Acceptability and feasibility of an innovative, user-friendly, interactive technology-based lifestyle intervention for weight loss

Objective : Our technology-based lifestyle intervention recently met its pre-specified primary endpoint for significant weight loss in a 6-month randomized controlled trial (1). Here we report evidence on the acceptability and feasibility of the smart lifestyle intervention, based on the retention rate, quantitative assessments of engagement with the technology-based coaching, and a questionnaire about satisfaction or dissatisfaction.

Methods: The intervention was delivered using smartphone applications (apps) and involved peer social networking and professional coaching employing behavior modification techniques delivered via group and private messaging. We incorporated shared activity data from wearable activity trackers, shared photographs of meals, daily weight data from smartscales, emoticons, and a virtual reward system for behavior modification to create an innovative, user-friendly, interactive smart lifestyle intervention. Intervention group n=13 received the intervention for 6 months, following which the wait-listed control group n=14 received the intervention for the next 6 months. 20 subjects completed an electronic questionnaire via the smartphone app after 6 months of intervention.

Results: The retention rates were 100% in the intervention group and 71.5% in the wait-listed control group. Overall retention rate for all subjects from both groups who received the intervention was 85%. We used several quantitative metrics to assess engagement with the app-based coaching.  Over the 6 months of intervention, the number of messages each subject sent per day was 0.40 ± 0.08 (95%CI 0.24 – 0.57), food photographs shared per subject per day were 0.45 ± 0.09 (95%CI 0.26 – 0.64), number of times each subject stepped on his/her smartscale per day was 0.64 ± 0.07 (95%CI 0.50 – 0.78), and the proportion of days each subject stepped on the smartscale at least once (daily weighing rate) was 0.42 ± 0.04 (95%CI 0.33 – 0.50). On the questionnaire, 70% of subjects responded that they were happy with their progress during the study, 20% were neutral, and 10% were unhappy about the progress.  75% said they enjoyed being connected to the social network, and 25% preferred to stay connected with only the professional coach.

Discussion/Conclusion: The high retention rates, high subject engagement, and overall subject satisfaction highlight the user-friendly, interactive, convenient design of our intervention. We conclude that our smart lifestyle intervention was effective, well accepted, and feasible as a means to promote weight loss during 6 months.