potential barriers to optimal nutrition encountered by health care providers in the workplace. Readily available and practical strategies to improve physician diet and nutrition include: mindful eating practices, home meal preparation, food journaling, and mobile applications. From an organizational level, once physicians are making more informed food choices it is the hospital's responsibility to make nutritional options available in the workplace.
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Affiliation(s)
- Alan Robert Bielsky
- University of Colorado School of Medicine, Children's Hospital Colorado, Anesthesia Box 090, 13123 East 16th Avenue, Aurora, CO 80045, USA.
| | - Carolyn Berger Foley
- Department of Anesthesiology, University of Colorado School of Medicine, Anesthesia Box 090, Children's Hospital Colorado, Aurora, CO 80045, USA
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Lim SL, Ong KW, Johal J, Han CY, Yap QV, Chan YH, Zhang ZP, Chandra CC, Thiagarajah AG, Khoo CM. A Smartphone App-Based Lifestyle Change Program for Prediabetes (D'LITE Study) in a Multiethnic Asian Population: A Randomized Controlled Trial. Front Nutr 2022; 8:780567. [PMID: 35141265 PMCID: PMC8819073 DOI: 10.3389/fnut.2021.780567] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 12/29/2021] [Indexed: 12/20/2022] Open
Abstract
Introduction Landmark studies have established that lifestyle interventions focused on weight loss, diet modification and physical activity can prevent diabetes progression. However, the effectiveness of mobile health application among Asians with prediabetes remains largely unexamined. We aimed to assess whether a smartphone app-based lifestyle intervention program would lead to weight loss, normoglycemia and improved metabolic indices in a multiethnic Asian population with prediabetes. Research Design and Methods This multicentre prediabetes RCT is part of the Diabetes Lifestyle Intervention using Technology Empowerment (D'LITE) trial. Adults (n = 148) with prediabetes and BMI ≥ 23 kg/m2 were randomly allocated either to the intervention group (n = 72) empowered by self-monitoring features of the Nutritionist Buddy Diabetes app with in-app dietitian coaching for 6 months, or the control group (n = 76) receiving standard diet counseling at baseline. Primary outcome was defined as change in body weight at 6 months, while secondary outcomes included glycemic control and other metabolic indices analyzed using Generalized Linear Mixed Model analysis with intention-to-treat approach. Results Intervention group achieved a significantly greater weight loss of 4.2 vs. 1.3 kg [mean difference of −3.1 kg (95% CI −4.5 to −1.7), p < 0.001], and a 4.3-fold increased likelihood of achieving ≥ 5% weight loss, as compared to the control group at 6 months. The likelihood of achieving normoglycemia (defined as HbA1c < 5.7%) was 2.1 times higher in intervention group than in the control group (p < 0.018). Changes to blood pressure, total and LDL cholesterol were not statistically significant. Conclusion An app-based lifestyle program led to clinically significant weight loss and improved glycemia, and can potentially augment current standard care in the prevention of diabetes among an Asian multiethnic population. Clinical Trial Registration anzctr.org.au, identifier: ACTRN12617001112358.
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Affiliation(s)
- Su Lin Lim
- Department of Dietetics, National University Hospital, Singapore, Singapore
- *Correspondence: Su Lin Lim
| | - Kai Wen Ong
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Jolyn Johal
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Chad Yixian Han
- Department of Dietetics, National University Hospital, Singapore, Singapore
| | - Qai Ven Yap
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Yiong Huak Chan
- Biostatistics Unit, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore
| | - Zhi Peng Zhang
- Department of Family Medicine, National University Polyclinics, Singapore, Singapore
| | | | | | - Chin Meng Khoo
- Division of Endocrinology, National University Hospital, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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