Community Research and Development Information Service - CORDIS


NoHoW Report Summary

Project ID: 643309
Funded under: H2020-EU.3.1.

Periodic Reporting for period 1 - NoHoW (Evidence-based ICT tools for weight loss maintenance)

Reporting period: 2015-03-01 to 2016-02-29

Summary of the context and overall objectives of the project

Health problems associated with obesity are a major healthcare challenge. Effective interventions and successful commercial weight loss programmes to help people lose weight already exist. However, most people re-gain the weight they lose – the real challenge is to maintain weight loss.

Researchers already know that weight loss maintenance (WLM) depends on changing behaviours. There are many techniques available to help people change their behaviour in the long term but we still don’t know which of these techniques work best for WLM or why. We also don’t know how different social and healthcare contexts influence the effectiveness of different techniques. To better tackle obesity and prevent weight regain, we need to learn more about what behaviour changes to make to best maintain weight loss in the long term – this is the main research aim of NoHoW.

GATHERING EVIDENCE - NoHoW will first carry out a survey to learn about patterns of weight loss, what people do to maintain their weight loss, and where people most often need support in preventing weight regain. The survey will specifically target people who have previously lost weight. The project will collect a wide range of information, including weight loss goals, motivation for weight loss, socioeconomic factors, and demographic information.

CHANGING BEHAVIOUR - NoHoW researchers will carry out in-depth interviews with people who have lost weight and are working to maintain their weight loss, looking at how they manage their daily activity and food intake, emotions/emotional eating and stress. Based on the results of these interviews, we will identify when support may be needed and propose the type of support that may work best to help people make lasting changes to behaviours that impact on their long-term WLM. We will then test the impact on long term WLM of these supports during the project.

NoHoW TOOLKIT - Information technology offers attractive tools for delivering interventions that would otherwise be delivered only through resource-intensive face-to-face therapies. NoHoW researchers will create the NoHoW Toolkit based on what we learn about WLM during the project, as well as what we already know about using technology to successfully change behaviours. The Toolkit will include a set of mobile apps, web-based tools and inputs from other technologies, such as smart scales and activity and sleep trackers. We’ll also learn what our potential users would like to see included and how they would like to interact with the Toolkit.

EVIDENCE IT WORKS - Once we’ve put the NoHoW Toolkit together, we’ll test it through a randomised controlled trial carried out in centres in the United Kingdom, Portugal and Denmark. We’ll recruit over one thousand overweight/obese men and women who have successfully lost more 5% of their body weight in the last twelve months. Participants will be randomly divided up into four different intervention groups and given different kinds of support, including motivation, goal setting and coping plans, emotion regulation and stress management through the ToolKit, or none at all. Everyone will be asked to weigh themselves regularly. We’ll learn if and how the Toolkit works by comparing success with WLM from the different groups.

Work performed from the beginning of the project to the end of the period covered by the report and main results achieved so far

In the first year of the project, we have gathered new evidence about weight loss maintenance by conducting an online survey on lifestyle and weight management experiences in the UK, Denmark and Portugal. From the results of the survey, we learned about how people lose weight and how successful they are at maintaining their weight loss, as well as what types of support they need for successful weight management. The results of the survey confirmed that people need support with motivation, self-regulating their behaviour and regulating their emotions - these types of support were already planned as part of the ToolKit. We also discovered that there were differences between the countries, which was not expected. For example, people in Denmark were more likely to use physical activity to lose weight, while people in the UK were more likely to plan meals. From this, we learned that we need to tailor the support offered by the ToolKit to each country.

In the UK, Denmark and Portugal, we have also started in-depth interviews with people who have recently lost weight to find out about what motivates them to lose weight, how they manage emotions and stress and regulate their diet. Analysis of the interviews is currently on-going, but early results have already been shared with the ToolKit developers.
The NoHoW ToolKit is an ICT-based set of tools, so we have also looked at what others have done to use ICT for behaviour change interventions for weight management. We learned that self-regulation of behaviour is commonly used in ICT-based interventions, but that little has been done related to stress and emotion regulation. Those previous studies that combined behavioural self-regulation techniques with stress and emotion regulation techniques were more effective in managing weight, in support of the combined approach we will develop in NoHoW. We also learned that automatic, tailored feedback and rich information environments are useful for supporting weight management, thus the NoHoW ToolKit will deliver personalised feedback to individual users, and will provide an interactive, engaging environment for users to learn about techniques for both self-regulation and stress/emotion regulation.

Much of our work so far has focused on developing the ToolKit, with the first version in English already operational. This development involved building the technology to support the ToolKit, as well as developing specific content to teach users about self-regulation and stress/emotion regulation. A dashboard has been developed, which will display relevant information for individual users, such as a chart showing their weight history. Each user will be able to decide their own path through the ToolKit content, so we have developed a personal project map, which will allow users to track their own progress. We are now testing version 1.0 with a subset of users to see how it can be improved, as well as developing the final content for version 2.0, which will be translated to Danish and Portuguese for testing in our upcoming trial.

Preparations for our randomised controlled trial of the ToolKit, planned for the coming year, are well underway. Trial teams in each centre have been working together to decide how to best recruit participants and carry out the trial in each centre. Procedures have been developed for the measurement of health biomarkers from hair and blood, as well as other behavioural information, such as diet and physical activity. A datahub has also been created in the UK to store all trial data. Initial applications for ethical approvals have already been submitted in the UK.

Progress beyond the state of the art and expected potential impact (including the socio-economic impact and the wider societal implications of the project so far)

Since the start of the project, NoHoW partners have been actively promoting the projects in the media, institutional publications, and academic conferences. Through the European Association for the Study of Obesity, we have circulated our first newsletter to over 22,000 subscribers and maintained an active social media presence. These activities have created a growing audience of key stakeholders, primed to receive more information about our results.

Through our multinational online survey, NoHoW has already generated new evidence that will have important impacts for researchers involved in obesity research, as well as commercial suppliers of weight management products and services. This evidence will be published in academic journals and presented at obesity-related meetings attended by a broad range of stakeholders, such as World Obesity's International or European Congresses on Obesity.

We have also begun to discuss how the NoHoW ToolKit might be used after the trial is completed to provide weight loss management support to a wider population. The ToolKit may be made available as a stand-alone tool or key elements integrated into a commercial weight management service. The team will investigate different scenarios as we finalise the ToolKit and gather evidence about the effectiveness of the ToolKit through the NoHoW trial.

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