A micro-randomized trial of JITAI messaging to improve adherence to multiple weight loss behaviors in young adults

JITAI 消息传递的微随机试验可提高年轻人对多种减肥行为的依从性

基本信息

批准号：
10545279
负责人：
CARMINA G VALLE
金额：
$ 73.31万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-01-15 至 2025-12-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10545279
关键词：
Accelerometer Achievement Address Adherence Adult Age Behavior Behavior Therapy Behavioral Body Weight Changes Body Weight decreased Body mass index Calories Characteristics Collection Diet Eating Electronic Mail Engineering Experimental Designs Feedback Food Future Gender Goals Individual Internet Intervention Location Monitor Morbidity - disease rate Nature Obesity Outcome Overweight Participant Patient Self-Report Persons Population Randomized Recording of previous events Schedule Self Assessment Structure Techniques Testing Text Messaging Time Update Weight Weight Gain adaptive intervention behavior change clinically significant contextual factors cost digital digital health digital intervention efficacious intervention evidence base health data high risk improved meetings mobile application mortality multiphase optimization strategy obesity treatment pilot trial programs public health intervention randomized trial success tailored messaging tool trial design web-based intervention weight loss intervention wireless young adult

项目摘要

PROJECT ABSTRACT An estimated 1 in 2 US adults will have obesity by 2030, which is a major cause of morbidity and mortality. The highest risk of weight gain is among young adults ages 18-35 years. In-person behavioral interventions generally produce clinically significant weight losses, but cost and reduced reach limit their ability to impact obesity at a population level. Web-based interventions that mimic the structure of weekly face-to-face treatment have proven a viable alternative, though weight losses are generally smaller than in-person treatment. Mobile treatments have the potential for high reach, but have been less effective, producing 1-3 kgs over 6 months. Newer digital intervention approaches called “just-in-time adaptive interventions” (JITAIs) promise to improve upon mobile outcomes by offering adaptive, personalized feedback on behavior, which consists of providing the “right type of support” at “the right time” rather than on a fixed schedule. This “just-in- time,” or JIT, approach is made possible by the emergence of low-cost and widely available digital health tools that allow for the collection of continually updated health data. However, to date, no JITAIs have successfully targeted multiple weight-related behaviors (weighing, activity, and diet), and there has been no systematic examination of what types of messaging interventions best promote adherence to these three weight loss behaviors, for whom they are effective, and under what conditions. To address this problem, we will use a micro-randomized trial to evaluate the effects of 7 types of intervention messages targeting specific behavior change techniques (i.e., BCT messages) delivered in JIT moments on daily achievement of behavioral goals among n=201 young adults with overweight and obesity. All participants will receive a 6-month behavioral weight loss intervention using our Nudge mobile app, which includes evidence-based weekly lessons, tailored feedback, self-monitoring, and daily BCT messages. Participants will receive a wireless scale, activity tracker, and track “red” foods (high-calorie foods) in the app and have 3 goals: weigh daily, a daily active minutes goal that gradually increases if met, and a daily red foods limit. At 3 decision points per day, participants will be micro-randomized to receive or not receive 1 of 7 types of BCT messages. Each intervention message has unique decision rules for availability. Candidate intervention message options have been carefully selected from empirical evidence, tested in our prior studies, or are from our pilot micro-randomized trial. Assessments will occur daily, and at 0, 3 and 6 months, to accomplish the following specific aims: 1) Evaluate the effects of each behavior change technique message (i.e., BCT message) on daily adherence to weight loss behaviors; 2) Determine whether the effects of BCT messages on proximal outcomes change over time; and 3) Assess whether the effects of BCT messages on proximal outcomes are moderated by participants’ contextual factors. Findings will guide how adaptive, behaviorally- and contextually-dependent messages are incorporated into future JITAIs for weight loss.

项目摘要据估计，到 2030 年，二分之一的美国成年人将患有肥胖症，这是发病和死亡的主要原因。体重增加的风险最高的是 18-35 岁的年轻人。通常会产生临床上显着的体重减轻，但成本和减少的范围限制了它们影响的能力基于网络的干预措施模仿每周面对面的结构。治疗已被证明是一种可行的替代方案，尽管体重减轻通常小于面对面治疗移动处理具有高覆盖范围的潜力，但效果较差，产生 1-3 公斤。超过 6 个月的新数字干预方法称为“及时适应性干预”(JITAI)。承诺通过提供自适应、个性化的行为反馈来改善移动结果，包括在“正确的时间”而不是按固定的时间表提供“正确类型的支持”。低成本且广泛使用的数字健康工具的出现使得“准时”（JIT）方法成为可能允许收集不断更新的健康数据。但是，迄今为止，还没有 JITAI 成功。针对多种与体重相关的行为（称重、活动和饮食），但目前还没有系统的研究检查哪些类型的信息干预措施最能促进坚持这三种减肥行为、它们对谁有效以及在什么条件下有效。为了解决这个问题，我们将使用一个方法。微随机试验评估针对特定行为的 7 种干预信息的效果改变在 JIT 时刻交付的关于每日行为目标实现的技术（即 BCT 消息）在 n=201 名超重和肥胖的年轻人中，所有参与者都将接受为期 6 个月的行为测试。使用我们的 Nudge 移动应用程序进行减肥干预，其中包括基于证据的每周课程，量身定制反馈、自我监控和每日 BCT 消息。参与者将收到无线秤、活动跟踪器、并在应用程序中跟踪“红色”食物（高热量食物）并设定 3 个目标：每日称重、每日活跃分钟数目标如果满足，则逐渐增加，并且每日红色食品限制每天 3 点，参与者将被限制。微随机化接收或不接收 7 种 BCT 消息中的一种。每条干预消息都有。候选人干预消息选项的独特决策规则经过精心挑选。来自我们之前研究中测试的经验证据，或者来自我们的试点微观随机试验评估。将每天进行，并在第 0、3 和 6 个月进行，以实现以下具体目标： 1) 评估关于每日坚持减肥行为的每项行为改变技术信息（即 BCT 信息）；确定 BCT 消息对近期结果的影响是否随时间变化；3) 评估； BCT 信息对近期结果的影响是否受到参与者的背景因素的调节。研究结果将指导如何将适应性、行为和情境相关的信息纳入到未来的 JITAI 减肥。