Weight Loss and Healthy Diet Through Mobile Phone-enabled Social Interactions
Condition: Overweight; Obese
MeSH terms: Overweight; Weight Loss
Study type: Interventional

Summary: 
      A randomized controlled trial comparing the effects of the social-enabled internet weight
      loss and diet change intervention with the delayed treatment group for 3 months. We will
      study the effect of adding social interactions and supports to an Internet weight loss and
      diet change intervention. The website intervention will have action planning with social
      interactions and support features for sharing, reusing, recommending, and discussing
      strategies for improving habits. We hypothesize that the intervention group with access to
      the website will lose more weight than the delayed treatment group after three months.
    

Detailed description: 
      Over the past two decades a very simple, low-cost and consistently effective intervention has
      been developed that we believe has potential to be disseminated online in primary care. The
      intervention, "action planning" (AP), is also known as "if-then planning" or "implementation
      intentions". Action Planning is one element of the process of self-regulation (Wing et al
      2006; Luszczynska et al 2007), in which individuals identify (1) situations that challenge
      their ability to perform a behavior and (2) make a specific plan for what they will do when
      the situation is next encountered. Luszczynska and colleagues observed that adding a single
      session of action planning onto a portion-controlled meal intervention increased the weight
      lost from 2.1 kg to 4.2 kg (Luszczynska et al 2007). A meta-analysis of 94 studies using AP,
      nearly all of which included a single-dose, observed a mean effect size of Cohen's d=.65,
      consistent with a medium to large effect. Studies of repeated doses appear to have even
      greater effects (Chapman and Armitage 2010). Dr. Sciamanna recently completed a pilot
      feasibility study in which 53 subjects used an AP intervention for weight loss for 2 months.
      All subjects attended a 1-hour introductory session about the use of portion-controlled meals
      and pedometers. Subjects were then emailed one AP writing prompt each day, representing one
      of the 21 of the most common barriers to weight control (Bond et al 2001). Despite receiving
      no personalized feedback, over 2 months the subjects wrote action plans, on an average of 4.2
      days per week. After 2 months, the average weight loss was 7.7 pounds. These adherence
      levels, though short-term, are greater than typical web-based weight control interventions
      included in a recent Cochrane review (Wieland 2012). This pilot study suggests that this
      low-cost intervention approach may have unusual levels of fidelity. Even though the average
      activities of user engagement with AP is quite high in the first two months, there is a
      slight decline toward the third month. In focus group discussions after a pilot conducted by
      Dr. Sciamanna in the Philadelphia area, participants of the pilot indicated consistent
      difficulties in coming up with ideas for habits that might be useful. These observations
      motivates this proposed study.
    

Intervention name(s): Website; Usual Care
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Website will have action planning with social interactions and support features for sharing, reusing, and recommending strategies for improving habits.; Participants will record their weight and complete surveys online.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: weight loss; healthy diet; website; action planning; phone; social