Vida Health, San Francisco, CA, United States of America.
PLoS One. 2020 Apr 30;15(4):e0232221. doi: 10.1371/journal.pone.0232221. eCollection 2020.
Some guidelines state that in-person weight management interventions are more efficacious than those delivered digitally. However, digital programs are more scalable and accessible. We hypothesized that one-on-one health coaching via app-based video chat would simulate an in-person experience and help achieve outcomes comparable to those of in-person interventions.
A 12-month digital weight management intervention was provided to overweight or obese adults recruited from a large technology company. One-on-one health coaching sessions were offered during a 24-week intensive phase as well as subsequent maintenance phase. Focused on sustainable changes in activity and diet, the intervention incorporates SMART goals, in-app food and activity logs, Fitbit integration, as well as optional sleep and stress modules. Self-Determination Theory and the Transtheoretical Model are incorporated to drive behavior change. Multilevel mixed-effects models were used to analyze weight changes retrospectively.
Six hundred eighty-three participants reported 29,051 weights. At 12 months, mean percent changes in body weight were -7.2% and -7.6% for overweight and obese groups, respectively. A weight change of -5% is commonly targeted for in-person weight management interventions. Observed weight loss exceeded this target by 2.2% (95% CI, 0.7% to 3.8%; P < .01) for the overweight group and 2.6% (95% CI, 1.4% to 3.9%; P < .01) for the obese group.
Further research is needed with randomization to in-person or digital interventions. Though limited by an observational, retrospective design, preliminary results suggest that some digital weight management programs with one-on-one coaching may achieve outcomes comparable to those of robust, in-person interventions.
一些指南指出，面对面的体重管理干预比数字方式更有效。然而，数字程序更具可扩展性和可及性。我们假设通过基于应用程序的视频聊天进行一对一健康指导将模拟面对面的体验，并帮助实现与面对面干预相当的结果。
一项为期 12 个月的数字体重管理干预措施提供给从一家大型科技公司招募的超重或肥胖成年人。在 24 周的强化阶段以及随后的维持阶段提供一对一的健康指导课程。该干预措施侧重于活动和饮食的可持续变化，包括 SMART 目标、应用内食物和活动记录、Fitbit 集成以及可选的睡眠和压力模块。纳入自我决定理论和跨理论模型以推动行为改变。使用多级混合效应模型回顾性分析体重变化。
683 名参与者报告了 29051 次体重。在 12 个月时，超重组和肥胖组的体重百分比变化平均值分别为-7.2%和-7.6%。常见的目标是为面对面的体重管理干预设定体重减轻 5%。超重组观察到的体重减轻超过该目标 2.2%（95%CI，0.7%至 3.8%；P <.01），肥胖组观察到的体重减轻超过该目标 2.6%（95%CI，1.4%至 3.9%；P <.01）。
需要进一步进行随机分组到面对面或数字干预的研究。虽然受到观察性、回顾性设计的限制，但初步结果表明，一些具有一对一指导的数字体重管理计划可能会取得与强大的面对面干预相当的结果。
