©pprnet 2014 the feasibility of primary care promotion of mhealth technology for weight loss
TRANSCRIPT
PPRNet2014 Annual Meeting
©PPRNet 2014
The Feasibility of Primary Care Promotion of mHealth Technology for Weight Loss
PPRNet2014 Annual Meeting
©PPRNet 2014
OBJECTIVES
• Discuss an unsuccessful grant application to pilot use of a mHealth app for weight loss in PPRNet practices
• Solicit your feedback on a proposed redesign for resubmission
PPRNet2014 Annual Meeting
©PPRNet 2014
BACKGROUND
• More than 2/3 of adults are obese or overweight
• Brief physician counseling for obesity does not result in weight loss
• Intensive interventions are effective but expensive/impractical in primary care
PPRNet2014 Annual Meeting
©PPRNet 2014
BACKGROUND
• Self-monitoring of dietary intake and physical activity is a centerpiece of successful weight loss programs
• Some studies suggest use of mHealth apps for self-monitoring may result in improved adherence with self-monitoring and sustained weight loss
• These studies recruited participants directly from the community
PPRNet2014 Annual Meeting
©PPRNet 2014
PROPOSED STUDY GOAL
Explore the feasibility of a practice-based approach to use of MyFitnessPal (MFP) for dietary and physical activity self-monitoring among patients in primary care practices
PPRNet2014 Annual Meeting
©PPRNet 2014
MYFITNESSPAL
www.myfitnesspal.com
PPRNet2014 Annual Meeting
©PPRNet 2014
PROPOSED STUDY DESIGN
6 PPRNet practices
Site visits to – Train all practice members on use of MFP– Practice planning to integrate use of MFP in practice– Input from patients on how to encourage patients to use it
Examples: • Empowering staff to recommend using it and providing brief training• Creation of patient handout with instructions for use• Incorporation of link in after visit summary• Encouraging patients to share diaries with providers• Staff members “friend” patients to provide continued motivation
PPRNet2014 Annual Meeting
©PPRNet 2014
PROPOSED EVALUATION
• Patient survey • Focus groups of patients and
providers/staff• Change in weight among patients who
were instructed in use of MFP
PPRNet2014 Annual Meeting
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STUDY REVIEW: STRENGTHS
• Use of a model (technology acceptance model)
• Quantitative and qualitative evaluation• Excellent PI with expertise in informatics
and productive researcher• Innovative focus
PPRNet2014 Annual Meeting
©PPRNet 2014
STUDY REVIEW: WEAKNESSES
• No control over MyFitnessPal, no documentation of benefits/harms
• One reviewer concerned about promotion of commercial app
• Low uptake of mHealth technology without approaches to improve this
• Lack of participant follow up• Lack of behavioral components to help
patients achieve weight loss
PPRNet2014 Annual Meeting
©PPRNet 2014
OVERCOMING WEAKNESSES FOR A RESUBMISSION
Weakness: • No control over MyFitnessPal
Redesign: • Provide choice of apps to use
What apps should we include?Would it be feasible for you to suggest several apps for your patients to use?
PPRNet2014 Annual Meeting
©PPRNet 2014
OVERCOMING WEAKNESSES FOR A RESUBMISSION
Weaknesses: • No documentation of benefits/harms• One reviewer concerned about promotion of
commercial app
Redesign: • Decreased focus on “promotion” of apps and
more emphasis on patient and provider feedback on use of apps
What is the best way to solicit feedback from patients in your practices?
PPRNet2014 Annual Meeting
©PPRNet 2014
OVERCOMING WEAKNESSES FOR A RESUBMISSION
Weakness: • Low uptake of mHealth technology without
approaches to improve this
Redesign: • Recruit patients and staff to “champion” the
app and provide feedback
Would this be feasible?What are other ideas to increase patient uptake?
PPRNet2014 Annual Meeting
©PPRNet 2014
OVERCOMING WEAKNESSES FOR A RESUBMISSION
Weaknesses: • Lack of participant follow up crucial to the success of
mHealth technology (phone calls, coaching, group visits)
• Lack of good behavioral components to help patients achieve weight loss
Redesign: • Integration with behavioral components of weight loss
What behavioral components do you currently use?Would group visits be feasible?
PPRNet2014 Annual Meeting
©PPRNet 2014
NEXT STEPS
September 2014- Letters of support needed
November 2014- Application deadline
July 2015- Earliest project start