Abstract:Objectives. This study explored young adults' experiences of using e-health internetbased computer or mobile phone applications (apps) and what they valued about those apps.Design and methods. A qualitative design was used. Semi-structured interviews were conducted with a community sample of 19 young adults who had used a publiclyavailable phone or internet-based application. Transcripts were analysed using thematic analysis.Results. Participants valued an attractive user interface. Structure, ease of use, personalised features and accessibility (including dual phone-computer access) were all important to participants and users indicated that continued use depended on these design features. Many believed that a focus on calorie counting was too limiting. Some users mentioned behaviour change strategies and known behaviour change techniques utilised by apps including; self-monitoring, goal setting and behavioural feedback. Only a few users reported positive changes in physical activity levels.Conclusions. Use of particular design features and application of evidence-based behaviour change techniques could optimise continued use and the effectiveness of internet/smart phone interventions. British Journal of Health PsychologyThank you for your comments and the opportunity to revise and re-submit our paper. We have been able to respond positively to all your comments.Our response to each comment (in red font) explains how we revised our paper, where necessary. We have highlighted changed text in the manuscript in red font and noted page numbers in our responses to each of the comments.We hope that our revised paper will be suitable for publication in British Journal of Health Psychology and look forward to hearing from you. Comments 1. Please add some further details about the data analysis conducted. It is not currently clear whether the themes were pre-determined and used as a basis for the analysis or if these were derived from the data. If they were predetermined -why?We employed a topic guide to ensure that participants did not stray off topic or fail to address our research questions. The themes identified emerged from the data and were not predetermined -as described in our data analysis section. We have added a sentence in the second paragraph of the results section (p6) to clarify this point.2. You refer to 'calorie counting' in the text on page 11. Please change this to e.g. selfmonitoring of calorie intake.We have now omitted 'calorie counting' in the text and replaced this with "calorie-intake monitoring" (p11, 12).3. Please rephrase the second sentence which was added to the data collection section in this revision. It is currently poorly phrased.We have now amended this sentence by dividing it into two simple sentences (p5).

BackgroundA wide range of self-directed weight-loss interventions are available, providing users with a variety of tools delivered through various formats to regulate weight-related behavior patterns. However, it is unclear how effective self-directed interventions are and how they promote weight loss and weight maintenance.ObjectiveA systematic review of reviews was conducted to examine the effectiveness of such interventions and to identify intervention content associated with effectiveness.MethodsMEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library for systematic reviews were searched from 2000-2012 for reviews of the effectiveness of self-directed interventions on weight loss and weight maintenance in adults. Two reviewers used predefined inclusion criteria to select relevant reviews and assess their quality using the Overview Quality Assessment Questionnaire (OQAQ). We extracted data on effectiveness and on relationships between intervention characteristics and effectiveness.ResultsTwenty reviews were included and quality assessed. Findings relevant to self-directed interventions, including interactive websites, smartphone applications, and text messaging (short message service, SMS) were summarized. Findings were mixed but promising. For example, one review of Internet-based interventions found that, when used in conjunction with standard weight loss programs, these interventions resulted in a significant average increase in weight loss of 1.5 kg over evaluation periods. Unfortunately, only 7 of 20 reviews were of high methodological quality according to OQAQ scores, and only 4 employed meta-analyses. Few reviews linked intervention content to effectiveness.ConclusionsCurrent evidence suggests that self-directed interventions can independently promote weight loss and can augment interventions involving personal contact. Particular change techniques and delivery modes including individualized feedback, email counseling, and online social support appear to enhance effectiveness. Further reviews of the content of self-directed weight-loss intervention studies are needed to clarify which change techniques delivered through which delivery formats optimize intervention effectiveness.

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Hospitality firms are exploring opportunities to incorporate innovative technologies, such as robotics, into their operations. This qualitative study used focus groups to investigate diner perspectives on issues related to using robot technology in quick-service restaurant (QSR) operations. QSR guests have major concerns regarding the societal impact of robotics entering the realm of QSR operations; the cleanliness and food safety of robot technology; and communication quality, especially voice recognition, from both native and nonnative English speakers. Participants also offered opinions about the functionality and physical appearance of robots, the value of the “human touch,” and devised creative solutions for deploying this technology. Surprisingly, few differences in attitudes and perceptions were found between age groups, and the participants were highly ambivalent about the technology. Future research may consider further exploration of robot applications in other restaurant segments, using quantitative methods with a larger sample.

Downloaded by [2.124.227.49] at 11:47 19 April 2016 2 Many self-directed weight-loss interventions have been developed using a variety of delivery formats (e.g. internet, smartphone) and change techniques. Yet, little research has examined whether self-directed interventions can exclusively promote weight loss. MEDLINE, Embase, PsycINFO, CINAHL, and the Cochrane Library were systematically reviewed for randomised controlled trials evaluating self-directed interventions in relation to weight loss outcomes in adults. Standard mean differences (SMD) and 95% confidence intervals (CI) were calculated using a random effects model. Twenty-seven trials incorporating 36 comparisons met our inclusion criteria. Participants using self-directed interventions lost significantly more weight (MD = -1.56 kg, CI -2.25, -0.86 ranging from 0.6 to 5.3 kg) compared to those in the minimal-intervention or no-treatment groups (3.1-month follow-up median). The majority of interventions were internet-based (18 evaluations) and these were effective at 3 months (MD = -1.74 kg, CI -2.65, -0.82 ranging from 0.6 to 4.8 kg) (SMD = -0.48, 95% CI -0.72, -0.24, I² = 82%; p < .0001; 16 evaluations) and 6 months follow-up (MD = -2.71 kg, CI -4.03, -1.39 ranging from 2.2 to 5.3 kg) (SMD = -0.59, 95% CI -0.99, -0.19, I² = 76%; p = .004; 4 evaluations). Self-directed weight-loss interventions can generate modest weight loss for up to 6 months but may need to be supplemented by other interventions to achieve sustained and clinically meaningful weight loss.