title: Patterns of success: online self-monitoring in a web-based behavioral weight control program.
abstract: OBJECTIVE
  Online weight control technologies could reduce barriers to treatment, including increased ease and convenience of self-monitoring. Self-monitoring consistently predicts outcomes in behavioral weight loss programs; however, little is known about patterns of self-monitoring associated with success.
  
  
  METHODS
  The current study examines 161 participants (92% women; 31% African American; mean body mass index = 35.7 ± 5.7) randomized to a 6-month online behavioral weight control program that offered weekly group "chat" sessions and online self-monitoring. Self-monitoring log-ins were continuously monitored electronically during treatment and examined in association with weight change and demographics. Weekend and weekday log-ins were examined separately and length of periods of continuous self-monitoring were examined.
  
  
  RESULTS
  We found that 91% of participants logged in to the self-monitoring webpage at least once. Over 6 months, these participants monitored on an average of 28% of weekdays and 17% of weekend days, with most log-ins earlier in the program. Women were less likely to log-in, and there were trends for greater self-monitoring by older participants. Race, education, and marital status were not significant predictors of self-monitoring. Both weekday and weekend log-ins were significant independent predictors of weight loss. Patterns of consistent self-monitoring emerged early for participants who went on to achieve greater than a 5% weight loss.
  
  
  CONCLUSIONS
  Patterns of online self-monitoring were strongly associated with weight loss outcomes. These results suggest a specific focus on consistent self-monitoring early in a behavioral weight control program might be beneficial for achieving clinically significant weight losses.
authors.affiliation: Fay W. Boozman College of Public Health, Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, Little Rock, AR, USA. RAKrukowski@uams.edu
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Krukowski
authors.forename: Jean
authors.initials: J
authors.lastname: Harvey-Berino
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bursac
authors.forename: Taka
authors.initials: T
authors.lastname: Ashikaga
authors.forename: Delia Smith
authors.initials: DS
authors.lastname: West
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy / Q000379:methods*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000628:therapy*; D010349:Patient Compliance / Q000523:psychology; D015397:Program Evaluation; D012648:Self Care / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult