Early weight loss in a standalone mHealth intervention predicting treatment success

Abstract

Summary Objective Early weight loss is a strong predictor of longer‐term and clinically meaningful weight loss but has not been studied in the context of mobile health (‘mHealth’) interventions. Methods GoalTracker was a randomized trial among adults (21–65 years) with overweight or obesity comparing three 12‐week standalone mHealth interventions for weight loss. All arms received a free commercial mobile app (MyFitnessPal) for daily self‐monitoring of diet and/or weight and a goal to lose 5% of weight by 3 months. Collapsing across arms, this analysis examined participants with a 1‐month weight ( n = 84), categorizing them as either early responders (≥2% weight loss at 1 month) or early non‐responders (<2% weight loss at 1 month). Results Early responders – 36% of participants – had greater per cent weight change at 3 months (−5.93% [95% confidence interval: −6.82%, −5.03%]) than early non‐responders (−1.45% [−2.15%, −0.75%]), which was sustained at 6 months (−5.91% [−7.33%, −4.48%] vs. −1.28% [−2.37%, −0.19%]; p s < 0.0001). Over half (57%) of early responders achieved ≥5% weight loss at 3 months vs. 11% of early non‐responders. At 4 weeks, self‐monitoring frequency (weight/diet) was significantly greater among early responders, which continued across 12 weeks. Conclusion Responding early to an mHealth treatment is associated with higher engagement and greater likelihood of achieving clinically meaningful weight loss.

User Engagement With Smartphone Apps and Cardiovascular Disease Risk Factor Outcomes: Systematic Review (Preprint)

“…The study characteristics are summarized in Multimedia Appendix 2 . Of the 24 studies, 17 used an RCT design [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32], 4 used a retrospective analysis [33][34][35][36], and 3 used a single-group pre-and posttest quasi-experimental design [37][38][39]. Although 20 studies used an RCT or single-group preand-posttest quasi-experimental design, it was the correlational studies nested within these larger parent studies that were of interest for this review.…”

“…For the 3 single-group pre-and-posttest quasi-experimental studies, intervention duration ranged from 3 months [37] to 6 months [38,39]. For the studies using a prospective design, follow-up ranged from 1 month [25,26,28] to 24 months [17,24]. All 24 studies were conducted in developed countries, including the United States (n=11), Australia (n=3), Canada (n=2), Spain (n=2), the United Kingdom (n=1), Norway (n=1), Finland (n=1), Japan (n=1), Singapore (n=1), and Korea (n=1).…”

“…Of the 17 RCT studies, 14 conducted an a priori power analysis. Of these 14 RCTs, 3 detected a significant difference in the primary outcome between groups [21,23,27], 9 did not detect a significant difference in the primary outcome between groups [16,17,22,[24][25][26]29,31,32], and 2 did not report the results of the difference in the primary outcome between groups [18,30]. One of the studies that did not detect a significant difference between groups did not achieve the target sample size [32].…”

“…All 24 studies reported on sex, with 16 of the samples consisting largely of women (range 51%-91%) [22,38], 7 of the samples consisting largely of men (range 51%-100%) [16,21], and one split evenly [39]. Thirteen studies reported sample races [17][18][19][21][22][23][24][25][26][27][28]32,39], with 7 consisting largely of White participants [18,19,22,[24][25][26]28]. Seventeen studies reported on sample educational level, with the majority of the participants within each individual study having attended some college [16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32]38,39].…”

“…Thirteen studies reported sample races [17][18][19][21][22][23][24][25][26][27][28]32,39], with 7 consisting largely of White participants [18,19,22,[24][25][26]28]. Seventeen studies reported on sample educational level, with the majority of the participants within each individual study having attended some college [16][17][18][19][20][21][22][23][24][25][26][28][29][30][31][32]38,39]. Ten studies limited their sample to participants who were overweight or obese [17,19,[21][22][23][24][25][26]28,35], and another 11 studies reported enrolling participants with a baseline mean or majority percentage BMI indicating overweight or obes...…”