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Randomized Controlled Trial
. 2020 Aug 26;17(17):6200.
doi: 10.3390/ijerph17176200.

Efficacy of a Multi-component m-Health Weight-loss Intervention in Overweight and Obese Adults: A Randomised Controlled Trial

Mitch J Duncan  1   2 , Sasha Fenton  1   2 , Wendy J Brown  3 , Clare E Collins  2   4 , Nicholas Glozier  5 , Gregory S Kolt  6 , Elizabeth G Holliday  1 , Philip J Morgan  2   7 , Beatrice Murawski  1   2 , Ronald C Plotnikoff  2   7 , Anna T Rayward  2   7 , Emmanuel Stamatakis  8 , Corneel Vandelanotte  9 , Tracy L Burrows  2   4
Affiliations
Randomized Controlled Trial

Efficacy of a Multi-component m-Health Weight-loss Intervention in Overweight and Obese Adults: A Randomised Controlled Trial

Mitch J Duncan et al. Int J Environ Res Public Health. .

Abstract

Background: This study compared the efficacy of two multi-component m-health interventions with a wait-list control group on body weight (primary outcome), and secondary outcomes of cardiovascular risk factors, lifestyle behaviours, and mental health.

Methods: Three-arm randomised controlled trial (Enhanced: physical activity, diet, sleep, Traditional: physical activity, diet, Control) with assessments conducted at baseline, 6 and 12 months. Participants (n = 116) were overweight or obese adults aged 19-65 (M = 44.5 [SD = 10.5]). The 6-month intervention was delivered via a smartphone app providing educational materials, goal-setting, self-monitoring and feedback, and also included one face-to-face dietary consultation, a Fitbit and scales. The trial was prospectively registered and conducted between May 2017 and September 2018. Group differences on primary and secondary outcomes were examined between the Pooled Intervention groups (Pooled Intervention = Enhanced and Traditional) and Control groups, and then between Enhanced and Traditional groups.

Results: Nineteen participants (16.4%) formally withdrew from the trial. Compared with the Control group, average body weight of the Pooled Intervention group did not differ at 6 (between-group difference = -0.92, (95% CI -3.33, 1.48)) or 12 months (0.00, (95% CI -2.62, 2.62)). Compared with the Control group, the Pooled Intervention group significantly increased resistance training (OR = 7.83, (95% CI 1.08, 56.63)) and reduced energy intake at 6 months (-1037.03, (-2028.84, -45.22)), and improved insomnia symptoms at 12 months (-2.59, (-4.79, -0.39)). Compared with the Traditional group, the Enhanced group had increased waist circumferences (2.69, (0.20, 5.18)) and sedentary time at 6 months (105.66, (30.83, 180.48)), and improved bed time variability at 12 months (-1.08, (-1.86, -0.29)). No other significant differences were observed between groups.

Conclusions: Relative to Controls, the Pooled Intervention groups did not differ on body weight but improved resistance training, and reduced energy intake and insomnia symptom severity. No additional weight loss was apparent when targeting improvements in physical activity, diet and sleep in combination compared with physical activity and diet.

Keywords: adult; diet; m-health; physical activity; sleep; weight loss.

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Conflict of interest statement

The authors and principal investigators of this study declare no conflict of interest.

Figures

Figure 1
Figure 1
Move, Eat and Sleep Study flow chart.
Figure 2
Figure 2
Individual weight change from baseline to 6 months by study group. (a) Control group participant change at 6 months; (b) Traditional group participant change at 6 months; (c) Enhanced group participant change at 6 months; (d) Pooled group participant change at 6 months.
Figure 2
Figure 2
Individual weight change from baseline to 6 months by study group. (a) Control group participant change at 6 months; (b) Traditional group participant change at 6 months; (c) Enhanced group participant change at 6 months; (d) Pooled group participant change at 6 months.
Figure 3
Figure 3
Proportion of Control Group and Pooled participants reporting sufficient resistance training (RT) at Baseline, 6 months and 12 months.
Figure 4
Figure 4
Frequency of weekly self-monitoring of body weight using the Balanced app by intervention participants.
Figure 5
Figure 5
Kaplan–Meier estimates of the survival distribution for time to non-usage attrition by group.
See this image and copyright information in PMC

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