Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial

Rhiannon E Halse; Charlene L Shoneye; Christina M Pollard; Jonine Jancey; Jane A Scott; Iain S Pratt; Satvinder S Dhaliwal; Richard Norman; Leon M Straker; Carol J Boushey; Edward J Delp; Fengqing Zhu; Amelia J Harray; Maria A Szybiak; Anne Finch; Joanne A McVeigh; Barbara Mullan; Clare E Collins; Syed Aqif Mukhtar; Kieran N Edwards; Janelle D Healy; Deborah A Kerr

doi:10.2196/12782

Improving Nutrition and Activity Behaviors Using Digital Technology and Tailored Feedback: Protocol for the Tailored Diet and Activity (ToDAy) Randomized Controlled Trial

JMIR Res Protoc. 2019 Feb 25;8(2):e12782. doi: 10.2196/12782.

Authors

Rhiannon E Halse¹, Charlene L Shoneye¹, Christina M Pollard^{1

2}, Jonine Jancey¹, Jane A Scott¹, Iain S Pratt^{3

4}, Satvinder S Dhaliwal¹, Richard Norman¹, Leon M Straker⁵, Carol J Boushey^{6

7}, Edward J Delp⁸, Fengqing Zhu⁸, Amelia J Harray¹, Maria A Szybiak³, Anne Finch³, Joanne A McVeigh^{9

10}, Barbara Mullan⁴, Clare E Collins^{11

12}, Syed Aqif Mukhtar¹, Kieran N Edwards⁵, Janelle D Healy¹, Deborah A Kerr^{1

13}

Affiliations

¹ School of Public Health, Curtin University, Perth, Western Australia, Australia.
² East Metropolitan Health Service, Perth, Western Australia, Australia.
³ Cancer Council WA, Perth, Western Australia, Australia.
⁴ Health Psychology & Behavioural Medicine Research Group, School of Psychology, Curtin University, Perth, Western Australia, Australia.
⁵ School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
⁶ Cancer Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, United States.
⁷ Department of Nutrition, Purdue University, West Lafayette, IN, United States.
⁸ School of Electrical and Computer Engineering, Purdue University, West Lafayette, IN, United States.
⁹ School of Occupational Therapy, Speech Therapy & Social Work, Curtin University, Perth, Western Australia, Australia.
¹⁰ Movement Physiology Laboratory, University of Witwatersrand, Johannesburg, South Africa.
¹¹ School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales, Australia.
¹² Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Callaghan, New South Wales, Australia.
¹³ Curtin Institute of Computation, Curtin University, Perth, Western Australia, Australia.

PMID: 30801257
PMCID: PMC6409509
DOI: 10.2196/12782

Abstract

Background: Excess weight is a major risk factor for chronic diseases. In Australia, over 60% of adults are overweight or obese. The overconsumption of energy-dense nutrient-poor (EDNP) foods and low physical activity (PA) levels are key factors contributing to population obesity. New cost-effective approaches to improve population diet and PA behaviors are needed.

Objective: This 1-year randomized controlled trial (6-month intervention and 6-month follow-up) aims to investigate whether a tailored intervention using mobile technology can improve diet and PA behaviors leading to weight loss in adults (aged 18-65 years) who are overweight or obese and recruited through a social marketing campaign (LiveLighter).

Methods: All eligible participants will provide data on demographics and lifestyle behaviors online at baseline, 6 months, and 12 months. Using two-stage randomization, participants will be allocated into one of three conditions (n=200 per group): tailored feedback delivered via email at seven time points, informed by objective dietary (mobile food record app) and activity (wearable activity monitor) assessment; active control receiving no tailored feedback, but undergoing the same objective assessments as tailored feedback; and online control receiving no tailored feedback or objective assessments. Primary outcome measures at 6 and 12 months are changes in body mass, EDNP food and beverage consumption, and daily moderate-to-vigorous PA (measured via accelerometry). Secondary outcomes include change in fruit and vegetable consumption, daily sedentary behaviors, and cost effectiveness.

Results: Enrolment commenced in August 2017. Primary outcomes at 12 months will be available for analysis from September 2019.

Conclusions: Tailored email feedback provided to individuals may deliver a cost-effective strategy to overcome existing barriers to improving diet and PA. If found to be successful and cost effective, upscaling this intervention for inclusion in larger-scale interventions is highly feasible.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12617000554369; https://www.anzctr.org.au /Trial/Registration/TrialReview.aspx?id=371325&isReview=true.

International registered report identifier (irrid): DERR1-10.2196/12782.

Keywords: diet; digital behavioral interventions; eHealth; health behavior; mHealth; mobile food record; obesity; physical activity; sedentary; wearable activity monitor.

©Rhiannon E Halse, Charlene L Shoneye, Christina M Pollard, Jonine Jancey, Jane A Scott, Iain S Pratt, Satvinder S Dhaliwal, Richard Norman, Leon M Straker, Carol J Boushey, Edward J Delp, Fengqing Zhu, Amelia J Harray, Maria A Szybiak, Anne Finch, Joanne A McVeigh, Barbara Mullan, Clare E Collins, Syed Aqif Mukhtar, Kieran N Edwards, Janelle D Healy, Deborah A Kerr. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 25.02.2019.

Abstract

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