Developing the "Choosing Health" Digital Weight Loss and Maintenance Intervention: Intervention Mapping Study

doi:10.2196/34089

. 2022 Oct 18;24(10):e34089.

doi: 10.2196/34089.

Developing the "Choosing Health" Digital Weight Loss and Maintenance Intervention: Intervention Mapping Study

Iga Palacz-Poborczyk^#¹, Paulina Idziak^#¹, Anna Januszewicz¹, Aleksandra Luszczynska¹, Eleanor Quested^{2

3}, Felix Naughton⁴, Martin S Hagger^{5

6}, Sherry Pagoto⁷, Peter Verboon⁸, Suzanne Robinson⁹, Dominika Kwasnicka^{1

10}

Affiliations

¹ Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.
² Physical Activity and Well-being Research Group, enAble Research Institute, Curtin University, Perth, Australia.
³ Curtin School of Population Health, Curtin University, Perth, Australia.
⁴ Behavioural and Implementation Science Research Group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
⁵ Psychological Sciences, University of California, Merced, CA, United States.
⁶ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁷ Department of Allied Health Sciences, The UConn Center for mHealth and Social Media, University of Connecticut, Storrs (Mansfield), CT, United States.
⁸ Department of Psychology and Educational Sciences, Open Universiteit Nederland, Heerlen, Netherlands.
⁹ Faculty of Health, Deakin University, Melbourne, Australia.
¹⁰ NHMRC Centre of Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

^# Contributed equally.

PMID: 36256827
PMCID: PMC9627465
DOI: 10.2196/34089

Developing the "Choosing Health" Digital Weight Loss and Maintenance Intervention: Intervention Mapping Study

Iga Palacz-Poborczyk et al. J Med Internet Res. 2022.

. 2022 Oct 18;24(10):e34089.

doi: 10.2196/34089.

Authors

Affiliations

¹ Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland.
² Physical Activity and Well-being Research Group, enAble Research Institute, Curtin University, Perth, Australia.
³ Curtin School of Population Health, Curtin University, Perth, Australia.
⁴ Behavioural and Implementation Science Research Group, School of Health Sciences, University of East Anglia, Norwich, United Kingdom.
⁵ Psychological Sciences, University of California, Merced, CA, United States.
⁶ Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
⁷ Department of Allied Health Sciences, The UConn Center for mHealth and Social Media, University of Connecticut, Storrs (Mansfield), CT, United States.
⁸ Department of Psychology and Educational Sciences, Open Universiteit Nederland, Heerlen, Netherlands.
⁹ Faculty of Health, Deakin University, Melbourne, Australia.
¹⁰ NHMRC Centre of Research Excellence in Digital Technology to Transform Chronic Disease Outcomes, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.

^# Contributed equally.

PMID: 36256827
PMCID: PMC9627465
DOI: 10.2196/34089

Abstract

Background: Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are widely accessible, personalized, and theory- and evidence-based are still limited.

Objective: This study aimed to develop a digital behavior change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and use these to provide tailored support.

Methods: We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of a logic model of the problem, a model of change, intervention design and intervention production, the implementation plan, and the evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research-including 4 focus groups (n=40), expert consultations (n=12), and interviews (n=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from a variety of relevant backgrounds (including nutrition, physical activity, and the health care sector).

Results: Following a structured process, we developed a tailored intervention that has the potential to reduce excess body weight and support behavior changes in people with overweight and obesity. The Choosing Health intervention consists of tailored, personalized text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. The intervention content includes behavior change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support, and addressing physical and psychological resources.

Conclusions: The use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of the general public, we were able to map out program facilitators and barriers while increasing the ecological validity of the program to ensure that we build an intervention that is useful, user-friendly, and informative. We also summarized the lessons learned for the Choosing Health intervention development and for other health promotion programs.

International registered report identifier (irrid): RR2-10.1136/bmjopen-2020-040183.

Keywords: Intervention Mapping; behavior change; behavior maintenance; behavioral theory; digital health; obesity; overweight; randomized controlled trial; weight loss; within-person design.

©Iga Palacz-Poborczyk, Paulina Idziak, Anna Januszewicz, Aleksandra Luszczynska, Eleanor Quested, Felix Naughton, Martin S Hagger, Sherry Pagoto, Peter Verboon, Suzanne Robinson, Dominika Kwasnicka. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 18.10.2022.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: None declared.

Cited by

The Impact of Digital Technology-Based Exercise Combined With Dietary Intervention on Body Composition in College Students With Obesity: Prospective Study.
Hu C, Lv Z, Zhu J, Lai C, Guo D, Chen M, Cheng X, Rao M, Zhou X, Su L. Hu C, et al. J Med Internet Res. 2025 Jun 2;27:e65868. doi: 10.2196/65868. J Med Internet Res. 2025. PMID: 40455565 Free PMC article.

References

1. Obesity and overweight. World Health Organization. 2021. Jun 9, [2021-08-01]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight .
1. Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VK, Mills SD, Morgan G, Morshed A, Nece PM, Pan AN, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: the Lancet commission report. Lancet. 2019 Feb 23;393(10173):791–846. doi: 10.1016/S0140-6736(18)32822-8.S0140-6736(18)32822-8 - DOI - PubMed
1. Wang J, Zhu L, Liu L, Zhao X, Zhang Z, Xue L, Yan X, Huang S, Li Y, Cheng J, Zhang B, Xu T, Li C, Ji F, Ming F, Zhao Y, Shao H, Sang D, Zhao H, Guan X, Chen X, Chen Y, Issa R, Wei J, Huang R, Zhu C, Wu C. Overweight and obesity are risk factors of severe illness in patients with COVID-19. Obesity (Silver Spring) 2020 Nov 23;28(11):2049–55. doi: 10.1002/oby.22979. https://europepmc.org/abstract/MED/32735706 - DOI - PMC - PubMed
1. Fastenau J, Kolotkin RL, Fujioka K, Alba M, Canovatchel W, Traina S. A call to action to inform patient-centred approaches to obesity management: development of a disease-illness model. Clin Obes. 2019 Jun 11;9(3):e12309. doi: 10.1111/cob.12309. https://europepmc.org/abstract/MED/30977293 - DOI - PMC - PubMed
1. Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Stefanetti R, Trenell M, Welsh P, Kean S, Ford I, McConnachie A, Sattar N, Taylor R. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018 Feb 10;391(10120):541–51. doi: 10.1016/S0140-6736(17)33102-1.S0140-6736(17)33102-1 - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

LinkOut - more resources

Full Text Sources
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

[1] Obesity and overweight. World Health Organization. 2021. Jun 9, [2021-08-01]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight .

[2] Obesity and overweight. World Health Organization. 2021. Jun 9, [2021-08-01]. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight .

[3] Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VK, Mills SD, Morgan G, Morshed A, Nece PM, Pan AN, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: the Lancet commission report. Lancet. 2019 Feb 23;393(10173):791–846. doi: 10.1016/S0140-6736(18)32822-8.S0140-6736(18)32822-8 - DOI - PubMed

[4] Swinburn BA, Kraak VI, Allender S, Atkins VJ, Baker PI, Bogard JR, Brinsden H, Calvillo A, De Schutter O, Devarajan R, Ezzati M, Friel S, Goenka S, Hammond RA, Hastings G, Hawkes C, Herrero M, Hovmand PS, Howden M, Jaacks LM, Kapetanaki AB, Kasman M, Kuhnlein HV, Kumanyika SK, Larijani B, Lobstein T, Long MW, Matsudo VK, Mills SD, Morgan G, Morshed A, Nece PM, Pan AN, Patterson DW, Sacks G, Shekar M, Simmons GL, Smit W, Tootee A, Vandevijvere S, Waterlander WE, Wolfenden L, Dietz WH. The global syndemic of obesity, undernutrition, and climate change: the Lancet commission report. Lancet. 2019 Feb 23;393(10173):791–846. doi: 10.1016/S0140-6736(18)32822-8.S0140-6736(18)32822-8 - DOI - PubMed

[5] Wang J, Zhu L, Liu L, Zhao X, Zhang Z, Xue L, Yan X, Huang S, Li Y, Cheng J, Zhang B, Xu T, Li C, Ji F, Ming F, Zhao Y, Shao H, Sang D, Zhao H, Guan X, Chen X, Chen Y, Issa R, Wei J, Huang R, Zhu C, Wu C. Overweight and obesity are risk factors of severe illness in patients with COVID-19. Obesity (Silver Spring) 2020 Nov 23;28(11):2049–55. doi: 10.1002/oby.22979. https://europepmc.org/abstract/MED/32735706 - DOI - PMC - PubMed

[6] Wang J, Zhu L, Liu L, Zhao X, Zhang Z, Xue L, Yan X, Huang S, Li Y, Cheng J, Zhang B, Xu T, Li C, Ji F, Ming F, Zhao Y, Shao H, Sang D, Zhao H, Guan X, Chen X, Chen Y, Issa R, Wei J, Huang R, Zhu C, Wu C. Overweight and obesity are risk factors of severe illness in patients with COVID-19. Obesity (Silver Spring) 2020 Nov 23;28(11):2049–55. doi: 10.1002/oby.22979. https://europepmc.org/abstract/MED/32735706 - DOI - PMC - PubMed

[7] Fastenau J, Kolotkin RL, Fujioka K, Alba M, Canovatchel W, Traina S. A call to action to inform patient-centred approaches to obesity management: development of a disease-illness model. Clin Obes. 2019 Jun 11;9(3):e12309. doi: 10.1111/cob.12309. https://europepmc.org/abstract/MED/30977293 - DOI - PMC - PubMed

[8] Fastenau J, Kolotkin RL, Fujioka K, Alba M, Canovatchel W, Traina S. A call to action to inform patient-centred approaches to obesity management: development of a disease-illness model. Clin Obes. 2019 Jun 11;9(3):e12309. doi: 10.1111/cob.12309. https://europepmc.org/abstract/MED/30977293 - DOI - PMC - PubMed

[9] Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Stefanetti R, Trenell M, Welsh P, Kean S, Ford I, McConnachie A, Sattar N, Taylor R. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018 Feb 10;391(10120):541–51. doi: 10.1016/S0140-6736(17)33102-1.S0140-6736(17)33102-1 - DOI - PubMed

[10] Lean ME, Leslie WS, Barnes AC, Brosnahan N, Thom G, McCombie L, Peters C, Zhyzhneuskaya S, Al-Mrabeh A, Hollingsworth KG, Rodrigues AM, Rehackova L, Adamson AJ, Sniehotta FF, Mathers JC, Ross HM, McIlvenna Y, Stefanetti R, Trenell M, Welsh P, Kean S, Ford I, McConnachie A, Sattar N, Taylor R. Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial. Lancet. 2018 Feb 10;391(10120):541–51. doi: 10.1016/S0140-6736(17)33102-1.S0140-6736(17)33102-1 - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Developing the "Choosing Health" Digital Weight Loss and Maintenance Intervention: Intervention Mapping Study

Affiliations

Developing the "Choosing Health" Digital Weight Loss and Maintenance Intervention: Intervention Mapping Study

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Related information

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous