title: Ancillary study to the PREFER trial: a descriptive study of participants' patterns of self-monitoring--rationale, design and preliminary experiences.
abstract: BACKGROUND
  The treatment of obesity, marked by a high rate of recidivism, lacks strategies that sustain the improved lifestyle behaviors that led to the weight loss. Self-monitoring, a behavioral strategy to increase awareness of one's behavior, is the cornerstone of behavioral treatment in weight loss management. However, adherence to self-monitoring is less than ideal. The actual patterns of self-monitoring of eating behaviors in weight loss treatment programs have not been studied previously; if done, these data could provide information on how self-monitoring patterns affect weight loss and if interventions can be developed that address deficits in self-monitoring. Technology now permits an instrumented paper-and-pencil diary to record the real time of individuals' self-monitoring behaviors (invivodata, inc.), thus providing more information about self-reported behaviors. This technology differs from PDA based products (ex. e-diary, e-trials, logpad, PICS) because, to the user, it is no different from a standard paper-and-pencil diary.
  
  
  METHODS
  The purposes of this ancillary study are: (1) to describe the electronically recorded patterns of self-monitoring of eating behaviors by weight-loss study participants; (2) compare reported vs. electronically recorded self-monitoring; and (3) examine the relationship between the electronically validated adherence to self-monitoring goals and success in weight loss in a sub-sample of participants in the PREFER study. This paper describes the design, methods and preliminary 6-month results.
  
  
  RESULTS
  Preliminary results reveal that participants frequently report recording their eating behavior during times when the binder was not opened. Two examples of data are shown that demonstrate the lack of concordance between the self-reported and the electronically recorded data.
  
  
  CONCLUSIONS
  These unobtrusively collected electronic data can lead to the development of strategies that can promote improved adherence to self-monitoring.
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA. lbu100@pitt.edu
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Susan
authors.initials: S
authors.lastname: Sereika
authors.forename: Jina
authors.initials: J
authors.lastname: Choo
authors.forename: Melanie
authors.initials: M
authors.lastname: Warziski
authors.forename: Edvin
authors.initials: E
authors.lastname: Music
authors.forename: Mindi
authors.initials: M
authors.lastname: Styn
authors.forename: Jessica
authors.initials: J
authors.lastname: Novak
authors.forename: Arthur
authors.initials: A
authors.lastname: Stone
mesh_terms: D001521:Behavior Therapy / Q000379:methods; D015930:Diet Records; D005247:Feeding Behavior; D006801:Humans; D016347:Medical Records Systems, Computerized; D009765:Obesity / Q000628:therapy; D010349:Patient Compliance; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D015431:Weight Loss