A Social-networking-site(SNS) Based Weight Loss Behavior Intervention- the Effect of Social Network and Multi-level Factors on Weight Loss
Condition: Weight Loss
MeSH terms: Body Weight; Weight Loss
Study type: Interventional

Summary: 
      In this project, investigators plan to conduct a randomized control trial of a weight loss
      intervention that is remotely delivered via SNS among the obese adult patients (20-64 years
      old, BMI ≥ 27 kg/m2) recruited from weight control clinic in a tertiary medical center in
      Taipei. Investigators will survey the participants' baseline characteristics at different
      dimensions including personal, behavioral, physiological, socio-environmental factors.
      Participants will be randomly assigned to a 16-week weight loss program of either enhanced
      intervention via Facebook group or standard intervention. After the intervention, the
      participants will be followed until 2 years after enrollment. Investigators will measure
      participants' change in weight as well as change in attitude, behavior, and physiological
      along the follow-up periods. Investigators proposed specific study aims as following: (1)
      Demonstrate the characteristics of the obese patient who visiting weight-control clinics at
      behavioral level, physiological level, and social level. (2) Implement an enhanced weight
      loss intervention by using SNS with personalized feedback (3) Investigate the social
      influence and the interaction between participants in the social networking site (4) Test the
      hypothesis that, compared with a standard behavioral weight loss intervention, the enhanced
      intervention would result in greater weight loss and physical benefit (5) Test the hypothesis
      that, the enhanced intervention would result in improvement on heath attitude, literacy, or
      behavior and minimize the attrition of weight loss program (6) Explore the trajectory of
      individual characteristics throughout the treatment course (7) Explore the predictor or
      correlate of successful weight loss, maintenance and attrition (8) Investigate the
      interrelationship between different behavioral, physiological, and environmental factors and
      their composite effect on weight loss (9) Refine the intervention and develop a further
      effective and individualized behavior intervention for weight loss
    

Detailed description: 
      Obesity with its increasing prevalence has become a global health problem. Even modest weight
      loss induced by lifestyle intervention can produce clinically meaningful health benefits,
      however, most participants in the weight loss program fail in the longer term because of poor
      adherence and easy weight regain. An effective behavior therapy for weight loss is believed
      to have two core elements: (1) a convenient program focusing on individual response and
      variability, and (2) a better understanding of the predictors and correlates of weight loss
      outcome. Nowadays, the internet-based program featured with dynamic materials and
      personalized feedback has been utilized as a novel tool for weight loss. Besides, social
      networking site (SNS), such as Facebook, is a web-based platform for interaction. Increasing
      evidence demonstrated interventions through SNSs had substantial potentials on social
      influence and health behavior change. Research about the effectiveness of weight loss
      intervention via SNSs has gained much concern in recent years. Predictions of weight loss
      outcome based on personal characteristics are under investigation for several decades.
      Identifying predictors or correlates to weight loss outcome can help optimize the efficacy of
      the program through a better matching of intervention. Because weight loss is a is a dynamic
      and complex process encompassing interaction of behavioral, physiological and
      socio-environmental factors, a multi-factorial approach is required for research design. n
      this 3-year study project, investigators plan to conduct a pilot randomized control trial of
      a 2-year weight loss intervention that is remotely delivered via social networking site among
      the obese adult participants (20-64 years old, BMI ≥ 27 kg/m2) recruited from weight control
      clinic in medical center in Taipei, Taiwan. Investigators will survey the participants'
      baseline characteristics at different dimensions including personal, behavioral,
      physiological, social and environmental factors. Participants will be randomly assigned to a
      16-week weight loss program of either enhanced intervention via Facebook or standard
      intervention. After the intervention, the participants will be followed for another 1 year
      and 8 months. The change in weight will be measured at 6 months, 12 months and 24 months
      after enrollment. Participants' change in attitude, behavior, and physiological condition
      will also be measured along the follow-up so that investigators can demonstrate the
      trajectory and interaction of different variables along the weight loss process. With this
      3-year project, investigators not only assess the efficacy of this pilot weight loss program
      in Taiwan, but investigators also explore the possible predictors and correlates of
      successful weight loss.
    

Intervention name(s): Enhanced intervention via social networking site (SNS); Standard intervention
Intervention type(s): Behavioral; Behavioral
Intervention description(s): We plan to organize a private Facebook group serve as platform to provide the intervention content. To ensure confidentiality, this Facebook group is completely private and the group member is invited only by study staff. The participants of intervention group received information about the private Facebook group and privacy settings and were instructed to join the Facebook group. The intervention comprises three parts. Doctor patient interaction: The interventionist (physicians and dietitians) act as health coach will provide evidence-based topics related to weight loss on Facebook discussion board every two weeks; In the session, the participants are instructed by an interventionist to have a reduced calorie diet and regular physical activity. Calorie intake was prescribed based on baseline weight at 1200 kcal/d for individuals who weighed less than 90 kg, 1500 kcal/d for those who weighed 90 to less than 115 kg, and 1800 kcal/d for those who weighed 115kg or more. The interventionist will give each participants dietary recommendation and sample meal plans are provided to facilitate adoption. The interventionist will prescribe non-supervised moderate-to-vigorous physical activity to participants. Participants should start moderate-to-vigorous physical activity at 100 minutes per week and increased at 4-week intervals until a prescription of 300 minutes per week was achieved
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment