使用移动医疗技术增强减肥自我监测：一项随机试验。
Using mHealth technology to enhance self-monitoring for weight loss: a randomized trial.
机构信息
Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania 15261, USA.
出版信息
Am J Prev Med. 2012 Jul;43(1):20-6. doi: 10.1016/j.amepre.2012.03.016.
BACKGROUND
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.
PURPOSE
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.
DESIGN
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.
INTERVENTION
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.
MAIN OUTCOME MEASURES
Percentage weight change at 24 months, adherence to self-monitoring over time.
RESULTS
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).
CONCLUSIONS
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.
TRIAL REGISTRATION
This study is registered at clinicaltrials.gov NCT00277771.
背景
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。
目的
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。
设计
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。
干预措施
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。
主要观察指标
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。
结果
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）。
结论
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。
试验注册
该研究在 clinicaltrials.gov 注册，NCT00277771。
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