Obesity Surgery

, Volume 25, Issue 10, pp 1875–1881 | Cite as

Feasibility of Smartphone-Based Education Modules and Ecological Momentary Assessment/Intervention in Pre-bariatric Surgery Patients

  • Manpreet S. Mundi
  • Paul A. Lorentz
  • Karen Grothe
  • Todd A. Kellogg
  • Maria L. Collazo-Clavell
Original Contributions



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.


Ecological 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.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Manpreet S. Mundi
    • 1
  • Paul A. Lorentz
    • 1
  • Karen Grothe
    • 2
  • Todd A. Kellogg
    • 3
  • Maria L. Collazo-Clavell
    • 1
  1. 1.Division of Endocrinology, Diabetes, Metabolism, and NutritionMayo ClinicRochesterUSA
  2. 2.Department of PsychiatryMayo ClinicRochesterUSA
  3. 3.Department of SurgeryMayo ClinicRochesterUSA

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