Abstract
BackgroundFeedback for participants’ self-monitoring is a crucial and costly component of technology-based weight loss interventions. Detailed examination of interventionist time when reviewing and providing feedback for online self-monitoring data is lacking.ObjectiveThe aim of this study was to longitudinally examine the time counselors spent providing feedback on participant self-monitoring data (ie, diet, physical activity, weight) in a 12-month technology-based weight loss intervention. We hypothesized that counselors would compose feedback for participants more quickly over time.MethodsThe time the lay counselors (N=10) spent reviewing self-monitoring records and providing feedback to participants via email was longitudinally examined for all counselors across the three years of study implementation. Descriptives were observed for counselor feedback duration across counselors by 12 annual quarters (ie, 3-month periods). Differences in overall duration times by each consecutive annual quarter were analyzed using Wilcoxon-Mann-Whitney tests.ResultsThere was a decrease in counselor feedback duration from the first to second quarter (mean 53 to 46 minutes; P<.001), and from the second to third (mean 46 to 30 minutes; P<.001). A trend suggested a decrease from the third to fourth quarter (mean 30 to 26 minutes; P=.053), but no changes were found in subsequent quarters. Consistent with the hypothesis, counselors may be increasing their efficiency in providing feedback; across 12 months, counselors spent less time reviewing participant self-monitoring and composing feedback (decreasing from mean 53 to 26 minutes).ConclusionsCounselors used increasingly less time to review online self-monitoring data and compose feedback after the initial 9 months of study implementation. Results inform counselor costs for future technology-based behavioral weight loss interventions. For example, regardless of increasing counselor efficiency, 25-30 minutes per feedback message is a high cost for interventions. One possibility for reducing costs would be generating computer-automated feedback.Trial RegistrationClinicalTrials.gov NCT02063178; https://clinicaltrials.gov/ct2/show/NCT02063178
Highlights
Consistent weight and dietary self-monitoring are key elements for successful weight loss in both in-person [1] and technology-based programs [2], and using technology for self-monitoring can increase self-monitoring adherence [3,4,5]
In studies that have evaluated the cost-effectiveness of behavioral weight loss interventions [14,15,16,17,18,19,20,21,22,23,24,25], interventionist compensation emerges in the available studies as one of the costliest components [21,24,25], including time for conducting the sessions and for providing feedback
The purpose of this study was to longitudinally examine the time required to review self-monitoring data and compose feedback among newly trained counselors for participants engaged in a 12-month behavioral weight loss intervention
Summary
Consistent weight and dietary self-monitoring are key elements for successful weight loss in both in-person [1] and technology-based programs [2], and using technology for self-monitoring (eg, apps, smart scales) can increase self-monitoring adherence [3,4,5]. Objective: The aim of this study was to longitudinally examine the time counselors spent providing feedback on participant self-monitoring data (ie, diet, physical activity, weight) in a 12-month technology-based weight loss intervention. Methods: The time the lay counselors (N=10) spent reviewing self-monitoring records and providing feedback to participants via email was longitudinally examined for all counselors across the three years of study implementation. Consistent with the hypothesis, counselors may be increasing their efficiency in providing feedback; across 12 months, counselors spent less time reviewing participant self-monitoring and composing feedback (decreasing from mean 53 to 26 minutes). Conclusions: Counselors used increasingly less time to review online self-monitoring data and compose feedback after the initial 9 months of study implementation.
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