Title: Using Interactive Technology to Improve Health: Is Weight Loss Just a Mouse- Click Away?

approved:________________________________________________________ Donna A. Champeau Since 1980, the prevalence of obesity among U.S. adults has more than doubled, accompanied by increases in chronic conditions like heart disease and diabetes. This high prevalence and associated disease burden continues to be a threat to public health. Despite years of efforts to stem the tide of obesity, successful weight loss has proven difficult to achieve and sustain. Motivational influences behind successful weight loss are not well-understood but are believed to include factors related to social support, exercise regulation, and self-monitoring activities. Web-based approaches using interactive technology and online social networking as strategies for motivating behavior change are increasingly being used and may provide the basis for improvements in short and long term weight loss. This exploratory study examined factors associated with weight loss and health improvement in overweight adult healthcare workers who used interactive technology and online social networking (OSN) in a 6-month weight loss intervention. Participants used tracking instruments (a wireless physical activity tracker and scale) and an interactive website and online social network to monitor progress and communicate with other participants throughout the study period. Data from 168 technology-enabled participants that finished the 6-month intervention was analyzed with weight loss (% BMI change) as the primary outcome of interest. Changes in weight and cardiovascular and metabolic disease markers was assessed in the technology-enabled participants at 6 months and in a subsample of these participants (n=48) one year postintervention to examine the predictive value of demographic variables (age, gender), use of technology features (OSN, activity uploaded, weight uploads), self-reported health status, weighing frequency and physical activity habits, and perceptions of benefit from study participation on short and longer term weight loss. Single and multiple variable linear regressions indicated statistically significant greater weight loss in participants who used technology features more than those that with lower utilization during the 6-month study period. Specifically, greater utilization of physical activity and weight tracking was associated with greater weight loss, for males and females. Overall utilization of the online social network was low, but greater utilization was significantly associated with greater weight loss in males (p<0.0001). To examine longer term outcomes, t-tests were used to compare weight loss from baseline to one year post-intervention in the subsample of the 6-month technology-enabled participants. From baseline to 6-months, a mean BMI change of -3.2% was observed in the subsample (p<0.001). At one year postintervention, weight maintenance was demonstrated, with a BMI decrease of 4.7% as measured from baseline to one year post-intervention (p<0.001). Age and gender were not predictive of weight loss maintenance one year post-intervention. Correlation analyses significantly associated perceived health status and current physical activity habits with weight loss maintenance one year post-intervention. Perceptions regarding benefit from study participation were not associated with longer term weight loss. In addition, diabetes risk reduction was demonstrated in the subsample at one year postintervention as indicated by a mean decrease in HbA1c of . 10 (p<0.05) and a statistically significant proportional change (10%) in fasting blood glucose for the subsample (p<0.05). This preliminary examination of a multi-component approach to weight loss is suggestive of modest but favorable short and longer term weight loss and health improvement outcomes in overweight participants who used weight and activity tracking features as part of an interactive technology weight loss intervention. ©Copyright by Sarah K. Grall July 18, 2013 All Rights Reserved Using Interactive Technology to Improve Health: Is Weight Loss Just a Mouse-Click Away?