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SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings.

Burke, Lora E and Styn, Mindi A and Glanz, Karen and Ewing, Linda J and Elci, Okan U and Conroy, Margaret B and Sereika, Susan M and Acharya, Sushama D and Music, Edvin and Keating, Alison L and Sevick, Mary Ann (2009) SMART trial: A randomized clinical trial of self-monitoring in behavioral weight management-design and baseline findings. Contemp Clin Trials, 30 (6). 540 - 551.

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BACKGROUND: The primary form of treatment for obesity today is behavioral therapy. Self-monitoring diet and physical activity plays an important role in interventions targeting behavior and weight change. The SMART weight loss trial examined the impact of replacing the standard paper record used for self-monitoring with a personal digital assistant (PDA). This paper describes the design, methods, intervention, and baseline sample characteristics of the SMART trial. METHODS: The SMART trial used a 3-group design to determine the effects of different modes of self-monitoring on short- and long-term weight loss and on adherence to self-monitoring in a 24-month intervention. Participants were randomized to one of three conditions (1) use of a standard paper record (PR); (2) use of a PDA with dietary and physical activity software (PDA); or (3), use of a PDA with the same software plus a customized feedback program (PDA + FB). RESULTS: We screened 704 individuals and randomized 210. There were statistically but not clinically significant differences among the three cohorts in age, education, HDL cholesterol, blood glucose and systolic blood pressure. At 24 months, retention rate for the first of three cohorts was 90%. CONCLUSIONS: To the best of our knowledge, the SMART trial is the first large study to compare different methods of self-monitoring in a behavioral weight loss intervention and to compare the use of PDAs to conventional paper records. This study has the potential to reveal significant details about self-monitoring patterns and whether technology can improve adherence to this vital intervention component.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Burke, Lora Elbu100@pitt.eduLBU1000000-0003-2434-9867
Styn, Mindi A
Glanz, Karen
Ewing, Linda J
Elci, Okan U
Conroy, Margaret B
Sereika, Susan Mssereika@pitt.eduSSEREIKA0000-0002-7840-1352
Acharya, Sushama D
Music, Edvin
Keating, Alison L
Sevick, Mary Ann
Date: 29 July 2009
Date Type: Acceptance
Journal or Publication Title: Contemp Clin Trials
Volume: 30
Number: 6
Page Range: 540 - 551
DOI or Unique Handle: 10.1016/j.cct.2009.07.003
Schools and Programs: School of Nursing > Nursing
Refereed: Yes
Uncontrolled Keywords: Adult, Body Weights and Measures, Clinical Protocols, Computers, Handheld, Diet, Exercise, Female, Humans, Male, Middle Aged, Monitoring, Ambulatory, Obesity, Patient Compliance, Patient Dropouts, Research Design, Socioeconomic Factors, Weight Loss, Young Adult
Funders: NCRR NIH HHS (5MO1-RR00056), NINR NIH HHS (K24 NR010742), NCRR NIH HHS (UL1 RR024153), NCRR NIH HHS (M01 RR000056), NINR NIH HHS (K24 NR010742-02), NINR NIH HHS (P30 NR003924), NIDDK NIH HHS (R01 DK071817), NIDDK NIH HHS (R01-DK71817), NIDDK NIH HHS (R01 DK071817-05), NINR NIH HHS (P30-NR03924)
MeSH Headings: Adult; Body Weights and Measures; Clinical Protocols; Computers, Handheld; Diet; Exercise; Female; Humans; Male; Middle Aged; Monitoring, Ambulatory--instrumentation; Monitoring, Ambulatory--methods; Obesity--therapy; Patient Compliance; Patient Dropouts--statistics & numerical data; Research Design; Socioeconomic Factors; Weight Loss; Young Adult
Other ID: NLM NIHMS143748, NLM PMC2860431
PubMed Central ID: PMC2860431
PubMed ID: 19665588
Date Deposited: 20 Sep 2012 17:54
Last Modified: 07 Nov 2023 11:56


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