NURS 6208 GWU Loss Intervention for Young Adults Using Mobile Technology

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NURS 6208 Informatics Article Review/Critique Guidelines This is a group assignment. Use the following guidelines to summarize your group’s article and develop a 15-20 minute Tegrity presentation. Your review should show that you can recognize arguments and engage in critical thinking about the course content. You need to address all the questions indicated in this guideline as they pertains to your article. Group presentation is worth up to 100 points. You are to address the following sections in your presentation. The presentation will thoroughly analyze and address the following: I. Author(s), Title, Abstract (10%) a. b. c. d. e. II. Article (10%) a. b. c. d. e. f. III. IV. V. VI. VII. VIII. Points Earned: ______ Thoroughly explain your own reactions and considered opinions regarding the work PowerPoint/Tegrity Presentation. (15%) a. b. c. d. e. f. g. Points Earned: ______ What exactly does the work contribute and relate to the overall topic of your course and/or assignment? What general problems and concepts in your discipline and course does it engage with? What implications does this topic have on nursing care? What implications does this topic have on advance practice? What implications does this topic have on future research? What implications does this topic have on nursing administration? What theoretical, ethical, legal issues and topics for further discussion does the work raise? Reactions/Opinions (15%) a. Points Earned: ______ Does the author clearly state an explicit thesis? Does the author have a specific point of view? Is the article “persuasive”? If so, please explain. Significance of Topic (35%) a. b. c. d. e. f. g. Points Earned: ______ the specific topic of the article is easily identified the overall purpose of the article is identified, clear, accurate, and unambiguous who is the intended audience? is the article appropriate for intended audience? what kinds of material does the work present (e.g. primary documents or secondary material, personal observations, literary analysis, quantitative data, biographical or historical accounts)? how is this material used to demonstrate and argue the thesis? (As well as indicating the overall argumentative structure of the work, your review could quote or summarize specific passages to describe the author’s presentation, including writing style and tone). Statement of Thesis (10%) a. b. c. Points Earned: ______ the author(s) qualification/position indicate a degree of knowledge in this particular field, explain how well the acknowledgements, reference list, and index provide clues about where and how the piece was originally published, and about the author’s background and position whether the title is clear, accurate, and/or unambiguous whether the abstract offers a clear overview of the study or not, and whether the abstract includes the research problem, sample, methodology, findings and/or recommendations Points Earned: ______ Overall presentation Style/manner of presentation. Creativity, presentation appeal (poise, pronunciation, voice quality, pitch, clarity) Ability to stimulate discussion (Each audience member is to post any discussion questions/comments using the “Discussion Tool”). NURS 6208 GWU Loss Intervention for Young Adults Using Mobile Technology. PowerPoint: Typing, neatness, spelling, punctuation, grammar References in APA format Time Management (15-20 minutes in length) Content (2.5%) a. Is accurate, thorough, and not just a reiteration of text b. Includes interpretation and clarification of meanings c. Is organized, coherent, tied together and fluent Evaluation by Group Members (individual score = evaluation avg from group members) (2.5%) Points Earned: ______ Points Earned: ______ (individual grade) Obesity Obesity Symposium CLINICAL TRIALS AND INVESTIGATIONS Cell Phone Intervention for You (CITY): A Randomized, Controlled Trial of Behavioral Weight Loss Intervention for Young Adults Using Mobile Technology Laura P. Svetkey1,2, Bryan C. Batch3, Pao-Hwa Lin1,2, Stephen S. Intille4,5, Leonor Corsino3, Crystal C. Tyson1, Hayden B. Bosworth6,7,8,9, Steven C. Grambow10, Corrine Voils6,9, Catherine Loria11, John A. Gallis10, Jenifer Schwager1,2, and Gary B. Bennett12,13 Objective: To determine the effect on weight of two mobile technology-based (mHealth) behavioral weight loss interventions in young adults. Methods: Randomized, controlled comparative effectiveness trial in 18- to 35-year-olds with BMI 25 kg/m2 (overweight/obese), with participants randomized to 24 months of mHealth intervention delivered by interactive smartphone application on a cell phone (CP); personal coaching enhanced by smartphone self-monitoring (PC); or Control. Results: The 365 randomized participants had mean baseline BMI of 35 kg/m2. Final weight was measured in 86% of participants. CP was not superior to Control at any measurement point. PC participants lost significantly more weight than Controls at 6 months (net effect 21.92 kg [CI 23.17, 20.67], P 5 0.003), but not at 12 and 24 months. Conclusions: Despite high intervention engagement and study retention, the inclusion of behavioral principles and tools in both interventions, and weight loss in all treatment groups, CP did not lead to weight loss, and PC did not lead to sustained weight loss relative to Control. NURS 6208 GWU Loss Intervention for Young Adults Using Mobile Technology. Although mHealth solutions offer broad dissemination and scalability, the CITY results sound a cautionary note concerning intervention delivery by mobile applications. Effective intervention may require the efficiency of mobile technology, the social support and human interaction of personal coaching, and an adaptive approach to intervention design. Obesity (2015) 23, 2133-2141. doi:10.1002/oby.21226 Introduction Obesity is present in 35% of young adults (defined as age 18-35 years) in the US (1) and deserves attention: Weight gain is most rapid during these years (2,3); increasing body mass index (BMI) in young adulthood increases the risk of developing metabolic syndrome over the subsequent 15 years almost 20-fold (4); and weight gain in early adulthood is also associated with increased coronary calcification in middle age (5), forecasting future cardiovascular disease (CVD) events. These data suggest the need for effective and sustainable weight control strategies early in adult life (6). 1 Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA. Correspondence: Laura P. Svetkey (svetk001@mc.duke.edu) 2 Sarah W. Stedman Nutrition and Metabolism Center, Duke Molecular Physiology Institute, Durham, North Carolina, USA 3 Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA 4 College of Computer and Information Science, Northeastern University, Boston, Massachusetts, USA 5 Bouve College of Health Sciences, Northeastern University, Boston, Massachusetts, USA 6 Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA 7 Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA 8 School of Nursing, Duke University Medical Center, Durham, North Carolina, USA 9 Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA 10 Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA 11 Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA 12 Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA 13 Duke Obesity Prevention Program, Duke University Medical Center, Durham, North Carolina, USA. Funding agencies: The CITY study was sponsored by grant number U01HL096720 from the National Heart, Lung, and Blood Institute, a component of the National Institutes of Health (NIH). Disclosure: Dr. Svetkey is a consultant to Oregon Center for Applied Science (ORCAS; Eugene, Oregon), a health innovation company that creates self-management programs to improve physical and emotional well-being. Dr. Grambow is a consultant to Gilead Sciences as a member of multiple DSMBs. Although the relationship is not perceived to represent a conflict with the present work, it has been included in the spirit of full disclosure. Dr. Bennett is a member of the scientific advisory board at Nutrisystem and owns shares in Scale Down, a digital weight loss vendor. Additional Supporting Information may be found in the online version of this article. Received: 21 March 2015; Accepted: 15 June 2015; Published online 4 November 2015. doi:10.1002/oby.21226 www.obesityjournal.org Obesity | VOLUME 23 | NUMBER 11 | NOVEMBER 2015 2133 Obesity CITY Weight Loss Trial—Main Results Svetkey et al. Effective behavioral weight loss strategies involve regular personal contact with a trained interventionist using behavioral techniques such as self-monitoring and goal setting (6). Evidence-based obesity treatment recommendations endorse high-intensity intervention: 14 in-person interventionist sessions over 6 months (6). However, the optimal behavioral “dose” is unclear (7), and a smaller effect with lower intensity intervention might be offset by the potential for increased scalability. In addition, trials testing comprehensive behavioral approaches have primarily included middle-aged adults and suggest that intervention is more effective as age increases (8,9). Thus the potential of personal coaching for weight loss in a younger population is unknown. Similarly, commercial mobile technology mHealth applications (“apps”) are widely downloaded for weight loss but have not been rigorously tested for efficacy or effectiveness. Behavior change techniques known to produce clinically meaningful weight loss are often absent (10,11), calling into question whether apps can have the desired effect (12,13). Because of the potential for scalability and wide dissemination, we sought to determine the weight loss potential of mobile technology on its own. In order to improve the efficiency of behavior change methods known to be effective, we tested a low-intensity personal coaching intervention enhanced by mobile technology. The Cell Phone Intervention for You (CITY) study was a three-arm randomized trial comparing the effect on weight over 24 months of behavioral intervention that was delivered almost entirely via a smartphone app of our design (CP) or behavioral intervention delivered through personal coaching enhanced by self-monitoring via smartphone (PC), each compared to Control. We hypothesized that CP and PC would each be superior to Control. We made no a priori hypothesis about CP relative to PC. Methods The CITY study was one of seven trials in the Early Adult Reduction of weight through LifestYle Intervention (EARLY) consortium, sponsored by NHLBI (1U01HL096720). Each EARLY trial was conducted independently. However, in order to facilitate future comparison, the EARLY trials had common eligibility criteria, measurement methods, and primary outcome (14). The design of CITY is reported elsewhere (15). Study population CITY was approved by the Duke Institutional Review Board and an NHLBI-appointed Protocol Review Committee/Data and Safety Monitoring Board (DSMB).NURS 6208 GWU Loss Intervention for Young Adults Using Mobile Technology. Enrollment occurred between December 2010 and February 2012. Individuals were eligible if they were aged 18-35 years, had overweight or obesity (BMI 25 kg/m2), and used a mobile telephone. For logistical reasons, participants were required to receive service from either Verizon or AT&T. Individuals were excluded if they were taking weight loss medications or corticosteroids, had weight loss surgery, weighed more than 440 lbs (the limit of study scales), or had any condition deemed unsafe for the study. Recruitment occurred primarily by advertising and mass mailings. 2134 Obesity | VOLUME 23 | NUMBER 11 | NOVEMBER 2015 Pre-screening assessment occurred by participants’ choice of telephone, interactive voice response (IVR), short message service (SMS), or online survey. Participants were further screened by telephone followed by a face-to-face visit, during which all participants provided written informed consent. Randomization occurred at a separate face-to-face visit within 10 weeks of screening, at which baseline weight was obtained. Randomization was stratified by gender and BMI (overweight [BMI 25 and
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