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Precision Public Health: Enhancing Connections to Develop Just-in-Time Adaptive Intervention Strategies (Nudge)

Primary Purpose

Overweight and Obesity, Overweight, Obesity

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Nudge
Sponsored by
University of North Carolina, Chapel Hill
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Overweight and Obesity focused on measuring Mobile health, Physical activity, Nutrition, Self-monitoring, Smartphone app, Digital health tools

Eligibility Criteria

18 Years - 35 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Age 18-35
  • BMI of 25-40 kg/m²
  • Not adhering to the US physical activity guidelines of at least 150 moderate-to-vigorous intensity activity minutes/week
  • English-speaking and writing
  • No pre-existing medical condition(s) that preclude adherence to an unsupervised exercise program, diabetes treated with insulin, history of heart attack or stroke, current treatment for cancer, or inability to walk for exercise
  • Has an iPhone with iOS 11 (or willing to download it) with internet access and text messaging plan
  • Has home wireless access compatible with Fitbit Aria 2 scale (802.11b/g/n)

Exclusion Criteria:

  • Current participation in another physical activity or weight control program
  • Currently pregnant, pregnant in last 6 months, or planning pregnancy in next 3 months
  • Report a heart condition, chest pain during periods of activity or rest, loss of consciousness, joint or bone problems, or prescription medicine usage for blood pressure or heart condition on the Physical Activity Readiness Questionnaire (PAR-Q)
  • Health or psychological diagnoses that preclude participation in a prescribed dietary and exercise program, including diagnosis of schizophrenia or bipolar disorder, hospitalization for a psychiatric diagnosis in the past year, diagnosis of alcohol or substance abuse
  • Occupation requires primarily night shift work
  • Owns and uses a physical activity tracker
  • Moving out of area in next 4 months
  • Out of town for a week or more during study period
  • Not willing to attend two study visits

Sites / Locations

  • Department of Health Behavior, University of North Carolina, Chapel Hill

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Nudge Intervention

Arm Description

Each of 7 intervention message options has specific decision rules (including weighed/not weighed and progress toward daily dietary and activity goals) that make a participant eligible to receive a specific intervention type at a specific time (decision points). At each decision point (early morning, morning, midday, and evening), the system evaluates which intervention options a participant is eligible to receive, and randomly chooses one intervention option from that list. Then the participant is randomly assigned to either receive or not receive that intervention message (with a 50-50 probability).

Outcomes

Primary Outcome Measures

Percent of person-days with same-day weighing
Percent who weighed after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Percent of person-days with next-day weighing
Percent who weighed the day after the message randomization (at the participant-day level) across the 12-week study
Percent of person-days met active minutes goal on same day
Percent who met active minutes goal after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Percent of person-days met active minutes goal on next day
Percent who met active minutes goal the day after the message randomization (at the participant-day level) across the 12-week study
Percent of person-days met red foods goal on same day
Percent who met red foods goal after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Percent of person-days met red foods goal on next day
Percent who met red foods goal the day after the message randomization (at the participant-day level) across the 12-week study

Secondary Outcome Measures

Number of active minutes
Total number of active minutes on the day of message randomization (at the participant-day level) across the 12-week study
Proximal effect of message on total red foods today
Total number of red foods on the day of message randomization (at the participant-day level) across the 12-week study
Mean weight change
Mean weight change across participants

Full Information

First Posted
February 7, 2019
Last Updated
November 11, 2019
Sponsor
University of North Carolina, Chapel Hill
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1. Study Identification

Unique Protocol Identification Number
NCT03836391
Brief Title
Precision Public Health: Enhancing Connections to Develop Just-in-Time Adaptive Intervention Strategies
Acronym
Nudge
Official Title
Precision Public Health: Enhancing Connections to Develop Just-in-Time Adaptive Intervention Strategies
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
February 12, 2019 (Actual)
Primary Completion Date
September 16, 2019 (Actual)
Study Completion Date
September 16, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of North Carolina, Chapel Hill

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this pilot study is to examine the effects of different types of just-in-time intervention messages on daily meeting dietary, activity, and weighing goals in a sample of young adults participating in a mobile-based weight loss program.
Detailed Description
Public health interventions typically rely on a set schedule of intervention delivery. Advances in technology and computer tailoring allow us to go from a "one size fits all" approach to one that uses digital health data to deliver "just-in-time adaptive interventions," or JITAIs, that can vary the timing, dose, and content of intervention messages to individuals. This pilot study is a micro-randomized trial that evaluates the effects of various intervention message options delivered in JIT moments on meeting dietary, activity, and weighing goals among young adults in a mobile-based weight loss program. The Nudge study is a 12-week mobile health weight loss program delivered via a native smartphone application. Individuals are asked to track their red foods (high-calorie, high-fat foods) in the app daily and meet their personalized red foods goal, wear a Fitbit daily and meet their daily active minutes goal, and weigh daily on their WiFi-enabled scale. Up to 4 times each day, participants are randomized to receive or not receive intervention messages in order to examine the effects of these intervention message types on meeting daily weighing goals, red food goals, and activity goals. This is a within-subjects design in which each participant serves as their own control, and data is analyzed at the person-day level.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Overweight and Obesity, Overweight, Obesity
Keywords
Mobile health, Physical activity, Nutrition, Self-monitoring, Smartphone app, Digital health tools

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Each participant-time point is randomized between intervention message or no intervention message
Masking
None (Open Label)
Allocation
N/A
Enrollment
53 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Nudge Intervention
Arm Type
Experimental
Arm Description
Each of 7 intervention message options has specific decision rules (including weighed/not weighed and progress toward daily dietary and activity goals) that make a participant eligible to receive a specific intervention type at a specific time (decision points). At each decision point (early morning, morning, midday, and evening), the system evaluates which intervention options a participant is eligible to receive, and randomly chooses one intervention option from that list. Then the participant is randomly assigned to either receive or not receive that intervention message (with a 50-50 probability).
Intervention Type
Behavioral
Intervention Name(s)
Nudge
Intervention Description
Nudge is a smartphone-app-based micro-randomized trial that tests the effect of 7 intervention message types based on behavior change techniques on daily goal attainment. Participants have three daily goals: weigh daily, red foods goal, and active minutes goal.
Primary Outcome Measure Information:
Title
Percent of person-days with same-day weighing
Description
Percent who weighed after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Percent of person-days with next-day weighing
Description
Percent who weighed the day after the message randomization (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Percent of person-days met active minutes goal on same day
Description
Percent who met active minutes goal after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Percent of person-days met active minutes goal on next day
Description
Percent who met active minutes goal the day after the message randomization (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Percent of person-days met red foods goal on same day
Description
Percent who met red foods goal after the message randomization time until the end of the day (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Percent of person-days met red foods goal on next day
Description
Percent who met red foods goal the day after the message randomization (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Secondary Outcome Measure Information:
Title
Number of active minutes
Description
Total number of active minutes on the day of message randomization (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Proximal effect of message on total red foods today
Description
Total number of red foods on the day of message randomization (at the participant-day level) across the 12-week study
Time Frame
from Baseline to Week 12
Title
Mean weight change
Description
Mean weight change across participants
Time Frame
from Baseline to Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
35 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Age 18-35 BMI of 25-40 kg/m² Not adhering to the US physical activity guidelines of at least 150 moderate-to-vigorous intensity activity minutes/week English-speaking and writing No pre-existing medical condition(s) that preclude adherence to an unsupervised exercise program, diabetes treated with insulin, history of heart attack or stroke, current treatment for cancer, or inability to walk for exercise Has an iPhone with iOS 11 (or willing to download it) with internet access and text messaging plan Has home wireless access compatible with Fitbit Aria 2 scale (802.11b/g/n) Exclusion Criteria: Current participation in another physical activity or weight control program Currently pregnant, pregnant in last 6 months, or planning pregnancy in next 3 months Report a heart condition, chest pain during periods of activity or rest, loss of consciousness, joint or bone problems, or prescription medicine usage for blood pressure or heart condition on the Physical Activity Readiness Questionnaire (PAR-Q) Health or psychological diagnoses that preclude participation in a prescribed dietary and exercise program, including diagnosis of schizophrenia or bipolar disorder, hospitalization for a psychiatric diagnosis in the past year, diagnosis of alcohol or substance abuse Occupation requires primarily night shift work Owns and uses a physical activity tracker Moving out of area in next 4 months Out of town for a week or more during study period Not willing to attend two study visits
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Deborah F Tate, PhD
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Carmina G Valle, PhD
Organizational Affiliation
University of North Carolina, Chapel Hill
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Health Behavior, University of North Carolina, Chapel Hill
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27599
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Precision Public Health: Enhancing Connections to Develop Just-in-Time Adaptive Intervention Strategies

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