Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial

Overview

Journal JMIR Res Protoc

Publisher JMIR Publications

Specialty General Medicine

Date 2019 Feb 26

PMID 30801257

Citations 7

Authors

Rhiannon E Halse

Charlene L Shoneye

Christina M Pollard

Jonine Jancey

Jane A Scott

Iain S Pratt

Satvinder S Dhaliwal

Richard Norman

Leon M Straker

Carol J Boushey

Edward J Delp

Fengqing Zhu

Amelia J Harray

Maria A Szybiak

Anne Finch

Joanne A McVeigh

Barbara Mullan

Clare E Collins

Syed Aqif Mukhtar

Kieran N Edwards

Janelle D Healy

Deborah A Kerr

Affiliations

Soon will be listed here.

Abstract

Background: Excess weight is a major risk factor for chronic diseases. In Australia, over 60% of adults are overweight or obese. The overconsumption of energy-dense nutrient-poor (EDNP) foods and low physical activity (PA) levels are key factors contributing to population obesity. New cost-effective approaches to improve population diet and PA behaviors are needed.

Objective: This 1-year randomized controlled trial (6-month intervention and 6-month follow-up) aims to investigate whether a tailored intervention using mobile technology can improve diet and PA behaviors leading to weight loss in adults (aged 18-65 years) who are overweight or obese and recruited through a social marketing campaign (LiveLighter).

Methods: All eligible participants will provide data on demographics and lifestyle behaviors online at baseline, 6 months, and 12 months. Using two-stage randomization, participants will be allocated into one of three conditions (n=200 per group): tailored feedback delivered via email at seven time points, informed by objective dietary (mobile food record app) and activity (wearable activity monitor) assessment; active control receiving no tailored feedback, but undergoing the same objective assessments as tailored feedback; and online control receiving no tailored feedback or objective assessments. Primary outcome measures at 6 and 12 months are changes in body mass, EDNP food and beverage consumption, and daily moderate-to-vigorous PA (measured via accelerometry). Secondary outcomes include change in fruit and vegetable consumption, daily sedentary behaviors, and cost effectiveness.

Results: Enrolment commenced in August 2017. Primary outcomes at 12 months will be available for analysis from September 2019.

Conclusions: Tailored email feedback provided to individuals may deliver a cost-effective strategy to overcome existing barriers to improving diet and PA. If found to be successful and cost effective, upscaling this intervention for inclusion in larger-scale interventions is highly feasible.

Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12617000554369; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=371325&isReview=true.

International Registered Report Identifier (irrid): DERR1-10.2196/12782.

Citing Articles

Mobile health (m-health) smartphone interventions for adolescents and adults with overweight or obesity.

Metzendorf M, Wieland L, Richter B Cochrane Database Syst Rev. 2024; 2:CD013591.

PMID: 38375882 PMC: 10877670. DOI: 10.1002/14651858.CD013591.pub2.

Health and sustainability co-benefits of eating behaviors: Towards a science of dietary eco-wellness.

Barrett B Prev Med Rep. 2022; 28:101878.

PMID: 35832638 PMC: 9272027. DOI: 10.1016/j.pmedr.2022.101878.

Demographic and psychosocial correlates of measurement error and reactivity bias in a four-day image-based mobile food record among adults with overweight and obesity.

Whitton C, Healy J, Dhaliwal S, Shoneye C, Harray A, Mullan B Br J Nutr. 2022; :1-39.

PMID: 35587722 PMC: 9899562. DOI: 10.1017/S0007114522001532.

Systematic review of process evaluations of interventions in trials investigating sedentary behaviour in adults.

Johansson J, Lam N, Ozer S, Hall J, Morton S, English C BMJ Open. 2022; 12(1):e053945.

PMID: 35105631 PMC: 8804646. DOI: 10.1136/bmjopen-2021-053945.

A Modern Flexitarian Dietary Intervention Incorporating Web-Based Nutrition Education in Healthy Young Adults: Protocol for a Randomized Controlled Trial.

Braakhuis A, Gillies N, Worthington A, Knowles S, Conner T, Roy R JMIR Res Protoc. 2021; 10(12):e30909.

PMID: 34931994 PMC: 8734916. DOI: 10.2196/30909.

References

Stunkard A, Messick S . The three-factor eating questionnaire to measure dietary restraint, disinhibition and hunger. J Psychosom Res. 1985; 29(1):71-83. DOI: 10.1016/0022-3999(85)90010-8. View

Hands B, Chivers P, Parker H, Beilin L, Kendall G, Larkin D . The associations between physical activity, screen time and weight from 6 to 14 yrs: the Raine Study. J Sci Med Sport. 2011; 14(5):397-403. DOI: 10.1016/j.jsams.2011.03.011. View

Kroeze W, Werkman A, Brug J . A systematic review of randomized trials on the effectiveness of computer-tailored education on physical activity and dietary behaviors. Ann Behav Med. 2006; 31(3):205-23. DOI: 10.1207/s15324796abm3103_2. View

Khaylis A, Yiaslas T, Bergstrom J, Gore-Felton C . A review of efficacious technology-based weight-loss interventions: five key components. Telemed J E Health. 2010; 16(9):931-8. PMC: 3000900. DOI: 10.1089/tmj.2010.0065. View

Boushey C, Harray A, Kerr D, Schap T, Paterson S, Aflague T . How willing are adolescents to record their dietary intake? The mobile food record. JMIR Mhealth Uhealth. 2015; 3(2):e47. PMC: 4464313. DOI: 10.2196/mhealth.4087. View

Pollard C, Howat P, Pratt I, Boushey C, Delp E, Kerr D . Preferred Tone of Nutrition Text Messages for Young Adults: Focus Group Testing. JMIR Mhealth Uhealth. 2016; 4(1):e1. PMC: 4738180. DOI: 10.2196/mhealth.4764. View

Straker L, Howie E, Smith K, Fenner A, Kerr D, Olds T . The impact of Curtin University's activity, food and attitudes program on physical activity, sedentary time and fruit, vegetable and junk food consumption among overweight and obese adolescents: a waitlist controlled trial. PLoS One. 2014; 9(11):e111954. PMC: 4222962. DOI: 10.1371/journal.pone.0111954. View

Rabin R, de Charro F . EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001; 33(5):337-43. DOI: 10.3109/07853890109002087. View

Norman R, Cronin P, Viney R . A pilot discrete choice experiment to explore preferences for EQ-5D-5L health states. Appl Health Econ Health Policy. 2013; 11(3):287-98. DOI: 10.1007/s40258-013-0035-z. View

10.

Teixeira P, Palmeira A, Vansteenkiste M . The role of self-determination theory and motivational interviewing in behavioral nutrition, physical activity, and health: an introduction to the IJBNPA special series. Int J Behav Nutr Phys Act. 2012; 9:17. PMC: 3330013. DOI: 10.1186/1479-5868-9-17. View

11.

Marlowe D, CROWNE D . Social desirability and response to perceived situational demands. J Consult Psychol. 1961; 25:109-15. DOI: 10.1037/h0041627. View

12.

Hawkins R, Kreuter M, Resnicow K, Fishbein M, Dijkstra A . Understanding tailoring in communicating about health. Health Educ Res. 2008; 23(3):454-66. PMC: 3171505. DOI: 10.1093/her/cyn004. View

13.

Myers V, McVay M, Champagne C, Hollis J, Coughlin J, Funk K . Weight loss history as a predictor of weight loss: results from Phase I of the weight loss maintenance trial. J Behav Med. 2012; 36(6):574-82. PMC: 3619009. DOI: 10.1007/s10865-012-9450-0. View

14.

Broekhuizen K, Kroeze W, Van Poppel M, Oenema A, Brug J . A systematic review of randomized controlled trials on the effectiveness of computer-tailored physical activity and dietary behavior promotion programs: an update. Ann Behav Med. 2012; 44(2):259-86. PMC: 3442159. DOI: 10.1007/s12160-012-9384-3. View

15.

Collins C, Boggess M, Watson J, Guest M, Duncanson K, Pezdirc K . Reproducibility and comparative validity of a food frequency questionnaire for Australian adults. Clin Nutr. 2013; 33(5):906-14. DOI: 10.1016/j.clnu.2013.09.015. View

16.

Michie S, Abraham C, Eccles M, Francis J, Hardeman W, Johnston M . Strengthening evaluation and implementation by specifying components of behaviour change interventions: a study protocol. Implement Sci. 2011; 6:10. PMC: 3041694. DOI: 10.1186/1748-5908-6-10. View

17.

Glanz K, Brug J, van Assema P . Are awareness of dietary fat intake and actual fat consumption associated?--a Dutch-American comparison. Eur J Clin Nutr. 1997; 51(8):542-7. DOI: 10.1038/sj.ejcn.1600442. View

18.

Kerr D, Harray A, Pollard C, Dhaliwal S, Delp E, Howat P . The connecting health and technology study: a 6-month randomized controlled trial to improve nutrition behaviours using a mobile food record and text messaging support in young adults. Int J Behav Nutr Phys Act. 2016; 13:52. PMC: 4839101. DOI: 10.1186/s12966-016-0376-8. View

19.

Rikli R . Reliability, validity, and methodological issues in assessing physical activity in older adults. Res Q Exerc Sport. 2000; 71(2 Suppl):S89-96. View

20.

Craig C, Marshall A, Sjostrom M, Bauman A, Booth M, Ainsworth B . International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003; 35(8):1381-95. DOI: 10.1249/01.MSS.0000078924.61453.FB. View