Using mHealth technology to enhance self-monitoring for weight loss: a randomized trial.
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2012-06-18
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Abstract
BACKGROUND Self monitoring for weight loss has traditionally been performed with paper diaries Technologic advances could reduce the burden of self monitoring and provide feedback to enhance adherence PURPOSE To determine if self monitoring diet using a PDA only or the PDA with daily tailored feedback PDA feedback FB was superior to using a paper diary on weight loss and maintenance DESIGN The Self Monitoring and Recording Using Technology SMART Trial was a 24 month randomized clinical trial participants were randomly assigned to one of three self monitoring groups SETTING PARTICIPANTS From 2006 to 2008 a total of 210 overweight obese adults 84 8 female 78 1 white were recruited from the community Data were analyzed in 2011 INTERVENTION Participants received standard behavioral treatment for weight loss that included dietary and physical activity goals encouraged the use of self monitoring and was delivered in group sessions MAIN OUTCOME MEASURES Percentage weight change at 24 months adherence to self monitoring over time RESULTS Study retention was 85 6 The mean percentage weight loss at 24 months was not different among groups paper diary 1 94 95 CI 3 88 0 01 PDA 1 38 95 CI 3 38 0 62 PDA FB 2 32 95 CI 4 29 0 35 only the PDA FB group p 0 02 demonstrated a significant loss For adherence to self monitoring there was a time by treatment group interaction between the combined PDA groups and the paper diary group p 0 03 but no difference between PDA and PDA FB groups p 0 49 Across all groups weight loss was greater for those who were adherent 60 versus Under30 of the time pUnder0 001 CONCLUSIONS PDA FB use resulted in a small weight loss at 24 months PDA use resulted in greater adherence to dietary self monitoring over time However for sustained weight loss adherence to self monitoring is more important than the method used to self monitor A daily feedback message delivered remotely enhanced adherence and improved weight loss which suggests that technology can play a role in improving weight loss TRIAL REGISTRATION This study is registered at clinicaltrials gov NCT00277771