A Digital Approach to Improving Carbohydrate Periodisation Behaviours in Athlete: SMART+ Study

NCT ID: NCT04487015

Last Updated: 2020-11-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-14

Study Completion Date

2020-12-31

Brief Summary

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The carbohydrate periodisation framework is a widely accepted nutritional intervention strategy in the field of sports nutrition. However, despite the validity of this approach, it is reported that athletes find it difficult to stick to this behaviour and that the support required is highly personalised, and as a result time consuming for the coach. Prior research has suggested that a digital environment can deliver better personalised dietary interventions to better support athletes.

The overall purpose of this study is to assess the feasibility and acceptability of a digital approach (a menu planner app with coach support), and gain understanding on the strategy to implement coach support according to app engagement in the digital approach to improve dietary carbohydrate periodisation behaviours in athletes.

Detailed Description

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The study is conducted in two consecutive parts.

For part one, to assess the feasibility and acceptability of the digital approach, participants are recruited to use the app for 6 weeks and were given coach support, where coaches message (MesC) and call (ad-hoc Call) and the participants. A control group (no app) is also separately recruited to compare with the menu planner group.

For part two, to gain better understanding on the strategy to implement coach support with the menu planner app according to app engagement, a pilot multiple assignment randomized trial (SMART) design is conducted. Participants are equally randomised to either receive a stringent engagement criteria strategy or relaxed adherence criteria strategy. A stringent engagement criteria strategy requires the user to use the app at least twice a week at stage 1, and at least 3 times a week at stage 2 to be considered a responder at stage 1 and stage 2 (R1 and R2).

A relaxed engagement criteria strategy requires the user to use the app at least once a week in week 1 of using the app at stage 1, and at least 2 times a week at stage 2, to be considered a responder at stage 1 and stage 2 (R1 and R2). Non-responders for both criteria strategies at stage 1 and 2 (NR1 and NR2) will be re-randomised to either continue with the app only or additional coach support (MesC + ad-hoc Call).

Timeline wise,

Stage 1: Participants will first receive app for 1 week and will be categorised as responder (R1) or non-responders (NR1) at the end of the 1 week.

Stage 2: Responders to stage 1 (R1) will continue with the menu planner for 1 week. Non-responders to stage 1 (NR1) will either continue with the menu planner or receive additional coach support (MesC + ad-hoc Call) for 1 week. Participants are categorised again as responder (R2) or non-responders (NR2) at the end of the week.

Stage 3: Responders to stage 2 (R2) will only have menu planner for 2 weeks. Non-responders to stage 2 (NR2) will either have menu planner only or receive/continue with additional coach support (MesC + ad-hoc Call) for 2 weeks.

The SMART trial will take a total of 4 weeks to complete and have up to two randomisation points per participant. All re-randomisations are done at 1:1 allocation ratio.

Conditions

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Diet Habit

Keywords

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carbohydrate periodisation mobile app nutrition adaptive design behaviour change digital intervention sports performance technology

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Sequential Multiple Assignment Randomized Trial
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Part I: Non-Digital (Control)

Participants who currently receive performance nutrition support, via a qualified practitioner as indicated by a member of the sports science team at their sporting organisation, will be assigned to the non-digital approach (control). These participants will not receive any intervention from the research team for the duration of this study (6 weeks).

Group Type NO_INTERVENTION

No interventions assigned to this group

Part I: MP+ Call + MesC [6 weeks]

For part one of study, participants who currently do not receive performance nutrition support, will be given access to an app-based menu planner (MP) for 6 weeks with coach support that gives ad-hoc messaging and calls.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Call

Intervention Type BEHAVIORAL

A 30-45 minutes coaching consultation telephone/Skype call from the nutrition coaching to give social support. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

MesC

Intervention Type BEHAVIORAL

Nutrition coach-led messaging (MesC) is where the mobile app (MP) has the text messaging feature activated, and the nutrition coach proactively initiates a conversation via text messaging up to three times a week to offer nutrition support to the participant. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

Part II: Stage 1- MP [1week]

For the pilot SMART trial (part two of study), participants (not the same participants as part one) who currently do not receive performance nutrition support, will be given access to a menu planner app (MP) for 4 weeks. In the first 1 week, participants will only receive MP.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Part II: Stage 2 - R1-MP [1 week]

For participants in Part II: Stage 1- MP \[1week\], after the first 1week, this group of participants are considered responders (R1) so they continue with MP only for another 1 week.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Part II: Stage 2 - NR1-MP [1 week]

For participants in Part II: Stage 1- MP \[1week\], after the first 1 week, this group of participants are considered non-responders (NR1) and are re-randomised to continue with MP only for another 1 week.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Part II: Stage 2 - NR1-MP + Call + MesC [1 week]

For participants in Part II: Stage 1- MP \[1 week\], after the first 1 week, this group of participants are considered non-responders (NR1) and are re-randomised to have MP and additional coach support for another 1 week. The coach support consists of up to 3 coach-initiated messaging and ad-hoc calls to participant.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Call

Intervention Type BEHAVIORAL

A 30-45 minutes coaching consultation telephone/Skype call from the nutrition coaching to give social support. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

MesC

Intervention Type BEHAVIORAL

Nutrition coach-led messaging (MesC) is where the mobile app (MP) has the text messaging feature activated, and the nutrition coach proactively initiates a conversation via text messaging up to three times a week to offer nutrition support to the participant. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

Part II: Stage 3 - R2-MP [2 weeks]

After going through Part II: Stage 2, this group of participants are considered responders (R2) so they continue with MP only for 2 weeks.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Part II: Stage 3 - NR2-MP [2 weeks]

After going through Part II: Stage 2, this group of participants are considered non-responders (NR2) and are re-randomised to use MP only for another 2 week.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Part II: Stage 3 - NR2-MP + Call + MesC [2 weeks]

After going through Part II: Stage 2, this group of participants are considered non-responders (NR2) and are re-randomised to have MP and additional coach support for another 2 weeks. The coach support consists of up to 3 coach-initiated messaging and ad-hoc calls to participant.

Participants' response status is dependent on whether they are randomised to using the stringent or relaxed engagement criteria as described in study details.

Group Type EXPERIMENTAL

MP

Intervention Type BEHAVIORAL

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Call

Intervention Type BEHAVIORAL

A 30-45 minutes coaching consultation telephone/Skype call from the nutrition coaching to give social support. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

MesC

Intervention Type BEHAVIORAL

Nutrition coach-led messaging (MesC) is where the mobile app (MP) has the text messaging feature activated, and the nutrition coach proactively initiates a conversation via text messaging up to three times a week to offer nutrition support to the participant. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

Interventions

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MP

The app-based menu planner (MP) given to the participants has an automated carbohydrate periodisation menu planning tool, an educational and motivational nutrition content (infographics, video and text articles), and recipes. Participants using the app will input their training schedule into the app to produce their own menu plans. The behaviour change techniques (BCT) underlying the intervention are goal \& planning, feedback \& monitoring, shaping knowledge, natural consequences, comparison of behaviour, comparison of outcome, associations, repetitions, reward \& threat, regulation and antecedents.

Intervention Type BEHAVIORAL

Call

A 30-45 minutes coaching consultation telephone/Skype call from the nutrition coaching to give social support. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

Intervention Type BEHAVIORAL

MesC

Nutrition coach-led messaging (MesC) is where the mobile app (MP) has the text messaging feature activated, and the nutrition coach proactively initiates a conversation via text messaging up to three times a week to offer nutrition support to the participant. The BCT underlying the intervention is goal \& planning, social support, natural consequences.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Have access to a personal smart phone.
* An elite or training athlete.
* Have a performance related weight loss or weight maintenance physical goal.
* Do not have or have not have a history of eating disorders or disordered eating.

Exclusion Criteria

* Participants with a medically diagnosed history of eating disorders or disordered eating will be asked to self-exclude from the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Applied Behaviour Systems Ltd

UNKNOWN

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role collaborator

Duke-NUS Graduate Medical School

OTHER

Sponsor Role collaborator

Liverpool John Moores University

OTHER

Sponsor Role lead

Responsible Party

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David Dunne

PhD Student

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Liverpool John Moores University

Liverpool, , United Kingdom

Site Status RECRUITING

Countries

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United Kingdom

Central Contacts

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David Dunne, PGDip

Role: CONTACT

Phone: +44 7798872877

Email: [email protected]

Facility Contacts

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David Dunne, PGDip

Role: primary

References

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Impey SG, Hearris MA, Hammond KM, Bartlett JD, Louis J, Close GL, Morton JP. Fuel for the Work Required: A Theoretical Framework for Carbohydrate Periodization and the Glycogen Threshold Hypothesis. Sports Med. 2018 May;48(5):1031-1048. doi: 10.1007/s40279-018-0867-7.

Reference Type BACKGROUND
PMID: 29453741 (View on PubMed)

Dunne DM, Lefevre C, Cunniffe B, Tod D, Close GL, Morton JP, Murphy R. Performance Nutrition in the digital era - An exploratory study into the use of social media by sports nutritionists. J Sports Sci. 2019 Nov;37(21):2467-2474. doi: 10.1080/02640414.2019.1642052. Epub 2019 Jul 26.

Reference Type BACKGROUND
PMID: 31345110 (View on PubMed)

Yan X, Ghosh P, Chakraborty B. Sample size calculation based on precision for pilot sequential multiple assignment randomized trial (SMART). Biom J. 2021 Feb;63(2):247-271. doi: 10.1002/bimj.201900364. Epub 2020 Jun 11.

Reference Type BACKGROUND
PMID: 32529788 (View on PubMed)

Bentley MRN, Mitchell N, Backhouse SH. Sports nutrition interventions: A systematic review of behavioural strategies used to promote dietary behaviour change in athletes. Appetite. 2020 Jul 1;150:104645. doi: 10.1016/j.appet.2020.104645. Epub 2020 Feb 27.

Reference Type BACKGROUND
PMID: 32112958 (View on PubMed)

Heikura IA, Stellingwerff T, Burke LM. Self-Reported Periodization of Nutrition in Elite Female and Male Runners and Race Walkers. Front Physiol. 2018 Dec 3;9:1732. doi: 10.3389/fphys.2018.01732. eCollection 2018.

Reference Type BACKGROUND
PMID: 30559680 (View on PubMed)

Heikura IA, Burke LM, Mero AA, Uusitalo ALT, Stellingwerff T. Dietary Microperiodization in Elite Female and Male Runners and Race Walkers During a Block of High Intensity Precompetition Training. Int J Sport Nutr Exerc Metab. 2017 Aug;27(4):297-304. doi: 10.1123/ijsnem.2016-0317. Epub 2017 Apr 7.

Reference Type BACKGROUND
PMID: 28387576 (View on PubMed)

Mazorra Blanco, Rodrigo; (2019) A Data Science approach to behavioural change: large scale interventions on physical activity and weight loss. Doctoral thesis (Ph.D), UCL (University College London).

Reference Type BACKGROUND

Soto CJ, John OP. Short and extra-short forms of the Big Five Inventory-2: The BFI-2-S and BFI-2-XS. Journal of Research in Personality. 2017; 68:69-81.

Reference Type BACKGROUND

Stich C, Knauper B, Tint A. A scenario-based dieting self-efficacy scale: the DIET-SE. Assessment. 2009 Mar;16(1):16-30. doi: 10.1177/1073191108322000. Epub 2008 Aug 14.

Reference Type BACKGROUND
PMID: 18703821 (View on PubMed)

Smit ES and Bol N. From self-reliers to expert-dependents: identifying classes based on health-related need for autonomy and need for external control among mobile users. Media Psychology. 2020; 23(3): 391-414.

Reference Type BACKGROUND

Wallin L, Bostrom AM, Gustavsson JP. Capability beliefs regarding evidence-based practice are associated with application of EBP and research use: validation of a new measure. Worldviews Evid Based Nurs. 2012 Aug;9(3):139-48. doi: 10.1111/j.1741-6787.2012.00248.x. Epub 2012 Mar 27.

Reference Type BACKGROUND
PMID: 22458331 (View on PubMed)

Other Identifiers

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20/NSP/027

Identifier Type: -

Identifier Source: org_study_id