A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional
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28 Journal Watch Journal Watch A quick look at the noteworthy articles in bariatric and metabolic research WEIGHT LOSS AND TECHNOLOGY Randomized controlled pilot study testing use of smartphone technology for obesity treatment. Allen JK, Stephens J, Dennison Himmelfarb CR, Stewart KJ, Hauck S. J Obes. 2013;2013:151597. Synopsis: The established interventions for weight loss are resource intensive which can create barriers for full participation and ultimate translation. The major goal of this pilot study was to evaluate the feasibility, acceptability, and preliminary efficacy of theoretically based behavioral interventions delivered by smartphone technology. The study randomized 68 obese adults to receive one of four interventions for six months: 1) intensive counseling intervention, 2) intensive counseling plus smartphone intervention, 3) a less intensive counseling plus smartphone intervention, and 4) smartphone intervention only. The outcome measures of weight, BMI, waist circumference, and self-reported dietary intake and physical activity were assessed at baseline and six months. The sample was comprised of 78 percent female and 49 percent African American participants, with an average age of 45 years, and average BMI of 34.3kg/m2. There were trends for differences in weight loss among the four intervention groups. Participants in the intensive counseling plus self-monitoring smartphone group and less intensive counseling plus self-monitoring smartphone group tended to lose more weight than other groups (5.4kg and 3.3kg, respectively). The results of this pilot trial of a weight loss intervention provide preliminary support for using a smartphone application for self-monitoring as an adjunct to behavioral counseling. PMID: 24392223 Successful weight loss: how information technology is used to lose. Shigaki CL, Koopman RJ, Kabel A, Canfield S. Telemed J E Health. 2013 Dec 4. [Epub ahead of print] Synopsis: Commercial producers have outpaced traditional academic healthcare in terms of novel repackaging of traditional approaches to weight control for online delivery. Little is known, however, about consumers' experiences with such products and services. We explored ways that people use information technology (IT) to facilitate healthrelated behavioral change. Qualitative methods and grounded theory methodology were used to analyze transcripts of audiotaped material from three focus groups, each with 12 participants. Participants were recruited from an ongoing, community-wide weight-loss event, who reported regular or frequent use of IT. Results: Participants frequently used IT applications for completing functional tasks associated with weight loss. In contrast, most participants preferred in-person social support. IT applications facilitated integration of behavior change tasks into everyday life. Despite easy access to a range of social networking websites and tools, however, having access to in-person social support was targeted as critical to successful weight loss and well-being. To this end, the role of work peers and work environments was emphasized by these participants. Conclusions: In terms of patient care, successful health portals may benefit from either developing or integrating existing IT applications that save time and/or provide users with visual feedback on progress toward goals. IT-delivered resources would likely optimize community-based behavioral health interventions that target naturally Bariatric Times • January 2014 occurring social groups. PMID: 24303931 Text messaging as adjunct to community-based weight management program. Bouhaidar CM, DeShazo JP, Puri P, Gray P, Robins JL, Salyer J. Comput Inform Nurs. 2013;31(10):469–476. Synopsis: Increasing obesity rates are still a public health priority. The primary aim of this study was to evaluate the effect of tailored text messages on body weight change in overweight and obese adults in a community-based weight management program. A secondary aim was to detect behavioral changes in the same population. The study design was quasi-experimental with pretest and posttest analysis, conducted over 12 weeks. A total of 28 participants were included in the analysis. Body weight, eating behaviors, exercise and nutrition self-efficacy, attitude toward mobile technology, social support, and physical activity were assessed at baseline and at 12 weeks. Text messages were sent biweekly to the intervention but not to the control group. At 12 weeks, the intervention group had lost significant weight as compared with the control group. There was a trend toward an improvement in eating behaviors, exercise, and nutrition self-efficacy in the intervention group, with no significant difference between groups. A total of 79 percent of participants stated that text messages helped in adopting healthy behaviors. Tailored text messages appear to enhance weight loss in a weight management program at a community setting. Large-scale and long-term intervention studies are needed to confirm these findings. PMID: 24141325 Evidence-based strategies in weight-loss mobile apps. Pagoto S, Schneider K, Jojic M, DeBiasse M, Mann D. Am J Prev Med. 2013;45(5):576–582. Synopsis: The primary aims of the study were to determine the degree to which commercial weight-loss mobile apps include the behavioral strategies included in evidence-based weightloss interventions, and to identify features that enhance behavioral strategies via technology. Thirty weight-loss mobile apps, available on iPhone and/or Android platforms, were coded for whether they included any of 20 behavioral strategies derived from an evidence-based weight-loss program (i.e., Diabetes Prevention Program). Data on available apps were collected in January 2012; data were analyzed in June 2012. The apps included on average 18.83 percent (SD=13.24; range=0%-65%) of the 20 strategies. Seven of the strategies were not found in any app. The most common technology-enhanced features were barcode scanners (56.7%) and a social network (46.7%). The researchers concluded that weight-loss mobile apps typically included only a minority of the behavioral strategies found in evidence-based weight-loss interventions. Behavioral strategies that help improve motivation, reduce stress, and assist with problem solving were missing across apps. Inclusion of additional strategies could make apps more helpful to users who have motivational challenges. PMID: 24139770 The effectiveness of telemedicine for weight management in the MOVE! Program. Ahrendt AD, Kattelmann KK, Rector TS, Maddox DA. J Rural Health. 2014;30(1):113–119. Synopsis: This retrospective cohort study was conducted by extraction of data from medical records for the years 2008 to 2010. The treatment included a series of 12 weekly MOVE!® classes delivered using videoconferencing. Data were extracted from the time of baseline weight to 1 year after baseline weight for the MOVE! participants (n= 60) and from a concurrent control group (n= 60) that did not participate in MOVE! treatment. Results indicated that the MOVE! group lost weight while the control group gained weight, resulting in a mean difference between the groups of -5.5±2.7 kg (95%CI= -8.0 to -3.0; P<0.0001). These results indicate that videoconferencing is an effective method to provide the MOVE! Weight Management Program to veterans. Weight loss was maintained for one year after baseline in the MOVE! group. The authors concluded that this is very promising as weight regain is a common issue and these results support using videoconferencing for a long-term weight management treatment option. PMID: 24112223 Measurement of self-monitoring web technology acceptance and use in an e-health weight-loss trial. Ma J, Xiao L, Blonstein AC. Telemed J E Health. 2013;19(10):739–745. Synopsis: The authors examined eight theoretical constructs about technology acceptance using adapted 5-point Likert scales and the association of measured website usage and weight loss. All scales had high internal consistency. The adapted acceptance measures showed acceptable psychometric properties and significant associations with actual web site use, which correlated with weight loss. The authors concluded that better understanding of technology acceptance and use in e-health weight-loss interventions may improve participant adherence and outcome. PMID: 23952787