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Randomized Controlled Trial
. 2020 Dec;26(4):2315-2331.
doi: 10.1177/1460458220902330. Epub 2020 Feb 6.

Refining an algorithm-powered just-in-time adaptive weight control intervention: A randomized controlled trial evaluating model performance and behavioral outcomes

Stephanie P Goldstein, J Graham Thomas  1 , Gary D Foster  2 , Gabrielle Turner-McGrievy  3 , Meghan L Butryn  4 , James D Herbert  5 , Gerald J Martin, Evan M Forman  4
Affiliations
Randomized Controlled Trial

Refining an algorithm-powered just-in-time adaptive weight control intervention: A randomized controlled trial evaluating model performance and behavioral outcomes

Stephanie P Goldstein et al. Health Informatics J. 2020 Dec.

Abstract

Suboptimal weight losses are partially attributable to lapses from a prescribed diet. We developed an app (OnTrack) that uses ecological momentary assessment to measure dietary lapses and relevant lapse triggers and provides personalized intervention using machine learning. Initially, tension between user burden and complete data was resolved by presenting a subset of lapse trigger questions per ecological momentary assessment survey. However, this produced substantial missing data, which could reduce algorithm performance. We examined the effect of more questions per ecological momentary assessment survey on algorithm performance, app utilization, and behavioral outcomes. Participants with overweight/obesity (n = 121) used a 10-week mobile weight loss program and were randomized to OnTrack-short (i.e. 8 questions/survey) or OnTrack-long (i.e. 17 questions/survey). Additional questions reduced ecological momentary assessment adherence; however, increased data completeness improved algorithm performance. There were no differences in perceived effectiveness, app utilization, or behavioral outcomes. Minimal differences in utilization and perceived effectiveness likely contributed to similar behavioral outcomes across various conditions.

Keywords: diet; mHealth; machine learning; mobile health; weight loss.

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Conflict of interest statement

Declaration of conflicting interests

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: G.D.F. reports salary support from Weight Watchers International during the conduct of the study. All other authors report no competing interests.

Figures

Figure 1.
Figure 1.
OnTrack screenshots of an EMA survey, a risk alert, and the intervention library.
Figure 2.
Figure 2.
CONSORT diagram.
Figure 3.
Figure 3.
Average proportion of completed EMA surveys over time.
Figure 4.
Figure 4.
Average proportion of opened risk alerts over time.
See this image and copyright information in PMC

References

    1. World Health Organization. Obesity and overweight, 2018, https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
    1. Norris SL, Zhang X, Avenell A, et al. Long-term effectiveness of lifestyle and behavioral weight loss interventions in adults with type 2 diabetes: a meta-analysis. Am J Med 2004; 117(10): 762–774. - PubMed
    1. Wing RR, Lang W, Wadden TA, et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care 2011; 34(7): 1481–1486. - PMC - PubMed
    1. Klem ML, Wing RR, McGuire MT, et al. A descriptive study of individuals successful at long-term maintenance of substantial weight loss. Am J Clin Nutr 1997; 66(2): 239–246. - PubMed
    1. Shick SM, Wing RR, Klem ML, et al. Persons successful at long-term weight loss and maintenance continue to consume a low-energy, low-fat diet. J Am Diet Assoc 1998; 98(4): 408–413. - PubMed

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