Remote coaching helps improve diet and exercise habits

By Ingrid Grasmo

Study findings suggest that remote coaching supported by mobile technology and financial incentives could encourage healthier eating and physical activity habits in adults.

"Interventions that target multiple, prevalent, covariant risk behaviors simultaneously have the potential to be powerfully efficient and cost-effective. Yet, many multiple behavior change interventions have achieved limited success presumably because their interventions were insufficiently intensive," say Bonnie Spring (Northwestern University, Chicago, Illinois, USA) and colleagues.

For the study, the researchers randomly assigned 200 adults with elevated saturated fat and low fruit and vegetable intake, high sedentary leisure time, and low physical activity to either one of the following four interventions: increase fruit/vegetable intake and physical activity; decrease fat and sedentary leisure; decrease fat and increase physical activity; or increase fruit/vegetable intake and decrease sedentary leisure.

Remote coaching over a 3-week period was provided in addition to mobile decision-support technology and financial incentives that were contingent on using the mobile device to self-monitor and attain behavioral targets.

Analysis of 5-month follow-up data from all participants revealed that all individuals attained their behavioral targets, with 8 and 9 days as the median time taken to achieve consumption of fat, sedentary, and physical activity targets and the target of five fruits/vegetables per day.

However, individuals assigned to increasing fruit/vegetable intake and reducing sedentary leisure activities had the best outcomes. After 20 weeks follow up, the average daily servings of fruit/vegetables increased significantly from 1.2 to 2.9, the average time spent per day of sedentary leisure activity decreased from 219.2 to 125.7 minutes, and the percentage of saturated fat in their daily calories decreased from 12.0% to 9.9%.

The traditional dieting approach of decreasing fat and increasing physical activity yielded the least improvements.

Although individuals were not asked to maintain eating or activity improvements, 86.5% of the 185 participants who took part in exit interviews said they "definitely" or "somewhat" tried to maintain their improvements.

"Via technology, we will soon be able to deliver fully automated and configurable multiple risk factor interventions that monitor progress continuously and can be delivered throughout the day every day…but many more research contributions such as this are needed to establish that technologically delivered multiple risk factor interventions improve outcomes," said William Riley (National Institutes of Health, Bethesda, Maryland, USA) in an associated commentary.

The findings are published in the Archives of Internal Medicine.

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