©PPRNet 2014 The Feasibility of Primary Care Promotion of mHealth Technology for Weight Loss

PPRNet2014 Annual Meeting

©PPRNet 2014

The Feasibility of Primary Care Promotion of mHealth Technology for Weight Loss


©PPRNet 2014

OBJECTIVES

• Discuss an unsuccessful grant application to pilot use of a mHealth app for weight loss in PPRNet practices

• Solicit your feedback on a proposed redesign for resubmission


©PPRNet 2014

BACKGROUND

• More than 2/3 of adults are obese or overweight

• Brief physician counseling for obesity does not result in weight loss

• Intensive interventions are effective but expensive/impractical in primary care


©PPRNet 2014

BACKGROUND

• Self-monitoring of dietary intake and physical activity is a centerpiece of successful weight loss programs

• Some studies suggest use of mHealth apps for self-monitoring may result in improved adherence with self-monitoring and sustained weight loss

• These studies recruited participants directly from the community


©PPRNet 2014

PROPOSED STUDY GOAL

Explore the feasibility of a practice-based approach to use of MyFitnessPal (MFP) for dietary and physical activity self-monitoring among patients in primary care practices


©PPRNet 2014

MYFITNESSPAL

www.myfitnesspal.com


©PPRNet 2014

PROPOSED STUDY DESIGN

6 PPRNet practices

Site visits to – Train all practice members on use of MFP– Practice planning to integrate use of MFP in practice– Input from patients on how to encourage patients to use it

Examples: • Empowering staff to recommend using it and providing brief training• Creation of patient handout with instructions for use• Incorporation of link in after visit summary• Encouraging patients to share diaries with providers• Staff members “friend” patients to provide continued motivation


©PPRNet 2014

PROPOSED EVALUATION

• Patient survey • Focus groups of patients and

providers/staff• Change in weight among patients who

were instructed in use of MFP


©PPRNet 2014

STUDY REVIEW: STRENGTHS

• Use of a model (technology acceptance model)

• Quantitative and qualitative evaluation• Excellent PI with expertise in informatics

and productive researcher• Innovative focus


©PPRNet 2014

STUDY REVIEW: WEAKNESSES

• No control over MyFitnessPal, no documentation of benefits/harms

• One reviewer concerned about promotion of commercial app

• Low uptake of mHealth technology without approaches to improve this

• Lack of participant follow up• Lack of behavioral components to help

patients achieve weight loss


©PPRNet 2014

OVERCOMING WEAKNESSES FOR A RESUBMISSION

Weakness: • No control over MyFitnessPal

Redesign: • Provide choice of apps to use

What apps should we include?Would it be feasible for you to suggest several apps for your patients to use?


©PPRNet 2014


Weaknesses: • No documentation of benefits/harms• One reviewer concerned about promotion of

commercial app

Redesign: • Decreased focus on “promotion” of apps and

more emphasis on patient and provider feedback on use of apps

What is the best way to solicit feedback from patients in your practices?


©PPRNet 2014


Weakness: • Low uptake of mHealth technology without

approaches to improve this

Redesign: • Recruit patients and staff to “champion” the

app and provide feedback

Would this be feasible?What are other ideas to increase patient uptake?


©PPRNet 2014


Weaknesses: • Lack of participant follow up crucial to the success of

mHealth technology (phone calls, coaching, group visits)

• Lack of good behavioral components to help patients achieve weight loss

Redesign: • Integration with behavioral components of weight loss

What behavioral components do you currently use?Would group visits be feasible?


©PPRNet 2014

NEXT STEPS

September 2014- Letters of support needed

November 2014- Application deadline

July 2015- Earliest project start

Documents

©PPRNet 2014 The Feasibility of Primary Care Promotion of mHealth Technology for Weight Loss