Bad Habits that Lead to Cancer, Chronic Disease Corrected by mHealth Intervention

Does this sound like someone you know? He or she spends too much time in front of screens, gets little exercise and eats a diet high in fat and low in fruits and vegetables. It likely sounds familiar because it describes a significant portion of the U.S. population. A new Northwestern Medicine study found that a lifestyle intervention could fully normalize these four unhealthy behaviors, which put people at risk of developing heart disease and common cancers, including breast, colon and prostate.

The study is published in the Journal of Medical Internet Research Tuesday, June 19.

"Our findings suggest that prevention of chronic disease through behavior change is feasible. They contradict the pessimistic assumption that it's not possible to motivate relatively healthy people to make large, long-lasting healthy lifestyle changes," said lead author Bonnie Spring, director of the Center for Behavior and Health in the Institute for Public Health and Medicine and professor of preventive medicine at Northwestern University Feinberg School of Medicine.

With the help of a smartphone app, a wearable activity tracker, some social support from a coach and a small financial incentive, study participants made large improvements in their eating and activity habits. From a starting point of less than two servings of fruits and vegetables per day, they increased their intake by 6.5 servings per day. They decreased saturated fat intake by 3.6 percent to consume less than 8 percent of their calories from saturated fat. From a baseline of 4.5 hours per day of leisure screen time, they decreased screen time by almost three hours and increased their moderate to vigorous exercise by 25 minutes per day over a nine-month trial.

Even better, participants were able to achieve the same gains whether they implemented all four diet and exercise changes simultaneously or sequentially (changing two or three first and then changing other behaviors later).

"When most people start a diet and exercise plan, they're excited to hit the ground running, but they can feel quickly defeated when they can't keep up with everything," Spring said. "The tech tools, support and incentives our intervention offered made the changes simple and motivating enough that our participants were able to start making them all at once without becoming overwhelmed."

Previous research has found that healthy behavior change usually reverts once financial incentives cease. But this study stopped offering the financial incentive after only 12 weeks, and participants still achieved positive results throughout the nine-month trial.

Additionally, the changes observed in this study and in a prior trial by the same group were larger and more sustained than what has been previously observed in studies of technology-supported interventions. Spring said she attributes this to two features of the intervention: modest early financial incentives that motivate participants to make changes larger than what they thought they could achieve; and giving digital feedback not only to participants but also to coaches.

How they Conducted the Study

Between 2012 and 2014, the study, Make Better Choices 2, enrolled 212 Chicago-area adults, primarily female (76 percent), minority (59 percent), college educated (69 percent) and with a mean age of 41 years old. All participants had low fruit and vegetable and high saturated fat intakes, low moderate to vigorous physical activity and high sedentary leisure screen time.

Participants used smartphones and accelerometers to track their activity and behavior, which they also sent to a coach who monitored whether they were tracking and how they were eating and being active. Perfect behavioral adherence was rewarded with an incentive of $5 per week for 12 weeks.

Based on the incoming data, the coach counseled people by telephone in 10- to 15-minute personalized sessions, weekly for three months, then biweekly for the next three months. Then, until nine months, they retained the intervention app but received no further coaching.

"We suggest that giving accelerometer feedback to both the participant and their coach is the way to improve diet and activity habits, because the coach can support, hold the person accountable and personalize coaching when they know what's going on," Spring said.

Spring B, Pellegrini C, McFadden HG, Pfammatter AF, Stump TK, Siddique J, King AC, Hedeker D.
Multicomponent mHealth Intervention for Large, Sustained Change in Multiple Diet and Activity Risk Behaviors: The Make Better Choices 2 Randomized Controlled Trial.
J Med Internet Res 2018; 20(6):e10528. doi: 10.2196/10528.

Most Popular Now

Novartis and Microsoft Announce Collabor…

Novartis announced an important step in reimagining medicine by founding the Novartis AI innovation lab and by selecting Microsoft as its strategic AI and data-science partner for this effort. The...

Guerbet and IBM Watson Health Announce a…

Guerbet, a global specialist in contrast agents and solutions for diagnostic and interventional medical imaging, announced that it has signed a new agreement with IBM Watson Health to co-develop and...

Bayer Inks Deals with Eleven Startups un…

Bayer announced today that the company has signed collaboration agreements with eleven digital health startups. As part of the program, Bayer will support these startup companies aiming for longer-term collaborations...

Orion Health Delivers the First Health I…

The first Health Information Exchange (HIE) in the Middle East, Malaffi, went live at the end of July just six months after contracts were signed between the project company, Abu...

Joined Up Health and Care 2019 to Explor…

Professionals from across the country will come together to seek real answers on how to deliver closely integrated services, as the Joined Up Health and Care conference returns for its...

IMS MAXIMS Wins Healthcare Innovation Aw…

Health technology specialist IMS MAXIMS has been recognised for its innovative work in the UK and Irish healthcare market in the 2019 CV Business Innovator Awards. The company has been...

Health Tech Marketing and PR Agency Incr…

Highland Marketing, a full service agency for health techmarketing, PR and communications, has appointed Tia Dissanayake to a new account executive role,in which she will support the team withher life...

Brain-Computer Interfaces without the Me…

It sounds like science fiction: controlling electronic devices with brain waves. But researchers have developed a new type of electroencephalogram (EEG) electrode that can do just that, without the sticky...

Up-Close and Personal with Neuronal Netw…

How our brain cells, or neurons, use electrical signals to communicate and coordinate for higher brain function is one of the biggest questions in all of science. For decades, researchers...

Almirall Takes a Leap into Dermatology D…

Almirall, S.A. (ALM) has launched its first call for innovation to start-ups focused on dermatology digital health. This initiative is the first step in the creation of an accelerator programme...