Accepted for/Published in: JMIR Research Protocols
Date Submitted: Sep 21, 2021
Date Accepted: Sep 28, 2021
Date Submitted to PubMed: Dec 7, 2021
Optimizing Just-in-Time Adaptive Intervention to Improve Dietary Adherence in Behavioral Obesity Treatment: Study Protocol for a Micro-randomized Trial
ABSTRACT
Background:
Behavioral obesity treatment (BOT) is a gold-standard approach to weight loss and reduces risk of cardiovascular disease (CVD). However, frequent lapses from the recommended diet stymie weight losses and prevent individuals from actualizing the health benefits of BOT. There is a need for innovative treatment solutions to improve adherence to the prescribed diet in BOT.
Objective:
This study seeks to optimize a smartphone-based just-in-time adaptive intervention (JITAI) that uses daily surveys to assess triggers for dietary lapses and deliver intervention when risk for lapse is high. A micro-randomized trial (MRT) design will: 1) evaluate the efficacy of any interventions (i.e., theory-driven or a generic alert to risk) on the proximal outcome of lapse during BOT; 2) compare the effects of theory-driven interventions versus generic risk alerts on the proximal outcome of lapse; and 3) examine contextual moderators of interventions.
Methods:
Adults with overweight/obesity and CVD risk (n=159) will participate in a 6-month online BOT while using the JITAI to prevent dietary lapses. Each time the JITAI detects elevated lapse risk, the participant will be randomized to no intervention, a generic risk alert, or one of four interactive theory-driven interventions (i.e., enhanced education, building self-efficacy, fostering motivation, and improving self-regulation). The primary outcome will be the occurrence of lapse in the 2.5 hours following randomization. Contextual moderators of intervention efficacy will be also explored (e.g., location, time of day). Data will inform an optimized JITAI that selects the theory-driven approach most likely to prevent lapses in a given moment.
Results:
Recruitment for the MRT began on April 19, 2021, and is ongoing.
Conclusions:
This study will optimize a JITAI for dietary lapses so that it empirically tailors the provision of evidence-based intervention to the individual and the context. The finalized JITAI will be evaluated for efficacy in a future RCT of distal health outcomes (e.g., weight loss). Clinical Trial: NCT04784585
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