Abstract
BackgroundMobile messaging is often used in behavioral weight loss interventions, yet little is known as to the extent to which they contribute to weight loss when part of a multicomponent treatment package. The multiphase optimization strategy (MOST) is a framework that researchers can use to systematically investigate interventions that achieve desirable outcomes given specified constraints.ObjectiveThis study describes the use of MOST to develop a messaging intervention as a component to test as part of a weight loss treatment package in a subsequent optimization trial.MethodsOn the basis of our conceptual model, a text message intervention was created to support self-regulation of weight-related behaviors. We tested the messages in the ENLIGHTEN feasibility pilot study. Adults with overweight and obesity were recruited to participate in an 8-week weight loss program. Participants received a commercially available self-monitoring smartphone app, coaching calls, and text messages. The number and frequency of text messages sent were determined by individual preferences, and weight was assessed at 8 weeks.ResultsParticipants (n=9) in the feasibility pilot study lost 3.2% of their initial body weight over the 8-week intervention and preferred to receive 1.8 texts per day for 4.3 days per week. Researcher burden in manually sending messages was high, and the cost of receiving text messages was a concern. Therefore, a fully automated push notification system was developed to facilitate sending tailored daily messages to participants to support weight loss.ConclusionsFollowing the completion of specifying the conceptual model and the feasibility pilot study, the message intervention went through a final iteration. Theory and feasibility pilot study results during the preparation phase informed critical decisions about automation, frequency, triggers, and content before inclusion as a treatment component in a factorial optimization trial.Trial RegistrationClinicalTrials.gov NCT01814072; https://clinicaltrials.gov/ct2/show/NCT01814072
Highlights
BackgroundMobile device use is ubiquitous in the United States: in 2018, 95% of adults owned a cell phone and 77% owned a smartphone [1,2]
The purpose of this paper is to describe the preparation phase of our project, when we engaged in a review of the literature and behavioral theory, conducted a pre-post feasibility pilot, and elicited user feedback and preferences to develop an automated, responsive, tailored messaging program to support weight loss as one component of a treatment package
The final stage of our preparation phase was to fully develop the message treatment component such that it could be implemented in the phase, the optimization trial
Summary
BackgroundMobile device use is ubiquitous in the United States: in 2018, 95% of adults owned a cell phone and 77% owned a smartphone [1,2]. Text messages can be sent to the most basic of mobile phones at little cost, or the same content can be sent through a native smartphone app as a push notification at no cost to the recipient. Objective: This study describes the use of MOST to develop a messaging intervention as a component to test as part of a weight loss treatment package in a subsequent optimization trial. Results: Participants (n=9) in the feasibility pilot study lost 3.2% of their initial body weight over the 8-week intervention and preferred to receive 1.8 texts per day for 4.3 days per week. A fully automated push notification system was developed to facilitate sending tailored daily messages to participants to support weight loss. Theory and feasibility pilot study results during the preparation phase informed critical decisions about automation, frequency, triggers, and content before inclusion as a treatment component in a factorial optimization trial.
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