Abstract
BackgroundExcess weight gain in young adulthood is associated with future weight gain and increased risk of chronic disease. Although multimodal, technology-based weight-loss interventions have the potential to promote weight loss among young adults, many interventions have limited personalization, and few have been deployed and evaluated for longer than a year. We aim to assess the effects of a highly personalized, 2-year intervention that uses popular mobile and social technologies to promote weight loss among young adults.MethodsThe Social Mobile Approaches to Reducing Weight (SMART) 2.0 Study is a 24-month parallel-group randomized controlled trial that will include 642 overweight or obese participants, aged 18–35 years, from universities and community colleges in San Diego, CA. All participants receive a wearable activity tracker, connected scale, and corresponding app. Participants randomized to one intervention group receive evidence-based information about weight loss and behavior change techniques via personalized daily text messaging (i.e., SMS/MMS), posts on social media platforms, and online groups. Participants in a second intervention group receive the aforementioned elements in addition to brief, technology-mediated health coaching. Participants in the control group receive a wearable activity tracker, connected scale, and corresponding app alone. The primary outcome is objectively measured weight in kilograms over 24 months. Secondary outcomes include anthropometric measurements; physiological measures; physical activity, diet, sleep, and psychosocial measures; and engagement with intervention modalities. Outcomes are assessed at baseline and 6, 12, 18, and 24 months. Differences between the randomized groups will be analyzed using a mixed model of repeated measures and will be based on the intent-to-treat principle.DiscussionWe hypothesize that both SMART 2.0 intervention groups will significantly improve weight loss compared to the control group, and the group receiving health coaching will experience the greatest improvement. We further hypothesize that differences in secondary outcomes will favor the intervention groups. There is a critical need to advance understanding of the effectiveness of multimodal, technology-based weight-loss interventions that have the potential for long-term effects and widespread dissemination among young adults. Our findings should inform the implementation of low-cost and scalable interventions for weight loss and risk-reducing health behaviors.Trial registrationClinicalTrials.govNCT03907462. Registered on April 9, 2019
Highlights
Overweight and obesity remain major public health concerns in the USA [1, 2]
We hypothesize that both Social Mobile Approaches to Reducing Weight (SMART) 2.0 intervention groups will significantly improve weight loss compared to the control group, and the group receiving health coaching will experience the greatest improvement
Participants assigned to intervention group 2 (IG2) receive everything that intervention group 1 (IG1) receives in combination with brief, technologymediated health coaching
Summary
Overweight and obesity remain major public health concerns in the USA [1, 2]. Recent data from the Centers for Disease Control and Prevention indicate the extent of this problem is great even among young adults. Excess weight gain occurs most rapidly in young adults and is associated with future weight gain [4, 5] and cardiovascular disease risk factors [6]. More than half of young adults in the USA are enrolled in tertiary education [5], and an estimated 40.7% of students are overweight or obese [7]. Excess weight gain in young adulthood is associated with future weight gain and increased risk of chronic disease. Technology-based weight-loss interventions have the potential to promote weight loss among young adults, many interventions have limited personalization, and few have been deployed and evaluated for longer than a year. We aim to assess the effects of a highly personalized, 2-year intervention that uses popular mobile and social technologies to promote weight loss among young adults
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