App Technology to Support Physical Activity and Intake of Vitamins and Minerals After Bariatric Surgery (the PromMera Study): Protocol of a Randomized Controlled Clinical Trial

Stephanie Erika Bonn; Mari Hult; Kristina Spetz; Marie Löf; Ellen Andersson; Mikael Wiren; Ylva Trolle Lagerros

doi:10.2196/19624

App Technology to Support Physical Activity and Intake of Vitamins and Minerals After Bariatric Surgery (the PromMera Study): Protocol of a Randomized Controlled Clinical Trial

JMIR Res Protoc. 2020 Aug 14;9(8):e19624. doi: 10.2196/19624.

Authors

Stephanie Erika Bonn¹, Mari Hult^{1

2}, Kristina Spetz^{3

4}, Marie Löf^{5

6}, Ellen Andersson^{3

4}, Mikael Wiren⁷, Ylva Trolle Lagerros^{1

8}

Affiliations

¹ Clinical Epidemiology Division, Department of Medicine (Solna), Karolinska Institutet, Stockholm, Sweden.
² Division of Upper Abdominal Surgery, Karolinska University Hospital, Stockholm, Sweden.
³ Department of Surgery, Linköping University, Norrköping, Sweden.
⁴ Department of Biomedical and Clinical Sciences, Linköping University, Norrköping, Sweden.
⁵ Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
⁶ Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden.
⁷ Department of Surgery, Ersta Hospital, Stockholm, Sweden.
⁸ Center for Obesity, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden.

PMID: 32795990
PMCID: PMC7455871
DOI: 10.2196/19624

Abstract

Background: To optimize postoperative outcomes after bariatric surgery, lifestyle changes including increased physical activity are needed. Micronutrient deficiency after surgery is also common and daily supplementation is recommended.

Objective: The aim of the PromMera study is to evaluate the effects of a 12-week smartphone app intervention on promotion of physical activity (primary outcome) and adherence to postsurgery vitamin and mineral supplementation, as well as on other lifestyle factors and overall health in patients undergoing bariatric surgery.

Methods: The PromMera study is a two-arm, randomized controlled trial comprising patients undergoing bariatric surgery. Participants are randomized postsurgery 1:1 to either the intervention group (ie, use of the PromMera app for 12 weeks) or the control group receiving only standard care. Clinical and lifestyle variables are assessed pre- and postsurgery after 18 weeks (postintervention assessment), 6 months, 1 year, and 2 years. Assessments include body composition using Tanita or BOD POD analyzers, muscle function using handgrip, biomarkers in blood, and an extensive questionnaire on lifestyle factors. Physical activity is objectively measured using the ActiGraph wGT3X-BT triaxial accelerometer.

Results: A total of 154 participants have been enrolled in the study. The last study participant was recruited in May 2019. Data collection will be complete in May 2021.

Conclusions: Implementing lifestyle changes are crucial after bariatric surgery and new ways to reach patients and support such changes are needed. An app-based intervention is easily delivered at any time and can be a key factor in the adoption of healthier behavioral patterns in this rapidly growing group of patients.

Trial registration: ClinicalTrials.gov NCT03480464; https://clinicaltrials.gov/ct2/show/NCT03480464.

International registered report identifier (irrid): DERR1-10.2196/19624.

Keywords: adults; body composition; exercise; metabolic health; mobile phone; obesity; randomized controlled trial; smartphones; vitamin intake.

©Stephanie Erika Bonn, Mari Hult, Kristina Spetz, Marie Löf, Ellen Andersson, Mikael Wiren, Ylva Trolle Lagerros. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 14.08.2020.

Associated data

ClinicalTrials.gov/NCT03480464