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Using mHealth technology to enhance self-monitoring for weight loss: A randomized trial

Burke, LE and Styn, MA and Sereika, SM and Conroy, MB and Ye, L and Glanz, K and Sevick, MA and Ewing, LJ (2012) Using mHealth technology to enhance self-monitoring for weight loss: A randomized trial. American Journal of Preventive Medicine, 43 (1). 20 - 26. ISSN 0749-3797

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Background: Self-monitoring for weight loss has traditionally been performed with paper diaries. Technologic advances could reduce the burden of self-monitoring and provide feedback to enhance adherence. Purpose: To determine if self-monitoring diet using a PDA only or the PDA with daily tailored feedback (PDA+feedback [FB]), was superior to using a paper diary on weight loss and maintenance. Design: The Self-Monitoring and Recording Using Technology (SMART) Trial was a 24-month randomized clinical trial; participants were randomly assigned to one of three self-monitoring groups. Setting/participants: From 2006 to 2008, a total of 210 overweight/obese adults (84.8% female, 78.1% white) were recruited from the community. Data were analyzed in 2011. Intervention: Participants received standard behavioral treatment for weight loss that included dietary and physical activity goals, encouraged the use of self-monitoring, and was delivered in group sessions. Main outcome measures: Percentage weight change at 24 months, adherence to self-monitoring over time. Results: Study retention was 85.6%. The mean percentage weight loss at 24 months was not different among groups (paper diary: -1.94%, 95% CI = -3.88, 0.01; PDA: -1.38%, 95% CI= -3.38, 0.62; PDA+FB: -2.32%, 95% CI= -4.29, -0.35); only the PDA+FB group (p=0.02) demonstrated a significant loss. For adherence to self-monitoring, there was a time-by-treatment group interaction between the combined PDA groups and the paper diary group (p=0.03) but no difference between PDA and PDA+FB groups (p=0.49). Across all groups, weight loss was greater for those who were adherent <60% versus <30% of the time (p<0.001). Conclusions: PDA+FB use resulted in a small weight loss at 24 months; PDA use resulted in greater adherence to dietary self-monitoring over time. However, for sustained weight loss, adherence to self-monitoring is more important than the method used to self-monitor. A daily feedback message delivered remotely enhanced adherence and improved weight loss, which suggests that technology can play a role in improving weight loss. Trial registration: This study is registered at NCT00277771. © 2012 American Journal of Preventive Medicine.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Burke, LElbu100@pitt.eduLBU1000000-0003-2434-9867
Styn, MA
Sereika, SMssereika@pitt.eduSSEREIKA
Conroy, MB
Ye, L
Glanz, K
Sevick, MA
Ewing, LJlje1@pitt.eduLJE1
Date: 1 July 2012
Date Type: Publication
Journal or Publication Title: American Journal of Preventive Medicine
Volume: 43
Number: 1
Page Range: 20 - 26
DOI or Unique Handle: 10.1016/j.amepre.2012.03.016
Schools and Programs: School of Nursing > Nursing
Refereed: Yes
ISSN: 0749-3797
PubMed ID: 22704741
Date Deposited: 18 Sep 2012 14:35
Last Modified: 26 Jan 2022 12:55


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