Systematic development of a text-driven and a video-driven web-based computer-tailored obesity prevention intervention

Abstract

BackgroundThis paper describes the systematic development of a text-driven and a video-driven web-based computer-tailored intervention aimed to prevent obesity among normal weight and overweight adults. We hypothesize that the video-driven intervention will be more effective and appealing for individuals with a low level of education.Methods and DesignThe Intervention Mapping protocol was used to develop the interventions, which have exactly the same educational content but differ in the format in which the information is delivered. One intervention is fully text-based, while in the other intervention in addition to text-based feedback, the core messages are provided by means of videos. The aim of the interventions is to prevent weight gain or achieve modest weight loss by making small changes in dietary intake or physical activity. The content of the interventions is based on the I-Change Model and self-regulation theories and includes behavior change methods such as consciousness raising, tailored feedback on behavior and cognitions, goal setting, action and coping planning, and evaluation of goal pursuit. The interventions consist of six sessions. In the first two sessions, participants will set weight and behavioral change goals and form plans for specific actions to achieve the desired goals. In the remaining four sessions, participants’ will evaluate their progress toward achievement of the behavioral and weight goals. They will also receive personalized feedback on how to deal with difficulties they may encounter, including the opportunity to make coping plans and the possibility to learn from experiences of others. The efficacy and appreciation of the interventions will be examined by means of a three-group randomized controlled trial using a waiting list control group. Measurements will take place at baseline and six and twelve months after baseline. Primary outcome measures are body mass index, physical activity, and dietary intake.DiscussionThe present paper provides insight into how web-based computer-tailored obesity prevention interventions consisting of self-regulation concepts and text-driven and video-driven messages can be developed systematically. The evaluation of the interventions will provide insight into their efficacy and will result in recommendations for future web-based computer-tailored interventions and the additional value of using video tailoring.Trial registrationNTR3501.

Innovative video tailoring for dietary change: final results of the Good for you! cluster randomized trial

“…No other studies to date have examined the effectiveness of tailored video for improving dietary habits. A colleague did use our tailored video approach for medication adherence with older adults and found that it was feasible and well-liked by patients, [ 42 ] and several other studies are exploring video tailoring as components of web-based interventions, [ 26 , 43 ] or computer touch screen interventions in physician offices, [ 44 ] but effectiveness of tailored video in dietary behavior change has not yet been reported. There have been studies of tailored internet interventions some of which have included video [ 45 – 49 ].…”

“…A smoking cessation intervention found that tailored video messages on the phone were more successful than tailored text or general text messages in smoking cessation especially in smokers with lower readiness to quit [ 60 ]. Several studies are also exploring the impact of video games on behavior modification using “serious video games” [ 43 , 61 , 62 ] and propose that tailoring in video gameplay has the potential to increase attention and subsequently increase positive behavior change [ 61 , 63 ]. Further research is needed on these interventions.…”

Rationale, design and baseline characteristics of a randomized controlled trial of a web-based computer-tailored physical activity intervention for adults from Quebec City

“…Hence, there is a need to focus interventions on these people in particular. As hypothesized by Walthouwer et al [ 27 ], a video intervention might be more appealing and effective for people with a low educational level. Based on the principles of the Elaboration Likelihood Model [ 9 ] and the I-Change Model [ 8 ], it can be reasoned that the use of online video information may increase attention, comprehension and appraisal better than traditional text-based approaches among people with lower levels of education.…”

“…Participants’ PA level will be assessed using a validated questionnaire [ 39 ]. The psychosocial determinants of the I-Change Model related to PA (intention, attitude, social influences, self-efficacy) will be assessed on a 7-point Likert scale [ 27 ]. The 3-month follow-up questionnaire consists of PA level reassessment as well as two I-Change Model variables, intention and self-efficacy.…”

Expert Panel Consensus for and Analysis of Key Attributes on Websites Devoted to Weight Control

“…Derived from the principles of learning theory and cognitive and behavioral counseling, behavioral weight control strategies assume that behaviors such as eating and exercise are learned (have a learned components) and thus can also be unlearned or modified. 4,29 The most frequently incorporated strategies included self-monitoring, such as dietary/physical activity logs and daily weight tracking 29 ; cognitive restructuring to recognize and change thinking patterns, such as nonrecognition of satiety, overeating, and dissatisfaction or distortions of body image 30 ; motivational techniques, such as cues to perform healthy behaviors 31,32 ; feedback and personalization (tailoring) 12,13,19,[33][34][35] ; and coping techniques to replace emotional eating or deal with discouragement. 18 Over the last decade, there has been unprecedented interest in obesity management.…”