Becoming United in Lifestyle Decisions

Study Overview
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Brief Summary
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The goal of this project is to investigate how to enhance the effects of an online-only (mHealth) couples weight loss program. This study will use an innovative methodological framework, the Multiphase Optimization Strategy (MOST), to test four different strategies for weight loss and partner support in addition to a core intervention (i.e., dyadic action planning, joint feedback on goal progress, autonomy support training, and home environment modifications).

Official Title
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Optimizing a Couples-Based mHealth Intervention for Weight Management

Conditions
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Overweight and Obesity

Intervention / Treatment
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* Behavioral: Core Behavioral Weight Loss (BWL) intervention
* Behavioral: Dyadic Action Planning
* Behavioral: Joint Feedback
* Behavioral: Autonomy Support Training
* Behavioral: Home Environment Modifications


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Married/cohabitating couple - both partners must be eligible BMI between 25-55kg/m2 English speaking/reading Have a smartphone and reliable internet access Have active email address Willing to videoconference Exclusion Criteria: Report being unable to walk 2 blocks without stopping Are currently participating in weight loss treatment, have a history of bariatric surgery, or lost ≥5% in the past 6-months Are pregnant or plan to become pregnant during the study period Report chest pain or loss of consciousness on the Physical Activity Readiness Questionnaire Report a medical condition that could jeopardize their safety in a weight control program with diet and exercise guidelines Report conditions that, in the judgment of the PI, would render them unlikely to follow the protocol (e.g. dementia)

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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 |
| --- | --- |
| Experimental: Condition 1<br>1) Core BWL Intervention | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>|
| Experimental: Condition 2<br>1) Core BWL Intervention; 2) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 3<br>1) Core BWL Intervention; 2) Autonomy Support Training | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>|
| Experimental: Condition 4<br>1) Core BWL Intervention; 2) Autonomy Support Training; 3) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 5<br>1) Core BWL Intervention; 2) Joint Feedback | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>|
| Experimental: Condition 6<br>1) Core BWL Intervention; 2) Joint Feedback; 3) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 7<br>1) Core BWL Intervention; 2) Joint Feedback; 3) Autonomy Support Training | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>|
| Experimental: Condition 8<br>1) Core BWL Intervention; 2) Joint Feedback; 3) Autonomy Support Training; 4) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 9<br>1) Core BWL Intervention; 2) Dyadic Action Planning | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>|
| Experimental: Condition 10<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 11<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Autonomy Support Training | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>|
| Experimental: Condition 12<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Autonomy Support Training 4) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 13<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Joint Feedback | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>|
| Experimental: Condition 14<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Joint Feedback; 4) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|
| Experimental: Condition 15<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Joint Feedback; 4) Autonomy Support Training | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>|
| Experimental: Condition 16<br>1) Core BWL Intervention; 2) Dyadic Action Planning; 3) Joint Feedback; 4) Autonomy Support Training; 5) Home Environment Modifications | Behavioral: Core Behavioral Weight Loss (BWL) intervention<br>* Behavioral weight loss core (lessons, self weighing, self-monitoring, individual action planning, feedback and progress check ins)<br>Behavioral: Dyadic Action Planning<br>* Participants will develop dyadic action plans together.<br>Behavioral: Joint Feedback<br>* Participants will see data on their partner's progress, in addition to their own weight and behavioral data.<br>Behavioral: Autonomy Support Training<br>* Participants will receive training in how to create an autonomy supportive environment within their marriage/partnership.<br>Behavioral: Home Environment Modifications<br>* Participants will be trained in how to structure their home environment to support health behavior.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Body Weight (kg) | Weight change from baseline to 6 months. Weight will be objectively measured on a digital scale in the participant's home and weight change will be calculated. | Baseline to 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Goal Coordination (Wingrove Goal Coordination Scale) | Goal coordination (the extent to which partners integrate and align their weight management goals) will be measured with the Wingrove Goal Coordination Scale at baseline, 3, and 6 months. | Baseline, 3 months, 6 months | 
| Transactive Density | Interdependence of partners will be measured with the Inclusion of Others in the Self Scale at baseline, 3, and 6 months. | Baseline, 3 months, 6 months | 
| Shared Goal Representation | The Important Others Questionnaire will be used to capture shared goal representation at baseline, 3, and 6 months. | Baseline, 3 months, 6 months | 
| Home Food Environment (Household Food Inventory) | The home food environment will be measured with the Household Food Inventory, administered at baseline, 3, and 6 months. | Baseline, 3 months, 6 months | 
| Home Exercise Environment (Exercise Environment Questionnaire) | The home exercise environment will be measured with the Exercise Environment Questionnaire, administered at baseline, 3, and 6 months. | Baseline, 3 months, 6 months | 
| Dietary Intake | Dietary intake will be assessed at baseline and 3 months as a hypothesized behavioral mediator and at 6 months as a secondary outcome measure. | Baseline, 3 months, 6 months | 
| Physical Activity (Paffenbarger Physical Activity Questionnaire) | Physical activity will be assessed using the Paffenbarger Physical Activity Questionnaire at baseline and 3 months as a hypothesized behavioral mediator and at 6 months as a secondary outcome measure. | Baseline, 3 months, 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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couples, mobile weight loss treatment, weight control