Habit App Pre-Pilot (BHT-OWL)

Building Habits Together: Feasibility Trial of an Integrated Mobile and Social Network Weight Loss Intervention

The purpose of this 6 week single-arm pilot is to evaluate the feasibility of the Habit app plus Facebook group intervention in 20 adults with obesity. Participants will participate in a 6-week version of the intervention which involves receiving a feed based on the Diabetes Prevention Program in a private Facebook group, access to a professional weight loss counselor in the Facebook group, MyFitnessPal, and the Habit app.

The purpose of this single-arm pilot is to evaluate the feasibility of the intervention in 20 adults with obesity. We define feasibility as use of the mobile app features (dietary self-monitoring, slip tracker, and problem sharing/solving), retention, engagement (overall, problem solving), acceptability, and burden. This study will give us information that we can use to modify the intervention and our procedures before the larger pilot study. We will enroll 20 adults with obesity to participate in the 6-week pilot. Eligible participants will receive a link to complete surveys, mailed a wifi scale, and asked to provide staff with login information for the scale so weight can be recorded during assessments. They will then have a 60-minute call with a counselor to 1) download and receive training on program technology (MyFitnessPal, Habit app, and Fitbit scale) and 2) be entered into the Facebook group. Participants will participate in a 6-week version of the intervention which involves receiving a feed based on the Diabetes Prevention Program in a private Facebook group, access to a professional weight loss counselor in the Facebook group, MyFitnessPal, and the Habit app. Every Monday in the group, participants will be given one diet and one exercise goal for the week and every Sunday they will be asked to share their progress on those goals. Every Friday they will participate in a "weigh in" thread in the group. In addition to the group, for the first two weeks, participants will be asked to use MyFitnessPal; for the second two weeks, they will be asked to use the Temptation/Slip Tracker and Exercise Planner; and for the final two weeks they will be asked to use the Problem Solver. We will ask each participant to share at least one diet or exercise problem with the group over the 6 weeks and to participate in each other's problem solving posts. Participants may attend optional weekly breakout sessions where weight loss related problems will be discussed. On the final day of the intervention, a post will go up in the group asking for a volunteer who used the app enough to brainstorm how to improve it to participate in a team meeting to discuss how to improve the program. If more than one participant volunteers, one will be randomly selected to participate. After the 6-week intervention, participants will complete the weight loss problem solving skills survey, provide a final weight, and complete individual phone interviews to discuss their experience. We will convene a team meeting with the investigators, interventionists, and a participant to discuss the results and any modifications that should be made to the program before progressing to the pilot study.

The intervention includes: the Facebook-delivered Diabetes Prevention Program (DPP) Lifestyle Intervention, MyFitnessPal and the Habit app. The DPP will be delivered within a counselor-led private Facebook group. It uses behavioral strategies to help participants 1) achieve a program assigned calorie goal based on amount needed to lose 1-2 pounds per week, 2) develop a healthy diet, and 3) engage in 150-300 minutes per week of moderate intensity exercise. Participants will be instructed to use MyFitnessPal for the first two weeks, the Habit app slip tracker and exercise planner for two weeks, and the Habit app problem solver for two weeks.

A backend server for Habit will capture data on total uses of the app, including the use of each feature (diet slip tracker, exercise planner, and problem solver.

Number of participants saying they would be likely or very likely to continue to use the Habit app if given the chance

Participants will rate how likely they would be to continue to use the Habit app (very unlikely to very likely) on 5-point Likert scales.

Participants will rate how likely they would be to recommend the Habit app to a friend (very unlikely to very likely) on 5-point Likert scales.

Participants will rate their agreement with statements about how time-consuming participation in the program and use of each component (slip tracker, problem solver, and Facebook group) is on 5-point Likert scales. This outcome counts number of participants that Strongly Agree or Agree.

Participants will rate their agreement with statements about how time-consuming participation in the program and use of each component (slip tracker, problem solver, and Facebook group) is on 5-point Likert scales. This outcome counts number of participants that Strongly Agree or Agree.

Participants will rate their agreement with statements about how time-consuming participation in the program and use of each component (slip tracker, problem solver, and Facebook group) is on 5-point Likert scales. This outcome counts number of participants that Strongly Agree or Agree.

Using Grytics, we will retrieve objective engagement data from the Facebook group, including the date and content of all posts, replies, reactions, and poll votes. We will calculate the total number of posts, replies, reactions, and poll votes per participant.

A backend server for Habit will capture data on participant use of exercise planner feature in Habit app

A backend server for Habit will capture data on participant use of problem solver feature in Habit app

A backend server for Habit will capture data on participant use of diet slip tracker feature in the Habit app

All posts and comments in the Facebook group will be qualitatively coded to determine if a participant is sharing a problem they are having with the group either via the app or as an original post.

All posts and comments in the Facebook group will be qualitatively coded for problem solving if a comment is directed toward another participant (or anonymous post) that serve to help the OP brainstorm ideas on how to solve the problem.

Participants can attend optional breakout sessions during the intervention to discuss problems related to weight loss and receive peer feedback. We will track attendance and report the number of participants that attended at least one breakout session during the 6-week intervention.

Inclusion Criteria: 18-65 years old BMI 30-45 kg/m2 has wifi connectivity at home (for wifi scale) logs into Facebook at least 5 days per week over the past 2 weeks, and has posted/replied at least once a week in the past 2 weeks able to participate in the study in English. Exclusion Criteria: Pregnant/lactating or plans to become pregnant during study period bipolar disorder, substance abuse, psychosis, bulimia, binge eating disorder, or severe depression had bariatric surgery or plans to have surgery during the study currently taking medication affecting weight has lost ≥10% of weight in past year is participating or intends to participate in another weight loss program during the study that provides coaching or problem solving chronic pain that interferes with the ability to exercise Type 1 or 2 Diabetes unable to make dietary changes or increase physical activity unable to walk ¼ mile unaided without stopping currently smokes or vapes nicotine does not live in the United States had major surgery in past 6 months hospitalized for psychiatric reasons in past 12 months has concerns about being audiotaped during the focus groups does not have or not willing to create Fitbit account for study unable to access smartphone at home and at work does not have FB has done a study with this PI before has concerns about being in FB group with faculty/students of same university in which they work/attend does not have smartphone smartphone type/version not meeting app requirements prisoner unable to provide consent does not complete onboarding steps for the study