Effect of a mobile app intervention on vegetable consumption in overweight adults: a randomized controlled trial

Abstract

BackgroundMobile applications (apps) have been heralded as transformative tools to deliver behavioral health interventions at scale, but few have been tested in rigorous randomized controlled trials. We tested the effect of a mobile app to increase vegetable consumption among overweight adults attempting weight loss maintenance.MethodsOverweight adults (n=135) aged 18–50 years with BMI=28–40 kg/m2 near Stanford, CA were recruited from an ongoing 12-month weight loss trial (parent trial) and randomly assigned to either the stand-alone, theory-based Vegethon mobile app (enabling goal setting, self-monitoring, and feedback and using “process motivators” including fun, surprise, choice, control, social comparison, and competition) or a wait-listed control condition. The primary outcome was daily vegetables servings, measured by an adapted Harvard food frequency questionnaire (FFQ) 8 weeks post-randomization. Daily vegetable servings from 24-hour dietary recalls, administered by trained, certified, and blinded interviewers 5 weeks post-randomization, was included as a secondary outcome. All analyses were conducted according to principles of intention-to-treat.ResultsDaily vegetable consumption was significantly greater in the intervention versus control condition for both measures (adjusted mean difference: 2.0 servings; 95% CI: 0.1, 3.8, p=0.04 for FFQ; and 1.0 servings; 95% CI: 0.2, 1.9; p=0.02 for 24-hour recalls). Baseline vegetable consumption was a significant moderator of intervention effects (p=0.002) in which effects increased as baseline consumption increased.ConclusionsThese results demonstrate the efficacy of a mobile app to increase vegetable consumption among overweight adults. Theory-based mobile interventions may present a low-cost, scalable, and effective approach to improving dietary behaviors and preventing associated chronic diseases.Trial registration ClinicalTrials.gov NCT01826591. Registered 27 March 2013.

Mobile phone interventions to improve adolescents' physical health: A systematic review and meta‐analysis

“…Results of a previous review examining the effectiveness of text message intervention for youth align with those of this review, where the level of physical activity significantly improved (Ludwig, Arthur, Sculthorpe, Fountain, & Buchan, ). Additionally, previous research demonstrated the effects of implementing mobile phone intervention on dietary habits, such as increasing vegetable consumption (Elbert, Dijkstra, & Oenema, ; Mummah et al, ).…”

A randomized controlled trial study of the acceptability, feasibility, and preliminary impact of SITA (SMS as an Incentive To Adhere): A mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda

“…The pilot study established the feasibility of sending text messages with information on a participant's own adherence and adherence performance relative to peers. Receipt of group information has been shown to effectively improve other health behaviors, such as increased physical activity [31][32][33] and improved food choices [33][34][35], as well as minimizing alcohol use [36] and improving sexual health [37,38]. Our pilot data suggests that it may also be used to improve ART adherence.…”

A randomized controlled trial study of the acceptability, feasibility, and preliminary impact of SITA (SMS as an Incentive To Adhere): A mobile technology-based intervention informed by behavioral economics to improve ART adherence among youth in Uganda

“…The pilot study established the feasibility of sending text messages with information on a participant's own adherence and adherence performance relative to peers. Receipt of group information has been shown to effectively improve other health behaviors, such as increased physical activity [30][31][32] and improved food choices [32][33][34], as well as minimizing alcohol use [35] and improving sexual health [36,37]. Our pilot data suggests that it may also be used to improve ART adherence.…”