Mobile Phone App for Self-Monitoring of Eating Rhythm: Field Experiment

Abstract

Background Temporal aspects of eating are an integral part of healthy eating, and regular eating has been associated with good diet quality and more successful weight control. Unfortunately, irregular eating is becoming more common. Self-monitoring of behavior has been found to be an efficient behavioral change technique, but the solution should be simple enough to ensure long-lasting adherence. Objective This study aimed to explore the influence of self-monitoring of daily eating pattern with mobile phone app on eating rhythm, eating behavior tendencies, and the underlying motives and attitudes related to eating. Methods A mobile phone app, Button, was developed for effortless self-monitoring of eating rhythm. The feasibility of the app was tested in a 30-day intervention. The participants (N=74) recorded their eating occasions during the intervention by pressing a button in the app widget. Results The average interval between meals increased (96 [SD 24] min during the first 10 days vs 109.1[SD 36.4] during the last 10 days) and the number of daily eating occasions decreased (4.9 [SD 0.9] during the first 10 days vs 4.4 [SD 0.9] during the last 10 days). The tendencies for cognitive restraint, emotional eating, and uncontrolled eating increased. Eating-related attitudes and motives remained largely unchanged. Conclusions These results indicate that a simple self-monitoring tool is able to draw a user’s attention to eating and is a potential tool to aid people to change their eating rhythm.

Smartphone-Delivered Ecological Momentary Interventions Based on Ecological Momentary Assessments to Promote Health Behaviors: Systematic Review and Adapted Checklist for Reporting Ecological Momentary Assessment and Intervention Studies

“…Sample size varied from 7-121 participants (mean 35.2, SD 33.3; 67% women). The health domains covered were: mental health [ 29 - 36 ], smoking cessation [ 37 - 39 ], and substance abuse control [ 40 - 42 ], as well as diet, weight loss, and physical activity [ 43 , 44 , 46 , 47 ]. Studies in the mental health domain mostly recruited patients from outpatient clinics diagnosed with a mental health problem (major depressive disorder [ 29 ], schizophrenia [ 34 , 36 ], bipolar disorder [ 31 ], and other conditions [ 30 , 32 , 35 ]), and only 1 study focusing on mood and anxiety management recruited participants without a diagnosis [ 33 ].…”

“…Studies on substance abuse control recruited individuals currently in treatment for an alcohol disorder from the community [ 40 ], college students with problematic drinking [ 41 ], and marijuana users from primary care clinics [ 42 ]. Finally, studies on diet, weight loss, and physical activity recruited obese individuals undergoing assessment for bariatric surgery [ 43 ], overweight or obese participants from the community [ 44 , 45 ], university students interested in well-being [ 46 ], and African American women after breast cancer treatment, recruited from the community [ 47 ].…”

“…Of the 17 studies, there were 4 (24%; 5/19, 26% papers) RCTs [ 39 , 42 , 44 , 45 , 47 ] and 12 (71%; 13/19, 68% papers) quasi-experimental studies (all with a single-arm design [ 29 - 35 , 37 , 38 , 40 , 41 , 43 , 46 ] except for one with 2 arms [ 36 ]). Of the 17 studies, participant retention was reported in 14 (82%; 16/19, 84% papers) studies, ranging from 62.1%-100% in the intervention arm [ 29 - 31 , 34 , 36 - 47 ], with 11 (65%; 13/19, 68% papers) studies having retention rates >75% [ 29 - 31 , 34 , 36 - 38 , 40 , 41 , 44 - 47 ].…”

“…In addition to user-reported EMAs, 18% (3/17) of studies also had sensor-collected data (eg, GPS and accelerometer) [ 40 , 48 , 49 ]. User-reported data collection was initiated either by the app (user would be prompted by the app to provide certain data) [ 29 , 31 , 32 , 34 - 39 , 41 - 45 ] or by the user (eg, as users saw fit; after a certain event, such as a meal) [ 29 , 30 , 33 , 37 - 41 , 44 - 46 ], sometimes with more than one modality in the same study [ 37 - 39 , 41 , 44 , 45 , 47 ]. The daily frequency of EMA prompts in app-initiated data collection was reported in 11 (65%; 13/19, 68% papers) studies [ 29 , 31 , 32 , 35 - 39 , 42 - 45 , 47 ], ranging from 2-8 times, with the most common being 4 to 5 times daily [ 29 , 32 , 37 - 39 , 42 , 43 ].…”

“…EMI characteristics were poorly reported and were not described in a standardized manner across studies, rarely detailing the decision mechanism (eg, algorithm). The EMI mechanism was not reported in 7 (41%, 8/19, 42% papers) studies [ 31 - 33 , 35 - 39 ], predetermined in 8 (47%) studies [ 30 , 34 , 40 - 43 , 46 , 47 ], and adaptive in 2 (12%; 3/19, 16% papers) studies [ 29 , 44 , 45 ]. The delivery format was in the form of text in most studies [ 29 , 31 - 34 , 36 - 45 , 47 ]; approximately 12% (2/17) of studies used tailored graphs [ 30 , 46 ], and 6% (1/17) of studies used texts and images [ 35 ].…”