Using Artificial Intelligence to Optimize Delivery of Weight Loss Treatment

Study Overview
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Brief Summary
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Project ReLearn is testing the efficacy and cost-effectiveness of an Artificial Intelligence system for optimizing weight loss coaching. Participants are randomized to a 1-year weekly gold standard behavioral weight loss remote (video) group treatment or the AI-optimized treatment, which is made up of a combination of remote group treatment, short video call and automated message. In the AI-optimized condition, the system monitors outcomes (via wireless scale, mobile phone app, and wristworn tracker) and, each week, assigns each participant the treatments they have responding to the best, within certain time constraints.

Official Title
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Using Artificial Intelligence to Optimize Delivery of Weight Loss Treatment

Conditions
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Obesity, Weight Loss

Intervention / Treatment
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* Behavioral: Standard Behavioral Weight Loss Treatment
* Behavioral: AI-optimized Behavioral Weight Loss Treatment


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals must be of overweight or obese BMI (27-50 kg/m) Individuals must be adults (aged 18-70) Able and willing to engage in the remote program Able to engage in physical activity (defined as walking two city blocks without stopping) Individuals must also provide consent for the research team to contact their personal physician if necessary, to provide clearance or to consult about rapid weight loss Access and willingness to use an Apple or Android smartphone Satisfactory completion of all enrollment procedures Exclusion Criteria: Medical condition (e.g., cancer, type I diabetes, psychosis, full-threshold eating disorder) that may pose a risk to the participant during intervention or cause a change in weight Currently pregnant, breastfeeding, or planning to become pregnant in the next 12 months Recently began or changed the dosage of medication that can cause significant change in weight History of bariatric surgery Weight loss of > 5% in the previous 3 months

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 70 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: BWL-S<br>1 year of remote gold standard, small group-based behavioral weight loss treatment with an MS-level clinician. | Behavioral: Standard Behavioral Weight Loss Treatment<br>* Behavioral weight loss treatment is the current gold standard treatment for obesity.<br>|
| Experimental: BWL-AI<br>1 year of remote weight loss treatment made up of a combination of (1) remote small group-based behavioral weight loss sessions, (2) 12-minute individual video calls, (2) automated text messages. An MS-level clinician will deliver the group treatment. Most video calls will be delivered by a paraprofessional coach, but some by an MS-level clinician. Each week the AI system will select one of the interventions for each participant based on which treatment the participant has responded to the best, within certain time constraints. | Behavioral: AI-optimized Behavioral Weight Loss Treatment<br>* AI-optimized Behavioral Weight Loss Treatment will continuously vary intensity (automated text message, videoconference group, individual coaching call) and coach type (paraprofessional or MS-level expert) based on continuously-monitored participant digital data.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Weight change | Weight will be measured using the Fitbit Aria Air wireless scale, which is accurate to 0.2 kg. In order to maximize accuracy, we will (1) provide instructions (e.g., place scale on flat, hard surface; weigh upon waking, without clothes, after using the bathroom), (2) require participants to confirm that they are following instructions at each assessment point, (3) use an average of 5 consecutive daily weights for each timepoint, (4) remove errant weights (e.g., >1 kg change in 1 day). | Baseline, 1-month, 6-month, and 12-month assessment | 
| Costs | All time spent training counselors, participants and supervising counselors, will be tracked by the project coordinator, as will time counselors spend delivering individual and group treatment. The web portal will track counselor time on the portal, e.g., reviewing food records and texting. While the basic time commitments are pre-set by condition, several factors will vary including participant no-shows, participant drop-outs, and counselor adherence to time limits. | Baseline, 1-month, 6-month, and 12-month assessment | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Activity | Minutes of moderate to vigorous physical activity (MVPA) will be measured via Fitbit, a consumer-grade wrist-worn activity tracker which has superior compliance and close-to-equivalent accuracy as a research-grade accelerometer. Number of days meeting MVPA goal will be used by the AI system, with MVPA minutes as a secondary outcome. | Baseline, 1-month, 6-month, and 12-month assessment | 
| Calorie intake | Seven days of calorie intake as derived from the Fitbit app's food log will be used as a secondary outcome. Participants will already be tracking their consumption using the app because data are used by both the coaches (per standard treatment) and the AI system. | Baseline, 1-month, 6-month, and 12-month assessment | 
| Acceptability as Measured by Likert Self-report Scale | Participants will be asked to rate satisfaction with and perceived effectiveness of the program. Counselors will rate effectiveness and ease of use. | 6-month and 12-month assessment | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obesity, Weight Loss, Behavioral treatment, Artificial intelligence