Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Sep 26, 2018
Date Accepted: Feb 10, 2019
(closed for review but you can still tweet)
Development of the Top Tips habit-based weight loss app and preliminary indications of its usage, effectiveness and acceptability
ABSTRACT
Background:
The Ten Top Tips (10TT) is an intervention based on habit formation theory that promotes a set of weight management behaviours alongside advice about repetition in a consistent context. Three studies have demonstrated that the 10TT can support individuals to lose weight when delivered in leaflet format. Delivery of 10TT via new technology such as a mobile app could potentially improve its effectiveness and make it more convenient, appealing, and wide-reaching.
Objective:
To develop an android app of the 10TT intervention (‘Top Tips ‘only’ app’), and a second version that included self-regulatory strategies for dealing with tempting foods (‘Top Tips ‘plus’ app’), and provide preliminary indications of their usage, effectiveness and acceptability.
Methods:
The Top Tips app was developed through an iterative process involving: i) initial development; ii) user testing and; iii) pilot testing. The 3-month pilot randomised adults with overweight or obesity to: i) Top Tips ‘only’ app; ii) Top Tips ‘plus’ app or iii) waiting list condition. Automated data from app users’ were collected. Online and validated questionnaires assessed self-regulatory skills, weight loss and behaviours at baseline and 3-months. Users’ feedback on their experience using the app was assessed using 8 open questions.
Results:
A total of 81 participants took part in the pilot; 28 were randomised to the Top Tips ‘only’ app; 27 to the Top Tips ‘plus’ app and 26 to the waiting list condition. On average participants viewed a mean of 43.4 (sd=66.9) screens, during a mean of 24.5 (sd=44.07) log-ins, and used the app for 124.2 (sd=240.2) minutes over the 3-month period. Participants randomized to the Top Tips only reported the greatest improvement in eating self-regulatory skills (M=0.59, sd=1.0), weight loss (M=-4.5, sd=5.2) and adherence to the target behaviours (M=0.59, sd=0.49), compared to the Top Tips plus (Self-regulationM=0.15, sd=0.42; weight lossM=-1.9, sd=3.9; behavioursM=0.29, sd=0.29), and waiting list condition (self-regulationM=-0.02, sd=0.29; weight lossM=-0.01, sd=0.51; behavioursM=0.08, sd=0.38). Participants who reported the largest improvements, on average, viewed pages 2 to 3 times more; had 2 to 3 times more log-ins, logged their weight 2 to 3 times more and achieved the tips more than those who reported smaller changes in these outcomes. According to users’ feedback, engagement with the app could be increased by making the app more interactive, allowing more tailoring to personal needs and including more resources for weight loss.
Conclusions:
This study suggests that the Top Tips app could potentially be a useful intervention for promoting eating self-regulatory skills, weight loss and weight management behaviours among adults with overweight or obesity. Future research should develop the app further based on user feedback and test it in larger sample sizes.
Citation
