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A UVA School of Medicine researcher has received $3.4 million from the National Institutes of Health to increase the availability of weight management programs that offer beneficial personalized feedback.

Rebecca Krukowski, PhD, and her colleagues are aiming to support people who track or “self-monitor” their diet, exercise, and weight in weight management programs. The researchers will create a semi-automated feedback system to find the “sweet spot” of combining human expertise and support with automated feedback to help participants stay on track. 

The study will be co-led by Kathryn M. Ross, PhD, MPH, Wake Forest University School of Medicine a professor and Advocate Aurora Research Institute senior research scientist. The research team also includes University of Florida computer science experts Jaime Ruiz, PhD, and Lisa Anthony, PhD; and biostatistics expert Peihua Qiu, PhD.

Personalized feedback can be motivating during weight loss, but it is also time consuming for clinicians, community-based weight program facilitators and other professionals to provide. That means this feedback often does not happen at all. Krukowski is excited to see how her hybrid approach will increase the availability of this critical element, particularly for underserved people who live in rural areas.

“If you think about homework assignments when you were in school, we all know what happens if the teacher doesn’t provide any grade or feedback on the assignments – we would all stop doing the homework because we didn’t receive praise or ideas about how we could refine our work and we didn’t feel accountable for the homework,” says Krukowski, of UVA Department of Public Health Sciences. “Self-monitoring feedback is similar — it provides positive reinforcement and accountability for continuing to put in the effort of tracking diet, exercise and weight, as well as provides personalized suggestions for reaching one’s goals.”

More Effective Weight Management

Tracking diet, exercise, and weight is one of the strongest predictors of weight loss success, the researchers note. But all that tracking — day in and day out — can be a grind, and many people struggle to stay motivated. Personalized feedback can help encourage people to stick with these important lifestyle changes.

Writing personalized messages, however, is labor intensive and requires a good amount of training. It takes a professional about 26 minutes per person per week, Krukowski says. Many clinical and community programs simply don’t have the resources to do this, reducing the programs’ effectiveness and leaving participants on their own, without this important component.

Krukowski and her colleagues aim to change this. In the first stage of their research, the scientists will provide feedback written by trained professionals over a 16-week weight-loss program. Participants will receive an e-scale, activity monitor, diet tracking app to self-monitor their behaviors, and weekly feedback messages. 

Over the next two years, the study is enrolling 300 people across the country so that the researchers can see how different types and lengths of feedback affect tracking behaviors and weight loss. They will also look at variables such as age, sex, and how quickly participants lose weight, to see how the feedback should be further personalized in a precision-medicine approach.

The researchers will use those findings to inform the second phase of their research, the development and refinement of the semi-automated feedback system. Once complete, the system will be tested with 50 more participants.

If successful, the research project could make the most effective weight management programs easier to offer and available to more people, including potentially programs for enhancing outcomes for individuals who have had metabolic/bariatric surgery or individuals taking obesity medications.

“Providing personalized self-monitoring feedback can double the amount of weight loss achieved in behavioral weight loss programs,” says Krukowski, co-lead, UVA Community Cancer Control and Obesity Research Center and a member of UVA Comprehensive Cancer Center. “Creating this tool that makes crafting personalized self-monitoring feedback easier and faster will allow every obesity treatment program to include this important element.”

People interested in learning more can email the study coordinator at AAH-FeedbackStudy@aah.org.

Finding new ways to improve the health of people across Virginia and around the world is a major mission of the new UVA Paul and Diane Manning Institute of Biotechnology. UVA also has launched a statewide clinical trials network that expands access to potential new treatments as they are developed and tested.

About the Grant and Study

The five-year, $3.4 million grant, No. R01DK140099, has been provided by the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.

To keep up with the latest medical research news from UVA, UVA Comprehensive Cancer Center and the Manning Institute, bookmark the Making of Medicine blog.