Mobile Delivery of the Diabetes Prevention Program in People With Prediabetes: Randomized Controlled Trial

Toro‐Ramos, Tatiana; Michaelides, Andreas; Anton, Maria; Karim, Zulekha; Kang-Oh, Leah; Argyrou, Charalambos; Loukaidou, Elisavet; Charitou, Marina M.; Sze, Wilson; Miller, Joshua D.

doi:10.2196/17842

Cited by 72 publications

(118 citation statements)

References 44 publications

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“…Schwalm et al 20 reported an intervention in which non-physician healthcare providers with the support of an algorithm-based app significantly reduced blood pressure and reported no adverse events from the use of the intervention. Finally, Toro-Ramos et al 21 found that a coach-guided mobile-delivery system reduced weight in pre-diabetic patients while reporting no adverse events from using the intervention.…”

Section: Resultsmentioning

confidence: 99%

“…Quality assessment is presented in Supplementary Material 1.5 . Two of the included studies 20 , 21 were deemed well-conducted and had a low risk of bias. However, two other included studies 18 , 19 had a medium risk of bias due to limited information regarding sampling 18 and lack of sufficient information regarding the outcome measures.…”

Section: Resultsmentioning

confidence: 99%

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Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

2021

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Objectives: The main objectives of this article are to systematically review the recent literature on patient safety in relation to the use of eHealth and to investigate how the Danish authorities supervise private eHealth clinics with regard to patient safety. Methods: Original studies reporting the association between patient safety and the use of eHealth as a means of communication between patients and healthcare providers were included. Four literature databases were searched for English-language articles reporting results from cohort studies and clinical trials, published from 2015 until March 2021. Moreover, registered private eHealth clinics in Denmark were evaluated with reference to a recent national audit of patient safety issues in eHealth. Results: The literature search retrieved four intervention studies. The studies did not identify any particular patient safety risks associated with the use of eHealth. Many different authorized healthcare providers (preferably, doctors) apply eHealth in various contexts. eHealth is being used as the only form of contact between the healthcare provider and the patient, as a supplement to patient visitations in an outpatient clinic, or as a tool for communicating between two or more healthcare providers. The regulation of eHealth involves patient safety issues but also has interfaces to marketing, IT systems, and infrastructure. Supervision of eHealth includes the organization of clinics, handling patient charts, prescription medicine, patient legal rights, and patient transition. However, there are many interfaces in the division of responsibilities among the various governmental players. Conclusion: eHealth is being used increasingly and in many settings, although recently published intervention studies investigating patient safety issues by the use of eHealth are limited. A structured and continuous governmental control and regulation of patient safety in relation to the use of eHealth is warranted.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

2021

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“…Noom is a mobile health behavior change weight loss program that has demonstrated effects on clinically significant weight loss [ 37 , 38 ]. The Noom Healthy Weight program is based on Cognitive Behavioral Therapy (CBT), third-wave CBT, and motivational interviewing techniques, all of which aid in behavior change and weight control [ 39 , 40 , 41 , 42 ].…”

Section: Methodsmentioning

confidence: 99%

Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight

Mitchell

Yang

Behr

et al. 2021

IJERPH

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There is substantial variability in weight loss outcomes. Psychosocial characteristics underlying outcomes require better understanding, particularly on self-managed digital programs. This cross-sectional study examines differences in psychosocial characteristics by weight loss and engagement outcome, and which characteristics are most associated with weight loss, on a self-managed digital weight loss program. Some underexplored psychosocial characteristics are included, such as flourishing, or a sense of meaning and purpose in life. A questionnaire was emailed to a random sample of 10,000 current users at week 5 in the program and 10,000 current users at week 17. The questionnaire was completed by 2225 users, and their self-reported weight and recorded program engagement data were extracted from the program’s database. Multiple comparison tests indicated that mental health quality of life, depression, anxiety, work-life balance, and flourishing differed by weight loss outcome at program end (week 17; ≥5%, 2–5%, below 2%) and by engagement tertile at program beginning and end (weeks 5 and 17). Only anxiety was associated with weight loss in a backward stepwise regression controlling for engagement and sociodemographic characteristics. Flourishing did not predict weight loss overall but predicted the weight loss outcome group. Our findings have implications for creating more effective interventions for individuals based on psychosocial characteristics and highlight the potential importance of anxiety in underexplored self-managed digital programs.

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“…Noom is a mobile commercial behavior change program that has led to clinically significant short-term and long-term weight reduction [33,34]. After voluntarily signing up for the program, users receive a curriculum; logging features for food, weight, and exercise; a 1:1 coach; and an online group that provides social support led by a group coach.…”

Section: Program and Food Categorization Systemmentioning

confidence: 99%

Self-Reported Nutritional Factors Are Associated with Weight Loss at 18 Months in a Self-Managed Commercial Program with Food Categorization System: Observational Study

Mitchell

Yang

et al. 2021

Nutrients

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Little is known about nutritional factors during weight loss on digital commercial weight loss programs. We examined how nutritional factors relate to weight loss for individuals after 4 and 18 months on a mobile commercial program with a food categorization system based on energy density (Noom). This is a two-part (retrospective and cross-sectional) cohort study. Two time points were used for analysis: 4 months and 18 months. For 4-month analyses, current Noom users who met inclusion criteria (n = 9880) were split into 5% or more body weight loss and stable weight loss (0 ± 1%) groups. Individuals who fell into one of these groups were analyzed at 4 months (n = 3261). For 18-month analyses, individuals from 4-month analyses who were still on Noom 18 months later were invited to take a one-time survey (n = 803). At 18 months 148 participants were analyzed. Noom has a system categorizing foods as low-, medium-, and high-energy-dense. Measures were self-reported proportions of low-, medium-, and high-energy-dense foods, and self-reported nutritional factors (fruit and vegetable intake, dietary quality, nutrition knowledge, and food choice). Nutritional factors were derived from validated survey measures, and food choice from a novel validated computerized task in which participants chose a food they would want to eat right now. ANOVAs compared participants with 5% or more body weight loss and participants with stable weight (0 ± 1%) at 4 months on energy density proportions. Analyses at 18 months compared nutritional factors across participants with >10% (high weight loss), 5–10% (moderate weight loss), and less than 5% body weight loss (low weight loss), and then assessed associations between nutritional factors and weight loss. Individuals with greater weight loss reported consuming higher proportions of low-energy-dense foods and lower proportions of high-energy-dense foods than individuals with less weight loss at 4 months and 18 months (all ps < 0.02). Individuals with greater weight loss had higher fruit and vegetable intake (p = 0.03), dietary quality (p = 0.02), nutrition knowledge (p < 0.001), and healthier food choice (p = 0.003) at 18 months. Only nutrition knowledge and food choice were associated with weight loss at 18 months (B = −19.44, 95% CI: −33.19 to −5.69, p = 0.006; B = −5.49, 95% CI: −8.87 to −2.11, p = 0.002, respectively). Our results highlight the potential influence of nutrition knowledge and food choice in weight loss on a self-managed commercial program. We also found for the first time that in-the-moment inclination towards food even when just depicted is associated with long-term weight loss.

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Mobile Delivery of the Diabetes Prevention Program in People With Prediabetes: Randomized Controlled Trial

Cited by 72 publications

References 44 publications

Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

Pros and cons of eHealth: A systematic review of the literature and observations in Denmark

Psychosocial Characteristics by Weight Loss and Engagement in a Digital Intervention Supporting Self-Management of Weight

Self-Reported Nutritional Factors Are Associated with Weight Loss at 18 Months in a Self-Managed Commercial Program with Food Categorization System: Observational Study

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