title: Enhancement of Self-Monitoring in a Web-Based Weight Loss Program by Extra Individualized Feedback and Reminders: Randomized Trial.
abstract: BACKGROUND
  Self-monitoring is an essential behavioral strategy for effective weight loss programs. Traditionally, self-monitoring has been achieved using paper-based records. However, technology is now more frequently used to deliver treatment programs to overweight and obese adults. Information technologies, such as the Internet and mobile phones, allow innovative intervention features to be incorporated into treatment that may facilitate greater adherence to self-monitoring processes, provide motivation for behavior change, and ultimately lead to greater weight loss success.
  
  
  OBJECTIVE
  The objective of our study was to determine whether the consistency of self-monitoring differed between participants randomly assigned to a basic or an enhanced 12-week commercial Web-based weight loss program.
  
  
  METHODS
  We randomly assigned a sample of 301 adults (mean age 42.3 years; body mass index 31.3 kg/m2; female 176/301, 58.5%) to the basic or enhanced group. The basic program included tools for self-monitoring (online food and exercise diary, and a weekly weigh-in log) with some feedback and reminders to weigh in (by text or email). The enhanced program included the basic components, as well as extra individualized feedback on self-monitoring entries and reminders (by text, email, or telephone) to engage with self-monitoring tools. We evaluated the level of self-monitoring by examining the consistency of self-monitoring of food, exercise, and weight during the 12 weeks. Consistency was defined as the number of weeks during which participants completed a criterion number of entries (ie, ≥3 days of online food or exercise diary records per week and ≥1 weigh-in per week).
  
  
  RESULTS
  The enhanced group's consistency of use of self-monitoring tools was significantly greater than that of the basic group throughout the 12 weeks (median consistency for food 8 vs 3 weeks, respectively, P<.001; for exercise 2.5 vs 1 weeks, respectively, P=.003).
  
  
  CONCLUSIONS
  Enhanced features, including additional individualized feedback and reminders, are effective in enhancing self-monitoring behaviors in a Web-based weight loss program.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12610000197033; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=335159 (Archived by WebCite at http://www.webcitation.org/6gCQdj21G).
authors.affiliation: Priority Research Centre in Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia.
authors.forename: Melinda Jane
authors.identifier: http://orcid.org/0000-0002-1851-0661
authors.initials: MJ
authors.lastname: Hutchesson
authors.forename: Chor Yin
authors.identifier: http://orcid.org/0000-0002-7327-9044
authors.initials: CY
authors.lastname: Tan
authors.forename: Philip
authors.identifier: http://orcid.org/0000-0002-5632-8529
authors.initials: P
authors.lastname: Morgan
authors.forename: Robin
authors.identifier: http://orcid.org/0000-0001-5592-6132
authors.initials: R
authors.lastname: Callister
authors.forename: Clare
authors.identifier: http://orcid.org/0000-0003-3298-756X
authors.initials: C
authors.lastname: Collins
mesh_terms: D000328:Adult; D001315:Australia; D015992:Body Mass Index; D040421:Cell Phone; D004038:Diet, Reducing; D034742:Electronic Mail; D015444:Exercise; D005246:Feedback; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009517:New South Wales; D009765:Obesity / Q000628:therapy; D050177:Overweight / Q000628:therapy*; D012648:Self Care; D061217:Weight Reduction Programs / Q000379:methods*
keywords: Web-based intervention; commercial weight loss program; randomized controlled trial; self-monitoring; weight loss