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      Wearable Sensor/Device (Fitbit One) and SMS Text-Messaging Prompts to Increase Physical Activity in Overweight and Obese Adults: A Randomized Controlled Trial

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          Abstract

          Background: Studies have shown self-monitoring can modify health behaviors, including physical activity (PA). This study tested the utility of a wearable sensor/device (Fitbit ® One™; Fitbit Inc., San Francisco, CA) and short message service (SMS) text-messaging prompts to increase PA in overweight and obese adults. Materials and Methods: Sixty-seven adults wore a Fitbit One tracker for 6 weeks; half were randomized to also receive three daily SMS-based PA prompts. The Fitbit One consisted of a wearable tracker for instant feedback on performance and a Web site/mobile application (app) for detailed summaries. Outcome measures were objectively measured steps and minutes of PA by intensity using two accelerometers: Actigraph™ (Pensacola, FL) GT3X+ (primary measure) at baseline and Week 6 and Fitbit One (secondary measure) at baseline and Weeks 1, 2, 3, 4, 5, and 6. Results: Mixed-model repeated-measures analysis of primary measures indicated a significant within-group increase of +4.3 (standard error [SE]=2.0) min/week of moderate- to vigorous-intensity PA (MVPA) at 6-week follow-up ( p =0.04) in the comparison group (Fitbit only), but no study group differences across PA levels. Secondary measures indicated the SMS text-messaging effect lasted for only 1 week: the intervention group increased by +1,266 steps (SE=491; p =0.01), +17.8 min/week MVPA (SE=8.5; p =0.04), and +38.3 min/week total PA (SE=15.9; p =0.02) compared with no changes in the comparison group, and these between-group differences were significant for steps ( p =0.01), fairly/very active minutes (p <0.01), and total active minutes (p =0.02). Conclusions: These data suggest that the Fitbit One achieved a small increase in MVPA at follow-up and that the SMS-based PA prompts were insufficient in increasing PA beyond 1 week. Future studies can test this intervention in those requiring less help and/or test strategies to increase participants' engagement levels.

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          A review of eHealth interventions for physical activity and dietary behavior change.

          Gregory Norman, Marion Zabinski, Marc Adams … (2007)
          To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Systematic literature searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Articles published in scientific journals were included if they evaluated an intervention for physical activity and/or dietary behaviors, or focused on weight loss, used randomized or quasi-experimental designs, measured outcomes at baseline and a follow-up period, and included an intervention where participants interacted with some type of electronic technology either as the main intervention or an adjunct component. All studies were published between 2000 and 2005. Eighty-six publications were initially identified, of which 49 met the inclusion criteria (13 physical activity publications, 16 dietary behaviors publications, and 20 weight loss or both physical activity and diet publications), and represented 47 different studies. Studies were described on multiple dimensions, including sample characteristics, design, intervention, measures, and results. eHealth interventions were superior to comparison groups for 21 of 41 (51%) studies (3 physical activity, 7 diet, 11 weight loss/physical activity and diet). Twenty-four studies had indeterminate results, and in four studies the comparison conditions outperformed eHealth interventions. Published studies of eHealth interventions for physical activity and dietary behavior change are in their infancy. Results indicated mixed findings related to the effectiveness of eHealth interventions. Interventions that feature interactive technologies need to be refined and more rigorously evaluated to fully determine their potential as tools to facilitate health behavior change.
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            Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease.

            Shari Bassuk, JoAnn Manson (2005)
            Epidemiological studies suggest that physically active individuals have a 30-50% lower risk of developing type 2 diabetes than do sedentary persons and that physical activity confers a similar risk reduction for coronary heart disease. Risk reductions are observed with as little as 30 min of moderate-intensity activity per day. Protective mechanisms of physical activity include the regulation of body weight; the reduction of insulin resistance, hypertension, atherogenic dyslipidemia, and inflammation; and the enhancement of insulin sensitivity, glycemic control, and fibrinolytic and endothelial function. Public health initiatives promoting moderate increases in physical activity may offer the best balance between efficacy and feasibility to improve metabolic and cardiovascular health in largely sedentary populations.
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              Using Facebook and text messaging to deliver a weight loss program to college students.

              Diana Foster, Gary Bennett, K Ives … (2012)
              Between 31 and 35% of the college-aged population is overweight or obese, yet few weight loss trials for this population have been conducted. This study examined the feasibility, acceptability, and initial efficacy of a technology-based 8-week weight loss intervention among college students. Students (N = 52) were randomly assigned to one of the three arms: Facebook (n = 17); Facebook Plus text messaging and personalized feedback (n = 18); Waiting List control (n = 17), with assessments at 4 weeks and 8 weeks (post-treatment). Participants were 20.47 ± 2.19 years old, 86.45 ± 17.11 kg, with a body mass index of 31.36 ± 5.3 kg/m(2) . Participants were primarily female (86.5%), and the sample was racially diverse (57.7% Caucasian, 30.8% African American, 5.8% Hispanic, and 5.7% other races). The primary outcome was weight loss after 8 weeks (post-treatment); 96.0% of the participants completed this assessment. At 8 weeks, the Facebook Plus group had significantly greater weight loss (-2.4 ± 2.5 kg) than the Facebook (-0.63 ± 2.4 kg) and Waiting List (-0.24 ± 2.6 kg) (both Ps < 0.05). Weight change at 8 weeks was not significantly different between the Facebook and Waiting List groups. Results show preliminary efficacy and acceptability of the two active intervention arms (97.0% found the program helpful, 81.3% found the videos/handouts helpful, and 100% would recommend the program to others). Results indicate the potential for an innovative weight loss intervention that uses technology platforms (Facebook and text messaging) that are frequently used and already integrated into the cultural life of college students. Copyright © 2012 The Obesity Society.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Telemed J E Health
                Journal ID (iso-abbrev): Telemed J E Health
                Journal ID (publisher-id): tmj
                Title: Telemedicine Journal and e-Health
                Publisher: Mary Ann Liebert, Inc. (140 Huguenot Street, 3rd FloorNew Rochelle, NY 10801USA )
                ISSN (Print): 1530-5627
                ISSN (Electronic): 1556-3669
                Publication date (Print): 01 October 2015
                Volume: 21
                Issue: 10
                Pages: 782-792
                Affiliations
                [ 1 ]Moores Cancer Center, University of California , San Diego, La Jolla, California.
                [ 2 ]Graduate School of Public Health, San Diego State University , San Diego, California.
                [ 3 ]Cardiovascular Research Institute, University of California , San Francisco, California.
                [ 4 ]Center for Wireless Population Health Systems, University of California , San Diego, La Jolla, California.
                Author notes

                This study is registered at ClinicalTrials.gov with clinical trial registration number NCT02188875.

                Address correspondence to: Julie B. Wang, PhD, MPH, University of California, San Francisco 530 Parnassus Avenue, San Francisco, CA 94143-1390, E-mail: julie.wang@ 123456ucsf.edu
                Article
                Accession ID: PMC4842945 Pmcid ID: PMC4842945 Pmc-uid ID: 4842945 Publisher ID: 10.1089/tmj.2014.0176
                DOI: 10.1089/tmj.2014.0176
                PMC ID: 4842945
                PubMed ID: 26431257
                SO-VID: 67e9f681-56dc-4fbf-936e-30f6cd17e402
                Copyright © Copyright 2015, Mary Ann Liebert, Inc.
                History
                Date received : 26 August 2014
                Date revision received : 04 December 2014
                Date accepted : 04 December 2014
                Page count
                Figures: 2, Tables: 3, References: 63, Pages: 11
                Categories
                Subject: Original Research

                Keywords: e-health , behavioral health , mobile health , sensor technology , technology
                Data availability:
                Keywords: e-health , behavioral health , mobile health , sensor technology , technology

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