Feasibility of Smartphone-Based Education Modules and Ecological Momentary Assessment/Intervention in Pre-bariatric Surgery Patients
- 765 Downloads
Bariatric surgery is the most effective means of long-term weight loss. Knowledge gaps and lack of engagement in pre-operative patients can result in suboptimal outcome after surgery. Mobile technology, utilizing ecological momentary assessment (EMA)/intervention (EMI), has shown tremendous promise in changing behaviors. The primary objective of the study is to assess feasibility of using smartphone app with EMA/EMI functionality to prepare patients for bariatric surgery.
Subjects seeking primary bariatric surgery were provided a smartphone app containing video-based education modules with linked assessments to evaluate mastery of topic. Subjects received algorithmic EMA text messages soliciting a response regarding lifestyle behavior. Upon answering, subjects received tailored EMI text messaging supporting healthy lifestyle.
Thirty subjects (27 female and 3 male), with age of 41.3 ± 11.4 years and BMI of 46.3 ± 7.4 kg/m2 were enrolled. Twenty subjects completed the study. Ten subjects withdrew. On average, seven out of nine education modules were completed (70.9 ± 27.3 %), and 37.8/123 EMA were answered (30.7 ± 21.7 %), with response time of 17.4 ± 4.4 min. Subjects reported high satisfaction with the app. Many felt that the app fit into their routine “somewhat easily” or “very easily” (n = 12), had “perfect” amount of EMA messages (n = 8), and was very helpful in preparing for surgery (n = 7).
This study is the first to reveal the feasibility of using a smartphone app in the education and engagement of patients prior to bariatric surgery. The app was well-received based on subject satisfaction scores and revealed trends toward positive behavior change and increased weight loss. Randomized trials are necessary to delineate true efficacy.
KeywordsEcological momentary assessment Ecological momentary intervention Bariatric surgery Mobile technology Patient education Smartphone app
Conflict of Interest
Manpreet S. Mundi, Paul A. Lorentz, Karen Grothe, Todd A. Kellogg, and Maria Collazo-Clavell do not have any conflict of interest to disclose. Work as part of this study has led to the development of iOS App available on Apple App Store, which was not used in the current study. All funds raised from app are donated toward research and further app development.
Statement of Informed Consent and Compliance to Ethics Standards
Written informed consent was obtained from all participants of this study.
Approval for the study was obtained from the Institutional Review Board at Mayo Clinic, Rochester, Minnesota.
- 17.Watson A, Bickmore T, Cange A, et al. An internet-based virtual coach to promote physical activity adherence in overweight adults: randomized controlled trial. J. Med. Internet Res. [Internet]. 2012 [cited 2014 Mar 22];14. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3374543/
- 18.Stevens DJ, Jackson JA, Howes N, Morgan J. Obesity surgery smartphone apps: a review. Obes. Surg. 2014;24(1):32–6. doi: 10.1007/s11695-013-1010-3.
- 19.Stone AA, Shiffman S. Ecological momentary assessment (EMA) in behavorial medicine. Ann Behav Med. 1994;16:199–202.Google Scholar
- 21.Stone A, Shiffman S, Atienza A, Nebeling L. The science of real-time data capture: self-reports in health research. 1st ed. USA: Oxford University Press; 2007.Google Scholar
- 24.Ratcliff MB, Zeller MH, Inge TH, Hrovat KB, Modi AC. Feasibility of ecological momentary assessment to characterize adolescent postoperative diet and activity patterns after weight loss surgery. Surg. Obes. Relat. Dis. [Internet]. [cited 2014 Jul 25]; Available from: http://www.sciencedirect.com/science/article/pii/S1550728914000513
- 25.Affleck G, Tennen H, Urrows S, Higgins P, Abeles M, Hall C, et al. Fibromyalgia and women’s pursuit of personal goals: a daily process analysis. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 1998;17:40–7.Google Scholar
- 27.Kamarck TW, Muldoon MF, Shiffman SS, Sutton-Tyrrell K. Experiences of demand and control during daily life are predictors of carotid atherosclerotic progression among healthy men. Health Psychol Off J Div Health Psychol Am Psychol Assoc. 2007;26:324–32.Google Scholar