title: The effect of electronic self-monitoring on weight loss and dietary intake: a randomized behavioral weight loss trial.
abstract: Technology may improve self-monitoring adherence and dietary changes in weight loss treatment. Our study aimed to investigate whether using a personal digital assistant (PDA) with dietary and exercise software, with and without a feedback message, compared to using a paper diary/record (PR), results in greater weight loss and improved self-monitoring adherence. Healthy adults (N = 210) with a mean BMI of 34.01 kg/m(2) were randomized to one of three self-monitoring approaches: PR (n = 72), PDA with self-monitoring software (n = 68), or PDA with self-monitoring software and daily feedback messages (PDA+FB, n = 70). All participants received standard behavioral treatment. Self-monitoring adherence and change in body weight, waist circumference, and diet were assessed at 6 months; retention was 91%. All participants had a significant weight loss (P < 0.01) but weight loss did not differ among groups. A higher proportion of PDA+FB participants (63%) achieved ≥ 5% weight loss in comparison to the PR group (46%) (P < 0.05) and PDA group (49%) (P = 0.09). Median percent self-monitoring adherence over the 6 months was higher in the PDA groups (PDA 80%; PDA+FB 90%) than in the PR group (55%) (P < 0.01). Waist circumference decreased more in the PDA groups than the PR group (P = 0.02). Similarly, the PDA groups reduced energy and saturated fat intake more than the PR group (P < 0.05). Self-monitoring adherence was greater in the PDA groups with the greatest weight change observed in the PDA+FB group.
authors.affiliation: University of Pittsburgh School of Nursing, Department of Health and Community Systems, Pittsburgh, Pennsylvania, USA. bu100@pitt.edu
authors.forename: Lora E
authors.initials: LE
authors.lastname: Burke
authors.forename: Molly B
authors.initials: MB
authors.lastname: Conroy
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sereika
authors.forename: Okan U
authors.initials: OU
authors.lastname: Elci
authors.forename: Mindi A
authors.initials: MA
authors.lastname: Styn
authors.forename: Sushama D
authors.initials: SD
authors.lastname: Acharya
authors.forename: Mary A
authors.initials: MA
authors.lastname: Sevick
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Ewing
authors.forename: Karen
authors.initials: K
authors.lastname: Glanz
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy; D015992:Body Mass Index; D003131:Combined Modality Therapy; D034201:Computers, Handheld; D015930:Diet Records; D004038:Diet, Reducing / Q000523:psychology; D002149:Energy Intake / Q000502:physiology*; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology*; D012648:Self Care; D012984:Software; D015431:Weight Loss; D055815:Young Adult