Web-Based and Mobile Delivery of an Episodic Future Thinking Intervention for Overweight and Obese Families: A Feasibility Study

Abstract

BackgroundThe bias toward immediate gratification is associated with maladaptive eating behaviors and has been cross-sectionally and prospectively related to obesity. Engaging in episodic future thinking, which involves mental self-projection to pre-experience future events, reduces this bias and energy intake in overweight/obese adults and children. To examine how episodic future thinking can be incorporated into clinical interventions, a Web-based system was created to provide training for adults and children in their everyday lives.ObjectiveOur study examined the technical feasibility, usability, and acceptability of a Web-based system that is accessible by mobile devices and adapts episodic future thinking for delivery in family-based obesity interventions.MethodsWe recruited 20 parent-child dyads (N=40) from the surrounding community and randomized to episodic future thinking versus a nutritional information thinking control to test the feasibility of a 4-week Web-based intervention. Parents were 44.1 (SD 7.8) years of age with BMI of 34.2 (SD 6.8) kg/m2. Children were 11.0 (SD 1.3) years of age with BMI percentile of 96.0 (SD 1.8). Families met weekly with a case manager for 4 weeks and used the system daily. Adherence was collected through the Web-based system, and perceived acceptance of the Web-based system was assessed postintervention. Measurements of body composition and dietary intake were collected at baseline and after the 4 weeks of intervention.ResultsAll 20 families completed the intervention and attended all sessions. Results showed parents and children had high adherence to the Web-based system and perceived it to be easy to use, useful, and helpful. No differences between conditions were found in adherence for parents (P=.65) or children (P=.27). In addition, results suggest that basic nutrition information along with episodic future thinking delivered through our Web-based system may reduce energy intake and weight.ConclusionsWe showed that our Web-based system is an accepted technology and a feasible utility. Furthermore, results provide initial evidence that our system can be incorporated into family-based treatments targeting behaviors related to weight control. These results show promising utility in using our Web-based system in interventions.

Think fast: rapid assessment of the effects of episodic future thinking on delay discounting in overweight/obese participants

“…Although estimates of time required for task completion could not be obtained in the present study due to constraints of the software platform (Qualtrics), prior data indicate that this task can be completed rapidly (25 s; Koffarnus & Bickel 2014), making it uniquely well suited to examine delay discounting non-intrusively and iteratively in the natural environment. The ability to measure real-time, EFT-dependent changes in delay discounting in the real world may enhance our understanding of mechanisms underlying this intervention’s effects on dietary and weight control (Sze et al 2015; O’Neill et al 2016) and other maladaptive behaviors such as alcohol use (Snider et al 2016) or cigarette smoking (Stein et al 2016). …”

“…Adapting these methods for use in natural settings has shown that EFT holds promise as a targeted weight loss treatment. For example, EFT has been used outside the laboratory to effectively reduce energy intake when administered both acutely (O’Neill et al 2016) and as part of a web-based treatment to aid in dietary and weight control (Sze et al 2015). Indeed, such covariance between EFT, delay discounting, and eating behavior further supports an etiological role of delay discounting in obesity.…”

“…Use of EFT interventions in natural treatment settings (Sze et al 2015; O’Neill et al 2016) could benefit from ecological momentary assessment of delay discounting, allowing real-time assessment of EFT-dependent changes in discounting and how these changes covary with dietary intake and other treatment-related behavior (e.g., adherence to exercise regimens). Moreover, discounting in the natural environment could be examined in the absence of EFT to identify fluctuating environmental conditions or times of day (e.g., stress, meal times) that individual participants would most benefit from enhanced self-control.…”

Efficacy of Web-Based Collection of Strength-Based Testimonials for Text Message Extension of Youth Suicide Prevention Program: Randomized Controlled Experiment

“…Public health practitioners and researchers are increasingly harnessing mobile technology to enhance the reach and effectiveness of evidence-based interventions [1-3]. Equipping members of a target population to deliver effective public health messaging to peers is an established approach in substance abuse prevention, human immunodeficiency virus prevention, and health promotion [4-7], and is promising for suicide prevention [8].…”

“…Text4Strength uses text-based peer testimonials and other types of text messages to introduce high school students to Sources of Strength concepts and extends Sources of Strength by also introducing emotional skills associated with decreased depressive symptoms and lower suicide risk [14-17]. Text messaging is a logical medium for disseminating messages because it is the dominant mode of communication for youth [18] and has strong empirical support for delivering health interventions [2,3,19-25]. The current version of Text4Strength specifically targets ninth graders because research indicates an increase in emotional and behavioral problems between ages 14 and 15, when most students are starting high school [26].…”