PATH to Health: An Exploration of Digital Behavioral Weight Loss Approaches

NCT ID: NCT05929469

Last Updated: 2024-05-30

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

COMPLETED

Clinical Phase

NA

Total Enrollment

99 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-10-02

Study Completion Date

2024-04-25

Brief Summary

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The purpose of this initial pilot and feasibility study is to test different digital, behavioral weight loss approaches, with or without human support, using a sequential, multiple assignment, randomized trial (SMART) design. All participants in this pilot trial will receive a 3-month mobile health (mHealth) program. The dose of human support will vary by first- and second-line randomizations. The feasibility, acceptability, and preliminary outcomes for each of the treatment sequences will be assessed.

Detailed Description

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Ninety-nine adults, ages 18-65, with overweight or obesity, will be randomized in total. All participants will receive an mHealth program (App) for program duration that includes activity tracking with a Fitbit, weight tracking with a smart scale, and an app for diet tracking. At baseline, participants will be randomized to either a a) Fully Automated Kick-Off, or b) Human-Enhanced Kick-Off. "Early responders" will continue with to use App, alone. After 4 weeks, "early non-responders" in both arms will be re-randomized once to one of two augmented interventions with human support: Counseling or Check-In. Assessments will occur at baseline, 1 week, 4 weeks, and 3 months to explore feasibility, acceptability, and preliminary outcomes (weight, self-monitoring adherence, behavioral goal adherence).

Conditions

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Overweight Obesity Overweight and Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

This initial pilot and feasibility study uses a sequential, multiple assignment, randomized trial (SMART) design to test digital, behavioral weight loss approaches, with or without human support. Sequential randomization will occur at baseline and at the end of 4 weeks. At baseline, participants will be randomized to receive a standard mHealth program and either a a) Fully Automated Kick-Off session, or b) Human-Enhanced Kick-Off session. Using an a priori decision rule after 4 weeks, those for whom the intervention is not effective will be re-randomized and receive one of two doses of human support. The final assessment will be at 3 months.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Human-Enhanced Kick-Off + App + Check-In

This arm includes participants who do not respond to the Human-Enhanced Kick-Off + App in stage 1.

In stage 1, the participant's kick-off will include a session with a study interventionist. They will also receive an mHealth program.

In stage 2, they will continue with the mHealth program, but will also receive a check-in with a study interventionist.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Human-Enhanced Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a kick-off session that includes time with a study interventionist.

Check-In

Intervention Type BEHAVIORAL

Participants will receive a check-in with a study interventionist.

Fully Automated Kick-Off + App + Counseling

This arm includes participants who do not respond to the Fully Automated Kick-Off + App in stage 1.

In stage 1, participants will receive a Fully Automated Kick-Off and an mHealth program.

In stage 2, they will continue with the standard mHealth program, but will also receive counseling from a study interventionist.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Fully Automated Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a fully automated kick-off session.

Counseling

Intervention Type BEHAVIORAL

Participants will receive counseling from a study interventionist.

Human-Enhanced Kick-Off + App

This arm includes participants who respond to the Human-Enhanced Kick-Off + App in stage 1.

In stage 1, the participant's kick-off will include a session with a study interventionist. They will also receive an mHealth program.

In stage 2, responders to the Human-Enhanced Kick-Off + App will continue with the mHealth program, alone, for the remainder of the study.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Human-Enhanced Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a kick-off session that includes time with a study interventionist.

Fully Automated Kick-Off + App + Check-In

This arm includes participants who do not respond to the Fully Automated Kick-Off + App in stage 1.

In stage 1, participants will receive a Fully Automated Kick-Off and an mHealth program.

In stage 2, they will continue with the mHealth program, but will also receive a check-in with a study interventionist.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Fully Automated Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a fully automated kick-off session.

Check-In

Intervention Type BEHAVIORAL

Participants will receive a check-in with a study interventionist.

Fully Automated Kick-Off + App

This arm includes participants who respond to the Fully Automated Kick-Off + App in stage 1.

In stage 1, participants will receive a Fully Automated Kick-Off and an mHealth program.

In stage 2, responders to the Fully Automated Kick-Off + App will continue with the mHealth program, alone, for the remainder of the study.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Fully Automated Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a fully automated kick-off session.

Human-Enhanced Kick-Off + App + Counseling

This arm includes participants who do not respond to the Human-Enhanced Kick-Off + App in stage 1.

In stage 1, the participant's kick-off will include a session with a study interventionist. They will also receive an mHealth program.

In stage 2, they will continue with the standard mHealth program, but will also receive counseling from a study interventionist.

Group Type EXPERIMENTAL

App

Intervention Type BEHAVIORAL

Participants will receive an mHealth program.

Human-Enhanced Kick-Off

Intervention Type BEHAVIORAL

As an orientation to the study, participants will receive a kick-off session that includes time with a study interventionist.

Counseling

Intervention Type BEHAVIORAL

Participants will receive counseling from a study interventionist.

Interventions

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App

Participants will receive an mHealth program.

Intervention Type BEHAVIORAL

Fully Automated Kick-Off

As an orientation to the study, participants will receive a fully automated kick-off session.

Intervention Type BEHAVIORAL

Human-Enhanced Kick-Off

As an orientation to the study, participants will receive a kick-off session that includes time with a study interventionist.

Intervention Type BEHAVIORAL

Check-In

Participants will receive a check-in with a study interventionist.

Intervention Type BEHAVIORAL

Counseling

Participants will receive counseling from a study interventionist.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Current age: 18-65 years
* Lives in North Carolina
* Body mass index (BMI) of 27.5-45 kg/m\^2
* Ability to read, write, and speak English
* Ownership of iPhone with a data and texting plan
* Ability to commit to the required counseling sessions (0-5 sessions, based on randomization)
* Is not living a participant or staff member on this trial
* Willingness to be randomized to any of the treatment sequences

Exclusion Criteria

* Weight loss of more than 10 pounds in the last 6 months that was maintained
* A history of weight loss surgery
* Pre-existing medical condition(s) that prevent them from adhering to a supervised exercise routine
* Have Type 1 Diabetes or are currently taking medicine for Type 2 Diabetes
* Have recently been diagnosed or treated for cancer
* Currently pregnant, pregnant within the past 6 months, or plan to become pregnant in the next 6 months
* Report taking prescription or over the counter medication with a known impact on metabolism or weight
* Report a history of an eating disorder
* History of psychotic disorder or bipolar disorder, or have been hospitalized for depression or other psychiatric disorder within the past 12 months
* History of alcohol or substance abuse
* Current participation in another weight loss program that may interfere with participation in this study
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Academy of Nutrition and Dietetics

OTHER

Sponsor Role collaborator

University of North Carolina, Chapel Hill

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Caitlin Martinez, MS, RD

Role: PRINCIPAL_INVESTIGATOR

University of North Carolina, Chapel Hill

Locations

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University of North Carolina at Chapel Hill

Chapel Hill, North Carolina, United States

Site Status

Countries

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United States

References

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Martinez CE, Nezami BT, Mayer-Davis E, Willis EA, Gorin AA, Tate DF. Results of a pilot sequential multiple assignment randomized trial using counseling to augment a digital weight loss program. Obes Sci Pract. 2024 Nov 7;10(6):e70018. doi: 10.1002/osp4.70018. eCollection 2024 Dec.

Reference Type DERIVED
PMID: 39512729 (View on PubMed)

Other Identifiers

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23-0396

Identifier Type: -

Identifier Source: org_study_id

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