title: Cell phone intervention for you (CITY): A randomized, controlled trial of behavioral weight loss intervention for young adults using mobile technology.
abstract: OBJECTIVE
  To determine the effect on weight of two mobile technology-based (mHealth) behavioral weight loss interventions in young adults.
  
  
  METHODS
  Randomized, controlled comparative effectiveness trial in 18- to 35-year-olds with BMI ≥ 25 kg/m(2) (overweight/obese), with participants randomized to 24 months of mHealth intervention delivered by interactive smartphone application on a cell phone (CP); personal coaching enhanced by smartphone self-monitoring (PC); or Control.
  
  
  RESULTS
  The 365 randomized participants had mean baseline BMI of 35 kg/m(2) . Final weight was measured in 86% of participants. CP was not superior to Control at any measurement point. PC participants lost significantly more weight than Controls at 6 months (net effect -1.92 kg [CI -3.17, -0.67], P = 0.003), but not at 12 and 24 months.
  
  
  CONCLUSIONS
  Despite high intervention engagement and study retention, the inclusion of behavioral principles and tools in both interventions, and weight loss in all treatment groups, CP did not lead to weight loss, and PC did not lead to sustained weight loss relative to Control. Although mHealth solutions offer broad dissemination and scalability, the CITY results sound a cautionary note concerning intervention delivery by mobile applications. Effective intervention may require the efficiency of mobile technology, the social support and human interaction of personal coaching, and an adaptive approach to intervention design.
authors.affiliation: Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Sarah W. Stedman Nutrition and Metabolism Center, Duke Molecular Physiology Institute, Durham, North Carolina, USA.
authors.forename: Laura P
authors.initials: LP
authors.lastname: Svetkey
authors.affiliation: Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Bryan C
authors.initials: BC
authors.lastname: Batch
authors.affiliation: Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Sarah W. Stedman Nutrition and Metabolism Center, Duke Molecular Physiology Institute, Durham, North Carolina, USA.
authors.forename: Pao-Hwa
authors.initials: PH
authors.lastname: Lin
authors.affiliation: College of Computer and Information Science, Northeastern University, Boston, Massachusetts, USA.|Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts, USA.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Intille
authors.affiliation: Division of Endocrinology, Metabolism, and Nutrition, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Leonor
authors.initials: L
authors.lastname: Corsino
authors.affiliation: Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Crystal C
authors.initials: CC
authors.lastname: Tyson
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina, USA.|School of Nursing, Duke University Medical Center, Durham, North Carolina, USA.|Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
authors.forename: Hayden B
authors.initials: HB
authors.lastname: Bosworth
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Grambow
authors.affiliation: Division of General Internal Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
authors.forename: Corrine
authors.initials: C
authors.lastname: Voils
authors.affiliation: Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Loria
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Gallis
authors.affiliation: Division of Nephrology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA.|Sarah W. Stedman Nutrition and Metabolism Center, Duke Molecular Physiology Institute, Durham, North Carolina, USA.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Schwager
authors.affiliation: Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA.
authors.forename: Gary G
authors.initials: GG
authors.lastname: Bennett
authors.affiliation: Department of Psychology & Neuroscience, Duke University, Durham, North Carolina, USA.|Duke Obesity Prevention Program, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Gary B
authors.initials: GB
authors.lastname: Bennett
mesh_terms: D000293:Adolescent; D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D001835:Body Weight; D040421:Cell Phone; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications; D009765:Obesity / Q000523:psychology / Q000628:therapy; D050177:Overweight / Q000523:psychology / Q000628:therapy*; D012944:Social Support; D017216:Telemedicine / Q000379:methods*; D015431:Weight Loss; D061217:Weight Reduction Programs / Q000379:methods*; D055815:Young Adult