Accepted for/Published in: JMIR Formative Research
Date Submitted: Sep 18, 2019
Date Accepted: Feb 16, 2020
Date Submitted to PubMed: Apr 29, 2020
Using the preparation phase of the Multiphase Optimization Strategy: Developing a messaging intervention component for weight loss
ABSTRACT
Background:
Mobile messaging is often used within behavioral weight loss interventions, yet varying messaging procedures (e.g., message content, delivery frequency) make it challenging to determine the most effective methods to implement. The multiphase optimization strategy is a framework that researchers can use to investigate treatment components, like mobile messaging, to optimize treatment packages.
Objective:
To describe a preparation phase process to develop a messaging intervention as a component to test as part of a weight loss treatment package in a subsequent optimization trial.
Methods:
A conceptual model was specified based on social cognitive theory and informed by previous text messaging interventions. Based on the model, a text message intervention was created and tested in the ENLIGHTEN pilot study. Adults with overweight/obesity were recruited to participate in an 8-week weight loss program. Participants received a commercially-available self-monitoring smartphone application, coaching calls, and text messages. The number and frequency of text messages sent were determined by individual preferences and weight was assessed at 8 weeks.
Results:
Participants (n=9) lost 3.2% of their initial body weight over the 8-week intervention and preferred to receive 1.8 texts/day 4.3 days/week. Researcher burden in manually sending messages was high and cost of receiving text messages were a concern. Therefore, a fully automated push notification system was developed to facilitate sending tailored daily messages to participants to support weight loss.
Conclusions:
Following the completion of specifying the conceptual model and the pilot study, the message intervention went through a final iteration. Theory and pilot study results during the preparation phase informed critical decisions about automation, frequency, triggers, and content before inclusion as a treatment component in a factorial optimization trial. Clinical Trial: ClinicalTrials.gov NCT01814072
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