title: Web-Based and Mobile Delivery of an Episodic Future Thinking Intervention for Overweight and Obese Families: A Feasibility Study.
abstract: BACKGROUND
  The bias toward immediate gratification is associated with maladaptive eating behaviors and has been cross-sectionally and prospectively related to obesity. Engaging in episodic future thinking, which involves mental self-projection to pre-experience future events, reduces this bias and energy intake in overweight/obese adults and children. To examine how episodic future thinking can be incorporated into clinical interventions, a Web-based system was created to provide training for adults and children in their everyday lives.
  
  
  OBJECTIVE
  Our study examined the technical feasibility, usability, and acceptability of a Web-based system that is accessible by mobile devices and adapts episodic future thinking for delivery in family-based obesity interventions.
  
  
  METHODS
  We recruited 20 parent-child dyads (N=40) from the surrounding community and randomized to episodic future thinking versus a nutritional information thinking control to test the feasibility of a 4-week Web-based intervention. Parents were 44.1 (SD 7.8) years of age with BMI of 34.2 (SD 6.8) kg/m(2). Children were 11.0 (SD 1.3) years of age with BMI percentile of 96.0 (SD 1.8). Families met weekly with a case manager for 4 weeks and used the system daily. Adherence was collected through the Web-based system, and perceived acceptance of the Web-based system was assessed postintervention. Measurements of body composition and dietary intake were collected at baseline and after the 4 weeks of intervention.
  
  
  RESULTS
  All 20 families completed the intervention and attended all sessions. Results showed parents and children had high adherence to the Web-based system and perceived it to be easy to use, useful, and helpful. No differences between conditions were found in adherence for parents (P=.65) or children (P=.27). In addition, results suggest that basic nutrition information along with episodic future thinking delivered through our Web-based system may reduce energy intake and weight.
  
  
  CONCLUSIONS
  We showed that our Web-based system is an accepted technology and a feasible utility. Furthermore, results provide initial evidence that our system can be incorporated into family-based treatments targeting behaviors related to weight control. These results show promising utility in using our Web-based system in interventions.
authors.affiliation: Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States.
authors.forename: Yan Yan
authors.identifier: http://orcid.org/0000-0002-3922-6934
authors.initials: YY
authors.lastname: Sze
authors.forename: Tinuke Oluyomi
authors.identifier: http://orcid.org/0000-0001-7595-1087
authors.initials: TO
authors.lastname: Daniel
authors.forename: Colleen K
authors.identifier: http://orcid.org/0000-0002-3031-9210
authors.initials: CK
authors.lastname: Kilanowski
authors.forename: R Lorraine
authors.identifier: http://orcid.org/0000-0002-3342-4788
authors.initials: RL
authors.lastname: Collins
authors.forename: Leonard H
authors.identifier: http://orcid.org/0000-0003-1167-8848
authors.initials: LH
authors.lastname: Epstein
keywords: Web-based; ecological momentary intervention; episodic future thinking; health behavior; obesity