Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania 15261, USA.
Am J Prev Med. 2012 Jul;43(1):20-6. doi: 10.1016/j.amepre.2012.03.016.
Self-monitoring for weight loss has traditionally been performed with paper diaries. Technologic advances could reduce the burden of self-monitoring and provide feedback to enhance adherence.
To determine if self-monitoring diet using a PDA only or the PDA with daily tailored feedback (PDA+feedback [FB]), was superior to using a paper diary on weight loss and maintenance.
The Self-Monitoring and Recording Using Technology (SMART) Trial was a 24-month randomized clinical trial; participants were randomly assigned to one of three self-monitoring groups.
SETTING/PARTICIPANTS: From 2006 to 2008, a total of 210 overweight/obese adults (84.8% female, 78.1% white) were recruited from the community. Data were analyzed in 2011.
Participants received standard behavioral treatment for weight loss that included dietary and physical activity goals, encouraged the use of self-monitoring, and was delivered in group sessions.
Percentage weight change at 24 months, adherence to self-monitoring over time.
Study retention was 85.6%. The mean percentage weight loss at 24 months was not different among groups (paper diary: -1.94%, 95% CI = -3.88, 0.01; PDA: -1.38%, 95% CI= -3.38, 0.62; PDA+FB: -2.32%, 95% CI= -4.29, -0.35); only the PDA+FB group (p=0.02) demonstrated a significant loss. For adherence to self-monitoring, there was a time-by-treatment group interaction between the combined PDA groups and the paper diary group (p=0.03) but no difference between PDA and PDA+FB groups (p=0.49). Across all groups, weight loss was greater for those who were adherent ≥60% versus <30% of the time (p<0.001).
PDA+FB use resulted in a small weight loss at 24 months; PDA use resulted in greater adherence to dietary self-monitoring over time. However, for sustained weight loss, adherence to self-monitoring is more important than the method used to self-monitor. A daily feedback message delivered remotely enhanced adherence and improved weight loss, which suggests that technology can play a role in improving weight loss.
This study is registered at clinicaltrials.gov NCT00277771.
传统上，体重减轻的自我监测是通过纸质日记进行的。技术进步可以减轻自我监测的负担，并提供反馈以增强依从性。
确定仅使用 PDA 进行饮食自我监测或使用 PDA 与每日定制反馈（PDA+FB）进行自我监测是否优于使用纸质日记进行体重减轻和维持。
自我监测和使用技术记录（SMART）试验是一项为期 24 个月的随机临床试验；参与者被随机分配到三个自我监测组之一。
地点/参与者：2006 年至 2008 年，共有 210 名超重/肥胖成年人（84.8%为女性，78.1%为白人）从社区招募。数据分析于 2011 年进行。
参与者接受了标准的减肥行为治疗，包括饮食和体力活动目标，鼓励使用自我监测，并在小组会议中进行。
24 个月时体重变化百分比，随时间推移对自我监测的依从性。
研究保留率为 85.6%。24 个月时各组的平均体重减轻百分比无差异（纸质日记组：-1.94%，95%CI=-3.88，0.01；PDA 组：-1.38%，95%CI=-3.38，0.62；PDA+FB 组：-2.32%，95%CI=-4.29，-0.35）；只有 PDA+FB 组（p=0.02）表现出明显的减重。对于自我监测的依从性，在联合 PDA 组和纸质日记组之间存在时间与治疗组的交互作用（p=0.03），但 PDA 组与 PDA+FB 组之间无差异（p=0.49）。在所有组中，依从性≥60%的患者比依从性<30%的患者减重更多（p<0.001）。
PDA+FB 使用在 24 个月时导致体重减轻幅度较小；PDA 使用导致随时间推移对饮食自我监测的依从性增加。然而，对于持续的体重减轻，自我监测的依从性比用于自我监测的方法更为重要。远程传递的每日反馈消息增强了依从性并改善了体重减轻，这表明技术可以在改善体重减轻方面发挥作用。
该研究在 clinicaltrials.gov 注册，NCT00277771。
