Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 29, 2019
Date Accepted: Jul 7, 2020
User experiences of a smartphone based attentive eating application and their association with diet and weight loss outcomes: Thematic and exploratory analyses from a randomised controlled trial.
ABSTRACT
Background:
Short-term laboratory studies suggest that eating attentively can reduce food intake. However, in a recent randomised controlled trial we found no evidence that using an attentive eating smartphone application outside of the laboratory had an effect on energy intake or weight loss over 8 weeks.
Objective:
The present research examined trial participants’ experiences of using an attentive eating smartphone application and whether application usage is associated with energy intake and weight loss outcomes over 8 weeks.
Methods:
We conducted thematic analysis of semi-structured interviews (N=38) among participants in the attentive eating smartphone application group of the trial who completed the 8-week assessment. Linear regression models examined the associations between energy intake and weight loss outcomes at 8 weeks and application usage.
Results:
Participants reported several barriers and facilitators to using the smartphone application, including repetition of app content, social setting, motivation and habitual use of the application. Participants believed that using the application had some beneficial effects on their eating behavior and diet. Exploratory analyses indicated that more frequently recording eating episodes in the application was associated with greater weight loss (B = -0.02, p = 0.004), and greater self-reported energy intake (B = 5.98, p = 0.010), but not body fat percentage or taste-test energy intake. Total audio clip plays, gallery views and percentage of food entries recorded using an image were not significantly associated with reductions in energy intake or weight loss.
Conclusions:
Frequent recording of eating episodes in a smartphone application was associated with greater weight loss. There are barriers and facilitators to frequent use of an attentive eating smartphone application which may be useful to address when designing dietary behavior change smartphone applications. Clinical Trial: ClinicalTrials.gov, NCT03602001. Registered retrospectively on 26th July 2018. Prospectively registered on the Open Science Framework on 11th August 2017, DOI 10.17605/osf.io/btzhw
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