Technology- and Phone-Based Weight Loss Intervention

Hartman, Sheri J.; Nelson, Sandahl H.; Cadmus-Bertram, Lisa A.; Patterson, Ruth E.; Parker, Barbara A.; Pierce, John P.

doi:10.1016/j.amepre.2016.06.024

Cited by 86Mobile Health and mHealth ApplicationsCancer Risks and FactorsObesity, Physical Activity, Diet

Technology- and Phone-Based Weight Loss Intervention

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Hartman, Sheri J., Nelson, Sandahl H., Cadmus-Bertram, Lisa A., Patterson, Ruth E., Parker, Barbara A., Pierce, John P.·2016·American Journal of Preventive Medicine

DOI 10.1016/j.amepre.2016.06.024PMC PMC5502803

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Abstract

Introduction For women with an increased breast cancer risk, reducing excess weight and increasing physical activity are believed to be important approaches for reducing their risk. This study tested a weight loss intervention that combined commercially available technology-based self-monitoring tools with individualized phone calls.Design Women were randomized to a weight loss intervention arm (n=36) or a usual care arm (n=18).Setting/participants Participants were women with a BMI ≥ 27.5 kg/m 2 and elevated breast cancer risk recruited from the mammography clinic at the Moores Cancer Center at the University of California San Diego.Intervention Intervention participants used the MyFitnessPal website and phone app to monitor diet and a Fitbit to monitor physical activity. Participants received 12 standardized coaching calls with trained counselors over 6 months. Usual care participants received the U.S. Dietary Guidelines for Americans at baseline and two brief calls over the 6 months.Main outcome measures Weight and accelerometer-measured physical activity were assessed at baseline and 6 months. Data were collected in San Diego, CA, from 2012 to 2014 and analyzed in 2015.Results Participants (n=54) had a mean age of 59.5 (SD=5.6) years, BMI of 31.9 (SD=3.5), and a mean Gail Model score of 2.5 (SD=1.4). At 6 months, intervention participants had lost significantly more weight (4.4 kg vs 0.8 kg, p=0.004) and a greater percentage of starting weight (5.3% vs 1.0%, p=0.005) than usual care participants. Across arms, greater increases in moderate-to-vigorous physical activity resulted in greater weight loss (p=0.01).Conclusions Combining technology-based self-monitoring tools with phone counseling supported weight loss over 6 months in women at increased risk for breast cancer.

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A total of 26 studies were included across all meta-analyses.
“A total of 26 studies were included across all meta-analyses [21,22,29-48,50-53].”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [35]
17 studies reported activity tracker adherence data, with 13 of these reporting activity tracker wear on at least 50% of the study intervention days.
“Moreover, 17 studies reported activity tracker adherence data [21,22,30,32,34,35, 37,38,40,41,43-45,50-52,54], with 13 of these studies [21,22,30,34,35,40,41,43,44,50-52,54] reporting activity tracker wear on at least 50% of the study intervention days.”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [35]
17 studies specified that participants must have regular access to the internet, a computer, tablet, and/or smartphone.
“Furthermore, 17 studies specified that the participant must have regular access to the internet, a computer, tablet, and/or smartphone [21,30,33,35-37,39,41-47,51-53]”
From Consumer-based wearable activity trackers increase physical activity participation: systematic review and meta-analysis (2019) · cites this paper as [35]
Only one study considered an mHealth-based intervention in breast cancer prevention, and therefore no strong conclusion can be drawn.
“Despite the high quality of the studies, only one study considered an mHealth-based intervention in breast cancer prevention [22], and therefore, no strong conclusion can be drawn.”
From Research-Tested Mobile Apps for Breast Cancer Care: Systematic Review (2019) · cites this paper as [22]

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“In addition, users might have had different interpretations of the items as some IRA indices pointed to low or no agreement within engagement items ( MyFitnessPal and My Diet Diary ), information ( My Diet Diary , MyPlate , and SparkPeople ), and subjective quality ( Lark , MyFitnessPal , and My Diet Diary ).”
Influential
Mobilizing Breast Cancer Prevention Research Through Smartphone Apps: A Systematic Review of the Literature
Houghton, L. C., Howland, R. E., & McDonald, J. A. (2019) · Frontiers in Public Health · doi:10.3389/fpubh.2019.00298 · Cited by 44 · see citing works
Breast cancer chemoprevention: An update on current practice and opportunities for primary care physicians
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Combined interventions for physical activity, sleep, and diet using smartphone apps: A scoping literature review
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Digital Health Solutions for Weight Loss and Obesity: A Narrative Review
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“In this review, one of the most frequently used apps for remote recording of dietary intake and exercise for weight loss was MFP.”
BackgroundMethodInfluential
Behavior Change Techniques in Digital Health Interventions for Midlife Women: Systematic Review
Sediva, H., Cartwright, T., Robertson, C. E., & Deb, S. K. (2022) · JMIR mhealth and uhealth · doi:10.2196/37234 · Cited by 33 · see citing works
“A total of 20% (3/15) of the studies aimed to induce weight loss in midlife women [60-62], with all using exercise and diet interventions.”
Influential
Development of the Physical activity and Your Nutrition for Cancer (PYNC) smartphone app for preventing breast cancer in women
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“00) (34-36) and a growing amount of research has successfully incorporated Fitbits into technology-oriented lifestyle interventions to increase physical activity, reduce overweight/obesity, and manage chronic conditions such as cancer (22,27-33).”
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Wearable technology-delivered lifestyle intervention amongst adults with overweight and obese: A systematic review and meta-regression
Wong, S. H., Tan, Z. Y. A., Cheng, L. J., & Lau, S. T. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.104163 · Cited by 26 · see citing works
Exercise in Obesity—the Role of Technology in Health Services: Can This Approach Work?
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Developing Workshops to Enhance Hope Among Patients With Metastatic Breast Cancer and Oncologists: A Pilot Study
Shah, M., Ferguson, A. K., Corn, P. D., Varadhan, R., Ariely, D., Stearns, V., Smith, B. D., Smith, T. J., & Corn, B. W. (2021) · JCO Oncology Practice · doi:10.1200/op.20.00744 · Cited by 25 · see citing works
The Application of Preventive Medicine in the Future Digital Health Era
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“In addition, mobile apps for primary prevention aim to promote healthy behaviors that reduce the risk of breast cancer [47,48].”
A meta-analysis of the overall effect of mHealth physical activity interventions for weight loss and the moderating effect of behavioral change theories, techniques, and mobile technologies
Qin, Y., Wang, X., & Namkoong, K. (2021) · Mobile Media & Communication · doi:10.1177/20501579211054929 · Cited by 22 · see citing works
Short-Term Pilot Study to Evaluate the Impact of Salbi Educa Nutrition App in Macronutrients Intake and Adherence to the Mediterranean Diet: Randomized Controlled Trial
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Patterns of self-monitoring technology use and weight loss in people with overweight or obesity
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“Consistent with previous studies, physical activity tracker use in this study was high [6, 13, 38, 39].”
Result
A Self-Directed Mobile Intervention (WaznApp) to Promote Weight Control Among Employees at a Lebanese University: Protocol for a Feasibility Pilot Randomized Controlled Trial
Bardus, M., Hamadeh, G. N., Hayek, B., & Kherfan, R. A. (2018) · JMIR Research Protocols · doi:10.2196/resprot.9793 · Cited by 18 · see citing works
“MyFitnessPal has been utilized in a few weight loss trials, showing some positive effects in weight reduction when employed as a supplement to telephone coaching [30], but small, no significant effects when used as a standalone tool [31,32].”
BackgroundMethod
Using factorial mediation analysis to better understand the effects of interventions
Strayhorn, J. C., Collins, L. M., Brick, T. R., Marchese, S. H., Pfammatter, A. F., Pellegrini, C. A., & Spring, B. J. (2021) · Translational Behavioral Medicine · doi:10.1093/tbm/ibab137 · Cited by 16 · see citing works
Investigating the Use of an Electronic Activity Monitor System as a Component of Physical Activity and Weight-Loss Interventions in Nonclinical Populations: A Systematic Review
Sypes, E. E., Newton, G. S., & Lewis, Z. H. (2019) · Journal of Physical Activity and Health · doi:10.1123/jpah.2017-0660 · Cited by 15 · see citing works
A Remotely Delivered, Peer-Led Physical Activity Intervention for Younger Breast Cancer Survivors (Pink Body Spirit): Protocol for a Feasibility Study and Mixed Methods Process Evaluation
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“To promote self-efficacy, women will be encouraged to set specific, step-wise goals [39,47].”
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Effects of a Mobile-Health Exercise Intervention on Body Composition, Vascular Function, and Autonomic Nervous System Function in Obese Women: A Randomized Controlled Trial
Choi, J.-H., Kim, S.-W., Seo, J., Sun, Y., Jung, W., Park, H., Kim, J., & Lim, K. (2023) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s406905 · Cited by 13 · see citing works
“The Fitbit Charge 4 has been validated by numerous studies and is a proven wearable device that can track HR, walking steps, and physical activity.(25,32,33) The data tracked using Fitbit were linked to the AI Fit webpage (AI-fit) through the synchronization process.”
Method
Mobile Web App Intervention to Promote Breast Cancer Screening Among American Indian Women in the Northern Plains: Feasibility and Efficacy Study
Roh, S., Lee, Y.-S., Kenyon, D. B., Elliott, A. J., Petereit, D. G., Gaba, A. G., & Lee, H. Y. (2023) · JMIR Formative Research · doi:10.2196/47851 · Cited by 13 · see citing works
Wearable activity trackers and health awareness: Nursing implications
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Developing Culturally Tailored Mobile Web App Education to Promote Breast Cancer Screening: Knowledge, Barriers, and Needs Among American Indian Women
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Feasibility and efficacy of a novel technology‐based approach to harness social networks for weight loss: the NETworks pilot randomized controlled trial
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The association between social media use for health related information and compliance with breast and cervical cancer screenings.
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Physical Activity Assessment and Promotion in Clinical Settings in the United States: A Scoping Review
Grogg, K. A., Giacobbi, P. R., Blair, E. K., Haggerty, T. S., Lilly, C. L., Winters, C., & Kelley, G. A. (2022) · American Journal of Health Promotion · doi:10.1177/08901171211051840 · Cited by 10 · see citing works
“Two other studies (3%) that used commercial activity tracking technology to record participant data did not report major findings from the collected information.(85,108) Physical activity was also assessed in 2 studies (3%) by direct observation through attendance in meetings and participation in physical assessments…”
Background
A randomized trial to promote physical activity in adult pre-hypertensive and hypertensive patients
Bai, Y., Burns, R. D., Gell, N., & Byun, W. (2022) · Journal of Sports Sciences · doi:10.1080/02640414.2022.2099179 · Cited by 8 · see citing works
“…Gell et al., 2020; Janevic et al., 2020), Facebook or in-person social support group (Bender et al., 2017; Butryn et al., 2016), self-regulatory through web-based tracking (Cadmus-Bertram et al., 2015; Li et al., 2020), and health-related website or App (Hartman et al., 2016; Korinek et al., 2018).”
BackgroundInfluential
Recommender systems use in weight management mHealth interventions: A scoping review
Castro, B. A., Levens, S. M., Sullivan, M., & Shaw, G. (2024) · Obesity Reviews · doi:10.1111/obr.13863 · Cited by 8 · see citing works
Heart Rate Alters, But Does Not Improve, Calorie Predictions in Fitbit Activity Monitors
Montoye, A. H. K., Vusich, J., Mitrzyk, J., & Wiersma, M. (2018) · Journal for the Measurement of Physical Behaviour · doi:10.1123/jmpb.2018-0003 · Cited by 8 · see citing works
Guideline-Based Digital Exercise Interventions for Reducing Body Weight and Fat and Promoting Physical Activity in Adults With Overweight and Obesity: Systematic Review and Meta-Analysis
Motevalli, M., Drenowatz, C., Tanous, D., Ruedl, G., Kirschner, W., Schauer, M., Rosemann, T., & Wirnitzer, K. (2025) · Interactive Journal of Medical Research · doi:10.2196/73656 · Cited by 7 · see citing works
“Figure 2 [18,20,33,34,37,39,40,42,43,45,46,48-55] shows the results of the meta-analysis assessing the effect of guideline-based digital exercise interventions on BW.”
Influential
The Impact of a 12-Month Activity Tracker Intervention on Activity Behavior Across Body Mass Index Subgroups Among Recent Retirees: Post Hoc Analysis of a Randomized Controlled Trial
Tuominen, M., Suorsa, K., Pentti, J., Koski, P., Stenholm, S., & Leskinen, T. (2021) · Journal of Physical Activity and Health · doi:10.1123/jpah.2021-0352 · Cited by 7 · see citing works
Reliability of a smartphone application to measure physical activity
Caputo, E. L., Feter, N., Alberton, C. L., Leite, J. S., Rodrigues, A. N., Dumith, S. C., & da Silva, M. C. (2021) · Research in Sports Medicine · doi:10.1080/15438627.2021.1899919 · Cited by 7 · see citing works
“These effects are reached regardless of how physical activity is measured: total steps (Bender et al., 2017; Maher et al., 2015; Walsh et al., 2016) or minutes per week (Hartman et al., 2016; Maher et al., 2015).”
Background
Methodological Insights on Recruitment and Retention From a Remote Randomized Controlled Trial Examining the Effectiveness of an Alcohol Reduction App: Descriptive Analysis Study
Oldham, M., Dinu, L. M., Loebenberg, G., Field, M., Hickman, M., Michie, S., Brown, J., & Garnett, C. V. (2023) · JMIR Formative Research · doi:10.2196/51839 · Cited by 6 · see citing works
Toward research-tested mobile health interventions to prevent diabetes and cardiovascular disease among persons with pre-diabetes
Coughlin, S. S., & Stewart, J. L. (2017) · Journal of Hospital Management and Health Policy · doi:10.21037/jhmhp.2017.11.02 · Cited by 6 · see citing works
“Mobile health (mHealth) technologies provide opportunities in patients with pre-diabetes to assist in preventing or reducing progression to diabetes through increased physical activity and healthy diet and nutrition (21-24).”
Background
Mobile applications in the control and correction of excess body weight (expert assessment results)
Gornyi, B., Bunova, A., Kulikova, M. S., Kushunina, D. V., Калинина, А. М., & Drapkina, O. M. (2021) · Russian Journal of Preventive Medicine · doi:10.17116/profmed20212408166 · Cited by 5 · see citing works
Effect of a Telephone-Based Lifestyle Intervention on Weight, Body Composition, and Metabolic Biomarkers in Rural Ohio: Results from a Randomized Pilot Study
Zhang, X., DeScenza, V. R., Chaplow, Z. L., Kilar, M., Bowman, J. L., Buga, A., Kackley, M. L., Shoben, A. B., Felix, A. S., Paskett, E. D., et al. (2023) · Nutrients · doi:10.3390/nu15183998 · Cited by 4 · see citing works
Optimizing intervention tools to improve nutrition and physical activity for colorectal cancer survivors (Tools To Be Fit): Study protocol of a randomized factorial experiment
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Research-Tested Mobile Apps for Breast Cancer Care: Systematic Review (Preprint)Preprint
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The Performance of an Algorithm for Classifying Gym-based Tasks across Individuals with Different Body Mass Index
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Sediva, H., Cartwright, T., Robertson, C. A., & Deb, S. (2022) · doi:10.2196/preprints.37234
Effects of Smartphone-based Physical Activity Interventions Comparing Meta Analysis and Network-Meta Analysis
이미영, & Yoon, J. (2018) · The Korean Journal of Measurement and Evaluation in Physical Education and Sports Science · doi:10.21797/ksme.2018.20.4.010
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Guidelines on Conducting Online Experiments with Repeated Measures and Using Smartphone Applications
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WaznApp, a self-directed mobile intervention to promote weight control among employees of a Lebanese university: Protocol for a feasibility pilot randomized controlled trialPreprint
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Les facteurs influençant l’adhésion à la santé connectée pour la gestion du poids auprès d’adultes en situation d’obésité ou de surpoids : une revue narrative de la littérature
Delestre, F., Debailly, R., Kerever, S., & Hansel, B. (2022) · Nutrition Clinique et Métabolisme · doi:10.1016/j.nupar.2022.07.002
Electronic Activity Monitoring
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Implementing mHealth Apps Through Community Engagement to Promote Cancer Screening: A Scoping Review
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A Multidimensional Framework Integrating Nutrition Health Coaching, Telenutrition, and Telemonitoring for Sustainable Weight Management: Evidence From Randomized Controlled Trials
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Randomized trial of a phone- and web-based weight loss program for women at elevated breast cancer risk: the HELP study
Cadmus‐Bertram, L., Nelson, S. H., Hartman, S. J., Patterson, R. E., Parker, B. A., & Pierce, J. P. (2016) · Journal of Behavioral Medicine · doi:10.1007/s10865-016-9735-9 · Cited by 22 · see citing works
Self-citation
12-Month Web- And Phone-based Weight Loss Intervention For Women At Elevated Breast Cancer Risk
Cadmus‐Bertram, L., Hartman, S. J., Nelson, S. H., Parker, B. A., & Pierce, J. P. (2015) · Medicine & Science in Sports & Exercise · doi:10.1249/01.mss.0000478421.77696.fc
Self-citation
Web‐based self‐monitoring for weight loss among overweight/obese women at increased risk for breast cancer: the HELP pilot study
Cadmus‐Bertram, L., Wang, J. B., Patterson, R. E., Newman, V. A., Parker, B. A., & Pierce, J. P. (2012) · Psycho-Oncology · doi:10.1002/pon.3219 · Cited by 37 · see citing works
Self-citation
Training overweight/obese older women at high risk for breast cancer to use web-based weight loss tools: The HELP pilot study.
Bertram, L. A. C., Pierce, J. P., Patterson, R. E., Ojeda‐Fournier, H., Newman, V. A., & Parker, B. A. (2011) · Journal of Clinical Oncology · doi:10.1200/jco.2011.29.27_suppl.233 · Cited by 1 · see citing works
Self-citation
Randomized Trial Comparing Telephone Versus In-Person Weight Loss Counseling on Body Composition and Circulating Biomarkers in Women Treated for Breast Cancer: The Lifestyle, Exercise, and Nutrition (LEAN) Study
Harrigan, M., Cartmel, B., Loftfield, E., Sanft, T. B., Chagpar, A. B., Zhou, Y., Playdon, M. C., Li, F., & Irwin, M. L. (2015) · Journal of Clinical Oncology · doi:10.1200/jco.2015.61.6375 · Cited by 186 · see citing works

Authors: Hartman, S. J., Nelson, S. H., Cadmus-Bertram, L. A., Patterson, R. E., Parker, B. A., & Pierce, J. P.
Affiliations: University of California San Diego (US)
Corresponding author: Hartman, Sheri J.
ORCID: Hartman, Sheri J.
Nelson, Sandahl H.
Patterson, Ruth E.
Parker, Barbara A.
Pierce, John P.
Venue: American Journal of Preventive Medicine
Publisher: Elsevier BV
Published: 2016-11
Volume: 51
Issue: 5
Pages: 714-721
ISSN: 0749-3797 (ISSN-L)
DOI: 10.1016/j.amepre.2016.06.024
PMC: PMC5502803
OpenAlex: W2512070917
Cited by: 86
References: 31
Citations by year: 2026: 5 · 2025: 2 · 2024: 2 · 2023: 8 · 2022: 10 · 2021: 16 · 2020: 8 · 2019: 13 · 2018: 14 · 2017: 7 · 2016: 1
FWCI: 21.70
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: American Journal of Preventive Medicine (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (K07CA181323, K07CA178870)
Topics: Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
Health Sciences › Medicine › Oncology › Cancer Risks and Factors
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Keywords: weight loss interventions, breast cancer risk, overweight women, MyFitnessPal, Fitbit, physical activity, moderate-to-vigorous physical activity, dietary monitoring, accelerometer-measured activity
MeSH terms: Aged, Breast Neoplasms, Female, Humans, Middle Aged, Pilot Projects, Telemedicine, Actigraphy, Weight Reduction Programs

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