Self-directed interventions to promote weight loss: a systematic review and meta-analysis

Abstract

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.

Identifying change processes in group-based health behaviour-change interventions: development of the mechanisms of action in group-based interventions (MAGI) framework

“…More than 80 behaviour change theories (Davis, Campbell, Hildon, Hobbs, & Michie, 2015;Michie, West, Campbell, Brown, & Gainforth, 2014) and over 100 categories of change techniques (Abraham, 2016;Abraham & Michie, 2008;Michie et al, 2013) have been identified, some for specific intervention types including those targeting diet and physical activity (Michie, Churchill, & West, 2011), weight loss (Hartmann-Boyce, Aveyard, Koshiaris, & Jebb, 2016), smoking cessation (West, Walia, Hyder, Shahab, & Michie, 2010), and gambling problems (Rodda et al, 2018). Moreover, evidence on which types of techniques are associated with improved intervention effectiveness is accumulating (e.g., Dombrowski et al, 2012;Hartmann-Boyce, Johns, Jebb, & Aveyard, 2014;Michie, Abraham, Whittington, McAteer, & Gupta, 2009;Tang, Abraham, & Greaves, 2016). However, to date most research into change processes and change techniques has focused on individual-level, intra-personal change.…”

Effects of a Web-Based, Evolutionary Mismatch-Framed Intervention Targeting Physical Activity and Diet: a Randomised Controlled Trial

“…The Internet is wellplaced to deliver self-directed interventions (i.e. those requiring no professional contact or simply an introductory face-to-face session [6]). If effective, self-directed interventions present a low-cost means of promoting healthy individual lifestyle change, requiring no or relatively less face-to-face time with specialist personnel [7].…”

Assessing the Quality of Mobile Phone Apps for Weight Management: User-Centered Study With Employees From a Lebanese University (Preprint)

“…Several recent systematic reviews suggest that mobile apps are effective in promoting dietary self-regulation [7] and weight management [8][9][10][11][12][13][14]. Despite lacking evidence-based content [6,15], health apps can be used as standalone delivery modes in 'self-directed' weight loss interventions [16,17], or as supplemental components of complex interventions. Some studies employing researcher-developed apps [18] or popular calorie-counting apps (e.g., MyFitnessPal [19,20]) in combination with face-to-face delivery modes, showed generally larger effects compared to interventions using the apps as standalone [21][22][23].…”

“…Apps may include messages or notifications that remind users about their weight goals and provide positive feedback or reinforcements for achieving those goals. These features can trigger cognitive processes underpinning effective behavior change strategies or techniques [24][25][26][27][28][29], combining principles derived from selfdetermination theory [16,17] and persuasive technology [30,31]. In a recent review of 23 popular weight management apps [24], researchers found that most apps included several change techniques that are commonly employed in effective behavior change interventions.…”