A smartphone-supported weight loss program: design of the ENGAGED randomized controlled trial

Background Obesity remains a major public health challenge, demanding cost-effective and scalable weight management programs. Delivering key treatment components via mobile technology offers a potential way to reduce expensive in-person contact, thereby lowering the cost and burden of intensive weight loss programs. The ENGAGED study is a theory-guided, randomized controlled trial designed to examine the feasibility and efficacy of an abbreviated smartphone-supported weight loss program. Methods/design Ninety-six obese adults (BMI 30–39.9 kg/m2) will be randomized to one of three treatment conditions: (1) standard behavioral weight loss (STND), (2) technology-supported behavioral weight loss (TECH); or (3) self-guided behavioral weight loss (SELF). All groups will aim to achieve a 7% weight loss goal by reducing calorie and fat intake and progressively increasing moderate intensity physical activity to 175 minutes/week. STND and TECH will attend 8 group sessions and receive regular coaching calls during the first 6 months of the intervention; SELF will receive the Group Lifestyle Balance Program DVD’s and will not receive coaching calls. During months 1–6, TECH will use a specially designed smartphone application to monitor dietary intake, body weight, and objectively measured physical activity (obtained from a Blue-tooth enabled accelerometer). STND and SELF will self-monitor on paper diaries. Linear mixed modeling will be used to examine group differences on weight loss at months 3, 6, and 12. Self-monitoring adherence and diet and activity goal attainment will be tested as mediators. Discussion ENGAGED is an innovative weight loss intervention that integrates theory with emerging mobile technologies. We hypothesize that TECH, as compared to STND and SELF, will result in greater weight loss by virtue of improved behavioral adherence and goal achievement. Trial registration NCT0105171

Additional adverse events among women exposed to intimate partner violence: Frequency and impact

Objective: To assess additional adverse life events that women exposed to intimate partner violence (IPV) may have endured and to ascertain whether, and in what ways, problems in adjustment are related more to IPV or to IPV plus other adverse life events. Method: Predictors of the effects of exposure to adversities were investigated in this study of 104 women exposed to severe IPV who reported conflict tactics, adverse life events, as well as symptoms of distress. Results: The majority of participants experienced additional adversities (86). Significant differences were found between those exposed to IPV-only and those exposed to IPV plus other adverse events in terms of IPV frequency and current symptoms of distress. Women with IPV plus other adverse events had twice as many physical assaults and 4 times as many sexual assaults from an intimate partner compared to IPV-only women. The number of adverse events contributed significantly to variance in trauma symptoms over and above that of exposure to IPV alone. Women exposed to additional events had approximately twice as many avoidance and physiological arousal symptoms as IPV-only women. Conclusions: The results of this study suggest a variety of implications for IPV treatment and interventions. Specifically, the role that additional interpersonal violence, especially sexual violence, plays in the expression of distress may relate to the type of service offered to the survivor. © 2011 American Psychological Association