The SHED-IT Community Trial: A Randomized Controlled Trial of Internet- and Paper-Based Weight Loss Programs Tailored for Overweight and Obese Men

KeywordsWeight loss, weight maintenance, men and women, systematic review 3 AcknowledgementsThis review is one of a series of systematic reviews for the ROMEO project (Review Of MEn and Conflict of interestThe authors have no conflict of interests to declare. Contribution of authorsCR drafted the manuscript under the supervision of AA. FS developed and ran the electronic literature search. CR and AA conducted the eligibility screening, data extraction and quality assessment. All authors contributed to the study design and manuscript preparation. 5 AbstractWe systematically reviewed the randomised controlled trial (RCT) evidence for long-term (>12 months) weight management interventions for obese men in contrast to women to help understand whether programmes should be designed differently for men.We searched 11 databases up to October 2014. Twenty-two RCTs reported data separately for men and women in weight loss or weight maintenance interventions.We found men were under-represented in RCTs of weight loss interventions open to both sexes. Men comprised 36% of participants (4771 from 13,305 participants). Despite this, men were 11% (95% CI 8% to 14%, p<0.001) more likely to be trial completers compared to women. The trials did not report service user consultation and none were designed to investigate whether men and women responded differently to given interventions. Our meta-analysis of 13 trials showed no significant difference in weight loss between men and women, either for weight loss in kg ( p=0.90) or percentage weight loss (p=0.78), although men tended to lose more weight with intensive low fat reducing diets, with or without meal replacements, and structured physical activity/exercise programmes than women.Orlistat was less beneficial for men for weight maintenance. Individual support and tailoring appeared more helpful for men than women.We found evidence that men and women respond differently to, and have different preferences for, varying types of weight management programme. We suggest that it is important to understand men's views on weight loss, as this is likely to also improve the uptake and effectiveness of programmes for men.

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“…Two recent trials [10,60] of men-only interventions achieved effective long-term weight loss results.…”

Section: Discussionmentioning

confidence: 98%

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

Robertson

Avenell

Boachie

et al. 2016

Obesity Research & Clinical Practice

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“…Also encouraging is Morgan et al's Self-Help, Exercise, and Diet using Information Technology (SHED-IT) series. Translation of SHED-IT from a university 83 to a community 84 sample is encouraging, as further adaptation into PC appears a straightforward step. Some technologies are currently under-represented in the literature, despite their widespread use.…”

Section: Areas For Future Researchmentioning

confidence: 96%

Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

et al. 2014

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BACKGROUND:The US Preventive Services Task Force recommends screening for and treating obesity. However, there are many barriers to successfully treating obesity in primary care (PC). Technology-assisted weight loss interventions offer novel ways of improving treatment, but trials are overwhelmingly conducted outside of PC and may not translate well into this setting. We conducted a systematic review of technology-assisted weight loss interventions specifically tested in PC settings. METHODS: We searched the literature from January 2000 to March 2014. Inclusion criteria: (1) Randomized controlled trial; (2) trials that utilized the Internet, personal computer, and/or mobile device; and (3) occurred in an ambulatory PC setting. We applied the Cochrane Effective Practice and Organization of Care (EPOC) and Delphi criteria to assess bias and the Pragmatic-Explanatory Continuum Indicator Summary (PRECIS) criteria to assess pragmatism (whether trials occurred in the real world versus under ideal circumstances). Given heterogeneity, results were not pooled quantitatively. RESULTS: Sixteen trials met inclusion criteria. Twelve (75 %) interventions achieved weight loss (range: 0.08 kg -5.4 kg) compared to controls, while 5-45 % of patients lost at least 5 % of baseline weight. Trial duration and attrition ranged from 3-36 months and 6-80 %, respectively. Ten (63 %) studies reported results after at least 1 year of follow-up. Interventions used various forms of personnel, technology modalities, and behavior change elements; trials most frequently utilized medical doctors (MDs) (44 %), webbased applications (63 %), and self-monitoring (81 %), respectively. Interventions that included clinician-guiding software or feedback from personnel appeared to promote more weight loss than fully automated interventions. Only two (13 %) studies used publically available technologies. Many studies had fair pragmatism scores (mean: 2.8/4), despite occurring in primary care. DISCUSSION: Compared to usual care, technologyassisted interventions in the PC setting help patients achieve weight loss, offering evidence-based options to PC providers. However, best practices remain undetermined. Despite occurring in PC, studies often fall short in utilizing pragmatic methodology and rarely provide publically available technology. Longitudinal, pragmatic, interdisciplinary, and opensource interventions are needed.

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“…Studies in Australia indicated that the rural population is physically less active than its urban counterpart due to limited accessibility to services and facilities [6]. Morgan et al also noted in their study that face-to-face programs for weight management are less attractive to men [7].…”

Section: Introductionmentioning

confidence: 96%

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review

et al. 2016

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Persuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood. AbstractPersuasive technology in mobile applications can be used to influence the behaviour of users. A framework known as the Persuasive Systems Design model has been developed for designing and evaluating systems that influence the attitudes or behaviours of users. This paper reviews the current state of mobile applications for health behavioural change with an emphasis on applications that promote physical activity. The inbuilt persuasive features of mobile applications were evaluated using the Persuasive Systems Design model. A database search was conducted to identify relevant articles. Articles were then reviewed using the Persuasive Systems Design model as a framework for analysis. Primary task support, dialogue support, and social support were found to be moderately represented in the selected articles. However, system credibility support was found to have only low levels of representation as a persuasive systems design feature in mobile applications for supporting physical activity. To ensure that available mobile technology resources are best used to improve the wellbeing of people, it is important that the design principles that influence the effectiveness of persuasive technology be understood.

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The SHED-IT Community Trial: A Randomized Controlled Trial of Internet- and Paper-Based Weight Loss Programs Tailored for Overweight and Obese Men

Abstract: Men achieved significant weight loss after receiving novel, minimal-contact, gender-tailored programs, which were designed for widespread dissemination.

Cited by 113 publications

References 42 publications

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

Should weight loss and maintenance programmes be designed differently for men? A systematic review of long-term randomised controlled trials presenting data for men and women: The ROMEO project

Technology-Assisted Weight Loss Interventions in Primary Care: A Systematic Review

Persuasive Technology in Mobile Applications Promoting Physical Activity: a Systematic Review

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