Self-monitoring Tools Research Articles

\u2018It\u2019s like a personal motivator that you carried around wi\u2019 you\u2019: utilising self-determination theory to understand men\u2019s experiences of using pedometers to increase physical activity in a weight management programme

BackgroundSelf-monitoring using pedometers is an effective behaviour change technique to support increased physical activity (PA). However, the ways in which pedometers operate as motivational tools in adoption and maintenance of PA is not well understood. This paper investigates men’s experiences of pedometers as motivational tools both during and after their participation in a 12-week group-based, weight management programme for overweight/obese men, Football Fans in Training (FFIT).MethodsSemi-structured telephone interviews were conducted with 28 men, purposively sampled to include men who did and did not achieve 5% weight loss during the programme. Data were analysed thematically utilising the framework approach, using Self-Determination Theory (SDT) - namely concepts of behavioural regulation and the basic needs of relatedness, competence and autonomy - as an analytical lens.ResultsDuring the programme, FFIT’s context and fellow participants supported relatedness and encouraged use of the pedometer. The pedometer was seen to provide tangible proof of progress, thus increasing competence for change, whilst the ability to monitor one’s own progress and take remedial action supported autonomy; these men portrayed the pedometer as an ‘ally’. However, a minority found the pedometer ‘dispiriting’ or controlling when it evidenced their inability to meet their PA targets.After the programme, some men no longer used the device as they had fully internalised their motivations for increased PA. In contrast, others continued to use pedometers or progressed to other self-monitoring technologies because it was enjoyable and facilitated maintenance of their increased PA. However, the minority of men who experienced the pedometer as controlling no longer used it. They were less successful in achieving 5% weight loss and appeared reliant on external factors, including support from coach and group members, to maintain motivation.ConclusionThese findings show how self-monitoring using pedometers and associated goal setting supported the development of autonomous motivation for PA, during and after participation in a group-based programme. They also suggest that programmes could focus on early identification of participants who remain motivated by extrinsic factors or express negative experiences of self-monitoring tools, to offer greater support to identify the benefits of PA based on a person’s own values.

Validation of a Self-Monitoring Tool for Use in Exercise Therapy

BackgroundAerobic exercise at a subsymptom heart rate has been recommended as therapy for postconcussion syndrome. Assessing adherence with an accurate heart rate-monitoring instrument is difficult, limiting the proliferation of large-scale randomized controlled trials. ObjectiveTo evaluate the validity of the Fitbit Charge HR compared with electrocardiogram (EKG) to monitor heart rate during a treadmill-based exercise protocol. DesignA methods comparison study. SettingSports medicine research center within a tertiary care institution. ParticipantsA convenience sample of 22 healthy participants (12 female) aged 18-26 years (mean age: 22 ± 2 years). MethodsFitbit Charge HR heart rate measurements were compared with EKG data concurrently collected while participants completed the Buffalo Concussion Treadmill Test. Main Outcome MeasuresAgreement between Fitbit Charge HR and EKG was assessed by intraclass correlation coefficients (ICC3,1), Bland-Altman limits of agreement, and percent error. ResultsWe observed a strong single-measure absolute agreement between Fitbit Charge HR and EKG (intraclass correlation coefficient = 0.83; 95% confidence interval 0.67-0.90). Fitbit Charge HR underestimated heart rate compared with EKG (mean difference = −6.04 bpm; standard deviation = 10.40 bpm; Bland-Altman 95% limits of agreement = −26.42 to 14.35 bpm). A total of 69.9% of Fitbit heart rate measurements were within 10% error compared with EKG, and 91.5% of all heart rate measurements were within 20% error. ConclusionsAlthough the mean bias in measuring heart rate was relatively small, the limits of agreement between the Fitbit Charge HR and EKG were broad. Thus, the Fitbit Charge HR would not be a suitable option for monitoring heart rate within a narrow range. For the purposes of postconcussion exercise therapy, the relatively inexpensive cost, easy implementation, and low maintenance make Fitbit Charge HR a viable option for assessing adherence to an exercise program when expensive clinical equipment is unavailable. Level of EvidenceII

Efficacy of a Self-Monitoring Tool for Improving the Quality of the Language Environment in the Preschool Classroom

ABSTRACTResearch Findings: This study evaluated the impact of a self-monitoring intervention on preschool teachers’ use of language and on children’s language growth. Nineteen classrooms from Santiago de Chile participated (10 intervention, 9 control). Twice a week, intervention teachers filled out a checklist to monitor the language stimulation they offered children. Research personnel used the checklists to elaborate a monthly summary of the language opportunities offered to each child in that month and discussed this information with teachers. Results revealed a significant advantage for intervention teachers in frequency of book readings and word discussions but not on children’s language growth. Dosage analyses showed that children identified by the self-monitoring device as receiving more language-learning opportunities improved significantly more from beginning to end of the school year in receptive vocabulary. Practice or Policy: Contextual barriers such as large numbers of children and unawareness of the impact of some language interactions can prevent teachers from engaging in important practices. Reminding teachers of the importance of those practices and helping them monitor their frequency may be a low-cost way of improving language opportunities for children in contexts where more intensive professional development is not possible.

Evaluating and Redesigning the Self-Monitoring Tool

In order to facilitate self-monitoring interventions designed by the Faculty of Computer Science Universitas Indonesia, a web-based self-monitoring tool was created. This paper aims to evaluate the tool regarding its usability and user-experiences prior to its wide adoption. The User-Experience Questionnaire (UEQ) and the System Usability Scale (SUS) were used to evaluate the self-monitoring tool. The tool was implemented in a Human-Computer Interaction course during odd semesters and the evaluations were taken by the participants of the course. The evaluation results were analyzed to help determine whether the tool needs to be enhanced or improved. Based the results, a new design of self-monitoring tool was developed using the interface design principles.

Using High-Tech and High-Touch Methods for Effective Population Health Management

Background: Healthcare consumers today are more engaged and empowered than ever before. Social, mobile, and in-home self-monitoring tools now enable health consumers to manage their health conditions and receive advice, support, and care without leaving home. Consumers are increasingly buying biometric devices such the Fitbit and Apple Watch to monitor their health. Many payers and employers are providing fitness devices to encourage consumers to be healthy, often offering discounts to their healthcare premiums. These devices create a sense of euphoria initially, but they do not yield sustainable health results and necessary behavioral changes in consumers to sustain it in the long-term. According to BJ Fogg, Stanford professor, sustainable behavior change (B) is a function of the motivation of the individual (M) × ability of the individual to do the task (A) × Trigger (T); B=MAT.

Technology- and Phone-Based Weight Loss Intervention: Pilot RCT in Women at Elevated Breast Cancer Risk.

For women with an increased breast cancer risk, reducing excess weight and increasing physical activity are believed to be important approaches for reducing their risk. This study tested a weight loss intervention that combined commercially available technology-based self-monitoring tools with individualized phone calls. Women were randomized to a weight loss intervention arm (n=36) or a usual care arm (n=18). Participants were women with a BMI ≥ 27.5 kg/m2 and elevated breast cancer risk recruited from the mammography clinic at the Moores Cancer Center at the University of California San Diego. Intervention participants used the MyFitnessPal website and phone app to monitor diet and a Fitbit to monitor physical activity. Participants received 12 standardized coaching calls with trained counselors over 6 months. Usual care participants received the U.S. Dietary Guidelines for Americans at baseline and two brief calls over the 6 months. Weight and accelerometer-measured physical activity were assessed at baseline and 6 months. Data were collected in San Diego, CA, from 2012 to 2014 and analyzed in 2015. Participants (n=54) had a mean age of 59.5 (SD=5.6) years, BMI of 31.9 (SD=3.5), and a mean Gail Model score of 2.5 (SD=1.4). At 6 months, intervention participants had lost significantly more weight (4.4 kg vs 0.8 kg, p=0.004) and a greater percentage of starting weight (5.3% vs 1.0%, p=0.005) than usual care participants. Across arms, greater increases in moderate-to-vigorous physical activity resulted in greater weight loss (p=0.01). Combining technology-based self-monitoring tools with phone counseling supported weight loss over 6 months in women at increased risk for breast cancer.

Technology-based interventions for weight management: current randomized controlled trial evidence and future directions.

Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs. In the present paper, a summary of the most current literature is provided along with potential solutions to methodological challenges (e.g., high attrition, minimal participant racial/ethnic diversity, heterogeneity of technology delivery modes). Dissemination and policy implications will be highlighted as future directions for the field of eHealth weight management.

A simple home-based self-monitoring tool for early detection of hand-foot syndrome in cancer patients.

Development of hand-foot syndromesymptoms, which is a common adverse effect of several cancer chemotherapy agents, can result in patient withdrawal from treatment. Its early identification allows appropriate modification of chemotherapy regimens and can avert treatment withdrawal by minimizing the impact on quality of lifeand duration of discontinued therapy. We sought to develop a simple home-based self-monitoring tool to facilitate reliable early identification ofhand-foot syndrome, based on the self-administered quality of lifequestionnaire hand-foot syndrome-14. We modified thehand-foot syndrome-14 to create a simple tool with binary responses ('yes' or 'no') for patients to self-evaluate subjective hand-foot syndrome symptoms daily. We evaluated this tool with 187 consecutive, consenting, eligible adult patients attending four centers and treated with capecitabine, sorafenib or sunitinib for various cancers. Univariate and multivariate logistic regression analyses were used to select the items with the greatest discrimination for detecting Common Terminology Criteria for Adverse Events (CTCAE) grade 2 or 3 reactions, which indicate the need to modify the treatment regimen. There were four items that were most strongly associated withCommon Terminology Criteria for Adverse Events grade 2 or higher symptoms. 'Pain associated with hand-foot syndrome' was the most strongly associated with moderate hand-foot syndrome. For detecting moderate hand-foot syndrome symptoms, the sensitivity was 100.0%, specificity was 94.6%, positive predictive value was 82.6% and area under the curve was 0.98 by a sum of the scores of four-item self-monitoring tool with cut-off value. We present a simple self-monitoring tool that can be used at home with high sensitivity and specificity for identifying grade 2 hand-foot syndrome. In addition, this tool might facilitate self-care.

Teaching Intuitive Eating and Acceptance and Commitment Therapy Skills Via a Web-Based Intervention: A Pilot Single-Arm Intervention Study.

BackgroundMiddle-aged women are at risk of weight gain and associated comorbidities. Deliberate restriction of food intake (dieting) produces short-term weight loss but is largely unsuccessful for long-term weight management. Two promising approaches for the prevention of weight gain are intuitive eating (ie, eating in accordance with hunger and satiety signals) and the development of greater psychological flexibility (ie, the aim of acceptance and commitment therapy [ACT]).ObjectivesThis pilot study investigated the usage, acceptability, and feasibility of “Mind, Body, Food,” a Web-based weight gain prevention intervention prototype that teaches intuitive eating and psychological flexibility skills.MethodsParticipants were 40 overweight women (mean age 44.8 [standard deviation, SD, 3.06] years, mean body mass index [BMI] 32.9 [SD 6.01] kg/m2, mean Intuitive Eating Scale [IES-1] total score 53.4 [SD 7.46], classified as below average) who were recruited from the general population in Dunedin, New Zealand. Module completion and study site metrics were assessed using Google Analytics. Use of an online self-monitoring tool was determined by entries saved to a secure online database. Intervention acceptability was assessed postintervention. BMI, intuitive eating, binge eating, psychological flexibility, and general mental and physical health were assessed pre- and postintervention and 3-months postintervention.ResultsOf the 40 women enrolled in the study, 12 (30%) completed all 12 modules (median 7.5 [interquartile range, IQR, 2-12] modules) and 4 (10%) used the self-monitoring tool for all 14 weeks of the intervention period (median 3 [IQR 1-9] weeks). Among 26 women who completed postintervention assessments, most women rated “Mind, Body, Food” as useful (20/26, 77%), easy to use (17/25, 68%) and liked the intervention (22/25, 88%). From pre- to postintervention, there were statistically significant within-group increases in intuitive eating (IES-2 total score P<.001; all IES-2 subscale scores: P ≤.01), psychological flexibility (P=.01), and general mental health (P<.001) as well as significant decreases in binge eating (P=.01). At the 3-month follow-up, IES-2 improvements were maintained, and there were further improvements in binge eating (P<.001) and general mental health (P=.03), and a marginal yet nonsignificant tendency for further improvement in psychological flexibility (P=.06). There were no significant within-group changes in BMI from pre- to postintervention and postintervention to 3-month follow-up (P=.46 and P=.93, respectively).ConclusionsThe “Mind, Body, Food” prototype Web-based intervention is appealing to middle-aged women and may be a useful tool to help women learn intuitive eating and ACT skills, reduce binge eating, and maintain weight over 3 months. Further work to improve the user experience and engagement is required before testing the online intervention in a randomized controlled trial.

A systematic review to determine the most effective interventions to increase water intake.

Maintaining adequate fluid intake has been hypothesized to be beneficial for the progression of chronic kidney disease (CKD). The aim of this study was to undertake a systematic review to determine the most effective interventions to increase water intake. Six electronic databases were searched from 1910 until March 2015 in the English language. Additional sources through hand-searches, expert recommendations and reviews were checked. Intervention studies increasing water intake in adults through non-pharmacological methods were eligible for inclusion. The quality of included studies was assessed. A total of 950 studies were found of which 16 met the inclusion criteria. Eight studies were randomized controlled trials, and seven studies spanned 6 months or longer. The study populations varied and included patients with recurrent nephrolithiasis (n = 6), autosomal dominant polycystic kidney disease (n = 3), CKD (n = 1), urinary tract infection (n = 1) and other miscellaneous conditions (n = 5). The quality of the studies was mostly neutral (63%) with no studies of high quality. Interventions ranged from instruction alone to self-monitoring tools, providing water bottles and counselling and education. Most interventions successfully increased water intake with 13 studies reporting an increase of at least 500 mL. The most effective strategies were instruction and self-monitoring using urine dipstick or 24 h urine volume. All interventions carried out in the studies succeeded in increasing water intake, with none leading to decreases in intake, and these could be implemented in potential clinical trials in CKD. However, more high quality long-term intervention studies are required to further validate findings.

The importance of a multi-disciplinary perspective and patient activation programmes in MS management

Background: Multiple sclerosis (MS) is a progressive disease associated with a large variety of symptoms and changing patients’ needs during the disease course. In order to provide appropriate care in every disease stage and let patients live their lives to the full, a multi-disciplinary approach and patient activation is needed. Objective: To summarise the multi-disciplinary perspective of MS, with focus on the organisation of a multi-disciplinary care team and possibilities to support patient activation. Methods: This review reflects the content of the presentations, audience polling results and discussions on the multi-disciplinary perspective of MS during the second Pan-European MS Multi-stakeholder Colloquium. Results: In many countries, the neurologist with or without the support of an MS nurse is responsible for the long-term care of MS patients. When needed, they should refer to other (non-)medical specialists. However, the patient should be empowered as well to manage his/her disease and to implement a physically active lifestyle in order to improve treatment outcomes and quality of life. Conclusion: To create equal access to care for MS patients across Europe, evidence-based standards of care, symptom self-monitoring tools and educational programmes for patients and healthcare professionals including non-medical treatment strategies should be developed at the European level.

Physical activity preferences of individuals diagnosed with schizophrenia or bipolar disorder

BackgroundIndividuals with a severe mental illness (SMI) are at least two times more likely to suffer from metabolic co-morbidities, leading to excessive and premature deaths. In spite of the many physical and mental health benefits of physical activity (PA), individuals with SMI are less physically active and more sedentary than the general population. One key component towards increasing the acceptability, adoption, and long-term adherence to PA is to understand, tailor and incorporate the PA preferences of individuals. Therefore, the objective of this study was to determine if there are differences in PA preferences among individuals diagnosed with different psychiatric disorders, in particular schizophrenia or bipolar disorder (BD), and to identify PA design features that participants would prefer.MethodsParticipants with schizophrenia (n = 113) or BD (n = 60) completed a survey assessing their PA preferences.ResultsThere were no statistical between-group differences on any preferred PA program design feature between those diagnosed with schizophrenia or BD. As such, participants with either diagnosis were collapsed into one group in order to report PA preferences. Walking (59.5 %) at moderate intensity (61.3 %) was the most popular activity and participants were receptive to using self-monitoring tools (59.0 %). Participants were also interested in incorporating strength and resistance training (58.5 %) into their PA program and preferred some level of regular contact with a fitness specialist (66.0 %).ConclusionsThese findings can be used to tailor a physical activity intervention for adults with schizophrenia or BD. Since participants with schizophrenia or BD do not differ in PA program preferences, the preferred features may have broad applicability for individuals with any SMI.

Physical activity in ankylosing spondylitis: evaluation and analysis of an eHealth tool

BackgroundAnkylosing spondylitis (AS) is a chronic inflammatory condition characterised by spinal arthritis and exercise is often recommended to reduce the symptoms and improve mobility. However, very little evidence exists for...

Impact of newer self-monitoring technology and brief phone-based intervention on weight loss: A randomized pilot study.

Despite the proliferation of newer self-monitoring technology (e.g., activity monitors and smartphone apps), their impact on weight loss outside of structured in-person behavioral intervention is unknown. A randomized, controlled pilot study was conducted to examine efficacy of self-monitoring technology, with and without phone-based intervention, on 6-month weight loss in adults with overweight and obesity. Eighty participants were randomized to receive standard self-monitoring tools (ST, n = 26), technology-based self-monitoring tools (TECH, n = 27), or technology-based tools combined with phone-based intervention (TECH + PHONE, n = 27). All participants attended one introductory weight loss session and completed assessments at baseline, 3 months, and 6 months. Weight loss from baseline to 6 months differed significantly between groups P = 0.042; there was a trend for TECH + PHONE (-6.4 ± 1.2 kg) to lose more weight than ST (-1.3 ± 1.2 kg); weight loss in TECH (-4.1 ± 1.4 kg) was between ST and TECH + PHONE. Fewer ST (15%) achieved ≥5% weight losses compared with TECH and TECH + PHONE (44%), P = 0.039. Adherence to self-monitoring caloric intake was higher in TECH + PHONE than TECH or ST, Ps < 0.05. These results suggest use of newer self-monitoring technology plus brief phone-based intervention improves adherence and weight loss compared with traditional self-monitoring tools. Further research should determine cost-effectiveness of adding phone-based intervention when providing self-monitoring technology.

Interest and preferences for using advanced physical activity tracking devices: results of a national cross-sectional survey

ObjectivesPedometers are an effective self-monitoring tool to increase users' physical activity. However, a range of advanced trackers that measure physical activity 24 hours per day have emerged (eg, Fitbit). The...

Use of self-monitoring tools in a clinic sample of adults with type 2 diabetes.

Self-monitoring is an effective strategy for chronic disease management; many readily available mobile applications allow tracking of diabetes-related health behaviors but their use has not yet been integrated into routine clinical care. How patients engage with these applications in the real world is not well understood. The specific aim of this study is to survey adults with type 2 diabetes (T2D) regarding self-monitoring behaviors, including mobile application use. In 2015, we surveyed an adult diabetes clinic population (n=96) regarding self-monitoring behaviors: diet, physical activity, weight, and blood glucose. Self-monitoring with any method ranged from 20-90%. About half of the participants owned smartphones; few had mobile applications. The most common app-tracked behavior was physical activity, then weight and diet. Despite numerous available mobile health-tracking applications, few T2D adults from our sample used them, though many reported self-monitoring with other methods.

Mobile Health for All: Public-Private Partnerships Can Create a New Mental Health Landscape.

Research has already demonstrated that different mHealth approaches are feasible, acceptable, and clinically promising for people with mental health problems. With a robust evidence base just over the horizon, now is the time for policy makers, researchers, and the private sector to partner in preparation for the near future. The Lifeline Assistance Program is a useful model to draw from. Created in 1985 by the U.S. Federal Communications Commission (FCC), Lifeline is a nationwide program designed to help eligible low-income individuals obtain home phone and landline services so they can pursue employment, reach help in case of emergency, and access social services and healthcare. In 2005, recognizing the broad shift towards mobile technology and mobile-cellular infrastructure, the FCC expanded the program to include mobile phones and data plans. The FCC provides a base level of federal support, but individual states are responsible for regional implementation, including engagement of commercial mobile phone carriers. Given the high rates of disability and poverty among people with severe mental illness, many are eligible to benefit from Lifeline and research has shown that a large proportion does in fact use this program to obtain a mobile phone and data plan. In the singular area of mobile phone use, the gap between people with severe mental illness and the general population in the U.S. is vanishing. Strategic multi-partner programs will be able to grant access to mHealth for mental health programs to those who will not be able to afford them—arguably, the people who need them the most. Mobile technology manufacturing costs are dropping. Soon all mobile phones in the marketplace, including the more inexpensive devices that are made available through subsidy programs, will have “smart” capabilities (ie, internet connectivity and the capacity to host apps). Programs like Lifeline could be expanded to include mHealth resources that capitalize on “smart” functions, such as secure/encrypted clinical texting programs and mental health monitoring and illness-management apps. Mobile phone hardware and software development companies could be engaged to add mHealth programs as a standard component in the suite of tools that come installed on their mobile phones; thus, in addition to navigation apps, media players, and games, the new Android or iPhone could come with guided relaxation videos, medication reminder systems, and evidence-based self-monitoring and self-management tools. Telecommunication companies could be encouraged to offer mHealth options with their data plans. Operating system updates pushed out by the mobile carrier companies could come with optional mHealth applications for those who elect to download them. In the same manner in which the Lifeline Assistance Program has helped increase access to fundamental opportunities to so many low-income individuals, innovative multi-partner programs have the potential to put mHealth for mental health resources in the hands of millions in the years ahead.

Accuracy Of A Smartphone-based “App” For The Assessement Of Sedentary And More Active Behaviors

Mobile devices provide a convenient platform for log-based assessments of sedentary and physical activity (PA) behaviors. PURPOSE: This study aimed to evaluate the accuracy of a smartphone-based “app” designed to assess context-specific forms of sitting, light-intensity PA (LPA), and moderate-vigorous PA (MVPA). METHODS: Adults (N=23 [323 observations]; 49.0±8.9 years; 85% men; 73% Caucasian; BMI=35.0±8.3kg/m2) reported their sitting, LPA, and MVPA over the course of an 11-week behavioral intervention. During three separate 7d time period, participants simultaneously wore the ActivPAL3c™ accelerometry/inclinometer as a criterion measure. Intraclass correlation (ICC [95% CI]) and bias estimates (mean difference [¯d] and absolute percent error [APE = difference/direct observation x 100]) were used to compare app-based reported behaviors to measure sedentary time (lying/seated position), LPA (standing or stepping < 3 metabolic equivalents [METs], and MVPA (stepping ≥ 3METs). RESULTS: Sitting time accuracy was moderate (ICC=0.50 [0.37, 0.60]) with under-reporting (¯d = -127 [-612.41, -356.73] minutes/day; APE = -8.61 [-155.73, 140.51]). LPA and MVPA time accuracy was also moderate (ICC=0.64 [0.55, .72] and 0.55 [0.32, 0.71], respectively) with over-reporting (¯d = 293.00 [-39.06, 625.06] minutes/day; APE = 31.87 [-138.28, 202.02]) and (¯d = 19.46 [-133.20, 172.12] minutes/day; APE=83.93 [-387.21, -555.07]). CONCLUSION: The smartphone-based log targeting sedentary and more active behaviors underreported sedentary time and overreported LPA and MVPA with only moderate accuracy relative to an objective monitor. This tool may still be useful as a self-monitoring tool in the context of a behavioral intervention as well as a tool to capture context-specific forms of sedentary, LPA, and MVPA behaviors. Given the wide variations in accuracy, future research may explain some reasons for under- or over-reporting of behaviors.

Validation Of A Self-monitoring Tool For Use In Post-concussion Syndrome Therapy

Validation Of A Self-monitoring Tool For Use In Post-concussion Syndrome Therapy

Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study.

Excess weight and physical inactivity are modifiable risk factors for breast cancer. Behavioral intervention is particularly important among women with an elevated risk profile. This trial tested an intervention that trained women to use a self-monitoring website to increase activity and lose weight. Women with BMI ≥27.5kg/m(2) at elevated breast cancer risk were randomized to the intervention (N=71) or usual care (N=34). The intervention group received telephone-based coaching and used web-based self-monitoring tools. At 6months, significant weight loss was observed in the intervention group (4.7% loss from starting weight; SD=4.7%) relative to usual care (0.4% gain; SD=3.0%) (p<0.0001). By 12months, the intervention group had lost 3.7% of weight (SD=5.4%), compared to 1.3% (SD=4.2) for usual care (p=0.003). At 12months, accelerometer-measured moderate-to-vigorous physical activity increased by 12min/day (SD=24) compared to no change in usual care (p=0.04. In summary, this web- and phone-based approach produced modest but significant improvements in weight and physical activity for women at elevated breast cancer risk.