Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART)

Social interactions increasingly take place online. Friendships and other offline social ties have been repeatedly associated with human longevity, but online interactions might have different properties. Here, we reference 12 million social media profiles against California Department of Public Health vital records and use longitudinal statistical models to assess whether social media use is associated with longer life. The results show that receiving requests to connect as friends online is associated with reduced mortality but initiating friendships is not. Additionally, online behaviors that indicate face-to-face social activity (like posting photos) are associated with reduced mortality, but online-only behaviors (like sending messages) have a nonlinear relationship, where moderate use is associated with the lowest mortality. These results suggest that online social integration is linked to lower risk for a wide variety of critical health problems. Although this is an associational study, it may be an important step in understanding how, on a global scale, online social networks might be adapted to improve modern populations' social and physical health.social networks | social media | health | longevity | social support P eople with more friends and more social ties in their community tend to live longer (1-4). Many researchers interpret this association as evidence that greater social support and social network integration lead to better health outcomes (4). For example, social integration is thought to improve health by motivating engagement in healthy behaviors (5, 6), improving immunity (7), and reducing inflammation (8). However, nearly all of this work has been conducted in the context of real-world, face-to-face social interactions. As more and more people use online social media to maintain friendships (as of June 2016, about 1.1 billion people use Facebook daily), an open question is whether or not this new context can be used to measure real world social activity and, distinctly, whether online social interactions are similarly associated with better health and increased human longevity.Many researchers have shown that online access to friends promotes real world social activities (9). This finding suggests that online social media may increase the amount of overall social integration. To the extent that people use social media to coordinate and engage in healthy face-to-face social behavior, we might therefore expect a positive relationship between online use and health. However, it may also be the case that spending time on social media reduces the amount of time available for offline socializing. If so, then social media use might be more like watching television, which tends to crowd out social activity and, along with other forms of sedentary behavior, has been associated with worse health outcomes (10). Of course, because social media use is not randomly assigned, use might also be a proxy for other unmeasured traits.To help adjudicate whether online social media use has a positive or negati...

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“…Indeed, some scholars are currently designing, implementing, and testing such applications (18), and we encourage others to do so as well.…”

Section: Discussionmentioning

confidence: 99%

Online social integration is associated with reduced mortality risk

Hobbs

Burke

Christakis

et al. 2016

Proc. Natl. Acad. Sci. U.S.A.

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“…37 Studies are underway investigating multicomponent interventions, utilizing social media, self-monitoring, cell phone delivery, and varying degrees of behavior changes. 38–40 None are specific to AI college students, so their effectiveness should be investigated for AI college students in particular while also using culturally tailored materials, such as the Special Diabetes Program for Indians Diabetes Prevention. 41 …”

Section: Discussionmentioning

confidence: 99%

Accuracy of Weight Perception Among American Indian Tribal College Students

Gibbs

Pacheco

Daley

et al. 2016

American Journal of Preventive Medicine

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Introduction National data indicate a higher prevalence of obesity among American Indian (AI) populations and greater disparity of morbidity and mortality among younger age groups compared with other ethnicities. Diet and physical activity are important obesity preventive behaviors, but no published data exist that describe these behaviors in relation to obesity in AI young adults at tribal colleges. Study purposes were to: (1) identify fruit and vegetable and physical activity practices of AI young adults from three U.S. tribal colleges according to BMI categories; (2) identify the accuracy of body weight perceptions; and (3) identify predictor variables for weight misperception. Methods In this observational study during 2011–2014, a total of 1,256 participants were recruited from three participating U.S. tribal colleges to complete an online survey addressing issues related to diet, physical activity, and weight perception. Reported height and weight were used to calculate BMI categories, and differences between BMI categories were examined. Gender differences related to accuracy of weight perception by BMI categories were also examined. Analyses were conducted in 2016. Results Based on self-reported height and weight, 68% of the sample was overweight or obese (BMI ≥25) and the mean BMI was 28.9 (SD=6.9). Most did not meet recommendations for fruit intake (78.7%), vegetable intake (96.6%), or physical activity (65.6%). More than half (53.7%%) who were overweight/obese underestimated their weight category. Men more often underestimated their weight category (54.2%) than women (35.1%). Conclusions Interventions are needed to improve weight-related lifestyle behaviors of AI tribal college students.

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“…The study methods have been described in detail elsewhere. 20 This was one of seven trials funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) to evaluate the efficacy of technology-based interventions for weight control in young adults. 7 The study procedures were approved by the University of California, San Diego (UCSD) Institutional Review Board (#091040, 07/23/2009 to 04/14/2016) in cooperation with the institutional review boards of San Diego State University (SDSU) and California State University, San Marcos (CSUSM).…”

Section: Methodsmentioning

confidence: 99%

Using social and mobile tools for weight loss in overweight and obese young adults (Project SMART): a 2 year, parallel-group, randomised, controlled trial

Godino

Merchant

Norman

et al. 2016

The Lancet Diabetes & Endocrinology

139

270

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Background Few weight-loss interventions are evaluated for longer than a year, and even fewer employ social and mobile technologies commonly used among young adults. We assessed the efficacy of a two-year, theory-based weight-loss intervention that was remotely and adaptively delivered via integrated user-experiences with 1) Facebook, 2) mobile apps, 3) text messaging, 4) emails, 5) a website, and 6) technology-mediated communication with a health coach. Methods From May 2011 to May 2012, 404 overweight or obese college students (aged 18 to 35 years) from three universities in San Diego, CA were randomized using a computer-based procedure to receive either the intervention (n=202) or general information about health and wellness (control group, n=202). The primary outcome was objectively measured weight in kg at 24 months, and differences between groups were evaluated using linear mixed-effects regression and an intention-to-treat framework. The trial was registered with ClinicalTrials.gov NCT01200459. Findings Participants’ mean (standard deviation (SD)) age was 22·7 (3.8) years. They were 70% female and 31% Hispanic. Mean (SD) body mass index was 29·0 (2.8) kg/m2. At 24 months, weight was assessed in 341 (84%) participants, but all 404 were included in analyses. Weight, adjusted for sex, ethnicity, and college, was significantly less in the intervention group compared to the control group at 6 months (−1·33 kg, 95% confidence interval (CI) = −2·36 to −0·30, p = 0·011) and 12 months (−1·33 kg, 95% CI =−2·30 to −0·35, p = 0·008). However, differences between groups at 18 months (−0·67 kg, 95% CI = −1·69 to 0·35, p = 0·200) and 24 months (−0·79 kg, 95% CI = −2·02 to 0·43, p = 0·204) were not significant. Interpretation Social and mobile technologies may facilitate limited short-term weight loss among young adults, but as utilized in this intervention, these approaches did not produce sustained reductions in weight.

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Design and implementation of a randomized controlled social and mobile weight loss trial for young adults (project SMART)

Cited by 96 publications

References 43 publications

Online social integration is associated with reduced mortality risk

Online social integration is associated with reduced mortality risk

Accuracy of Weight Perception Among American Indian Tribal College Students

Using social and mobile tools for weight loss in overweight and obese young adults (Project SMART): a 2 year, parallel-group, randomised, controlled trial

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