title: Effectiveness of a mHealth Lifestyle Program With Telephone Support (TXT2BFiT) to Prevent Unhealthy Weight Gain in Young Adults: Randomized Controlled Trial.
abstract: BACKGROUND
  Weight gained in young adulthood often persists throughout later life with associated chronic disease risk. Despite this, current population prevention strategies are not specifically designed for young adults.
  
  
  OBJECTIVE
  We designed and assessed the efficacy of an mHealth prevention program, TXT2BFiT, in preventing excess weight gain and improving dietary and physical activity behaviors in young adults at increased risk of obesity and unhealthy lifestyle choices.
  
  
  METHODS
  A two-arm, parallel-group randomized controlled trial was conducted. Subjects and analyzing researchers were blinded. A total of 250 18- to 35-year-olds with a high risk of weight gain, a body mass index (BMI) of 23.0 to 24.9 kg/m(2) with at least 2 kg of weight gain in the previous 12 months, or a BMI of 25.0 to 31.9 kg/m(2) were randomized to the intervention or control group. In the 12-week intervention period, the intervention group received 8 text messages weekly based on the transtheoretical model of behavior change, 1 email weekly, 5 personalized coaching calls, a diet booklet, and access to resources and mobile phone apps on a website. Control group participants received only 4 text messages and printed dietary and physical activity guidelines. Measured body weight and height were collected at baseline and at 12 weeks. Outcomes were assessed via online surveys at baseline and at 12 weeks, including self-reported weight and dietary and physical activity measures.
  
  
  RESULTS
  A total of 214 participants-110 intervention and 104 control-completed the 12-week intervention period. A total of 10 participants out of 250 (4.0%)-10 intervention and 0 control-dropped out, and 26 participants (10.4%)-5 intervention and 21 control-did not complete postintervention online surveys. Adherence to coaching calls and delivery of text messages was over 90%. At 12 weeks, the intervention group were 2.2 kg (95% CI 0.8-3.6) lighter than controls (P=.005). Intervention participants consumed more vegetables (P=.009), fewer sugary soft drinks (P=.002), and fewer energy-dense takeout meals (P=.001) compared to controls. They also increased their total physical activity by 252.5 MET-minutes (95% CI 1.2-503.8, P=.05) and total physical activity by 1.3 days (95% CI 0.5-2.2, P=.003) compared to controls.
  
  
  CONCLUSIONS
  The TXT2BFiT low-intensity intervention was successful in preventing weight gain with modest weight loss and improvement in lifestyle behaviors among overweight young adults. The short-term success of the 12-week intervention period shows potential. Maintenance of the behavior change will be monitored at 9 months.
  
  
  BACKGROUND
  
  
  
  BACKGROUND
  The Australian New Zealand Clinical Trials Registry ACTRN12612000924853; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612000924853 (Archived by WebCite at http://www.webcitation.org/6Z6w9LlS9).
authors.affiliation: School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, Australia.
authors.forename: Stephanie R
authors.identifier: http://orcid.org/0000-0001-5390-3922
authors.initials: SR
authors.lastname: Partridge
authors.forename: Kevin
authors.identifier: http://orcid.org/0000-0002-9679-9827
authors.initials: K
authors.lastname: McGeechan
authors.forename: Lana
authors.identifier: http://orcid.org/0000-0003-1017-5827
authors.initials: L
authors.lastname: Hebden
authors.forename: Kate
authors.identifier: http://orcid.org/0000-0002-3653-3963
authors.initials: K
authors.lastname: Balestracci
authors.forename: Annette Ty
authors.identifier: http://orcid.org/0000-0002-0919-330X
authors.initials: AT
authors.lastname: Wong
authors.forename: Elizabeth
authors.identifier: http://orcid.org/0000-0001-9879-4969
authors.initials: E
authors.lastname: Denney-Wilson
authors.forename: Mark F
authors.identifier: http://orcid.org/0000-0002-0705-8913
authors.initials: MF
authors.lastname: Harris
authors.forename: Philayrath
authors.identifier: http://orcid.org/0000-0003-2460-5031
authors.initials: P
authors.lastname: Phongsavan
authors.forename: Adrian
authors.identifier: http://orcid.org/0000-0002-0369-4621
authors.initials: A
authors.lastname: Bauman
authors.forename: Margaret
authors.identifier: http://orcid.org/0000-0002-6478-1374
authors.initials: M
authors.lastname: Allman-Farinelli
keywords: lifestyle behavior; mHealth; weight gain prevention; young adults