mHealth interventions for weight loss: a guide for achieving treatment fidelity.
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2014-11
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mHealth interventions have shown promise for helping people sustain healthy behaviors such as weight loss. However, few have assessed treatment fidelity, that is, the accurate delivery, receipt, and enactment of the intervention. Treatment fidelity is critical because the valid interpretation and translation of intervention studies depend on treatment fidelity assessments. We describe strategies used to assess treatment fidelity in mobile health (mHealth) interventions aimed at sustaining healthy behaviors in weight loss. We reviewed treatment fidelity recommendations for mHealth-based behavioral interventions and described how these recommendations were applied in three recent weight loss studies. We illustrate how treatment fidelity can be supported during study design, training of providers, treatment delivery, receipt of treatment, and enactment of treatment skills. Pre-planned strategies to ensure the treatment fidelity of mHealth interventions will help counter doubts concerning valid conclusions about their effectiveness and allow investigators and clinicians to implement robustly efficacious mobile health programs.Trial registration number
1F31 NR012599.Type
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Shaw, Ryan J, Dori M Steinberg, Leah L Zullig, Hayden B Bosworth, Constance M Johnson and Linda L Davis (2014). mHealth interventions for weight loss: a guide for achieving treatment fidelity. Journal of the American Medical Informatics Association : JAMIA, 21(6). pp. 959–963. 10.1136/amiajnl-2013-002610 Retrieved from https://hdl.handle.net/10161/30005.
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Ryan Shaw
As the Chief Nurse Innovation Officer at Duke University Health System, I advance nursing practice through innovative solutions across disciplines and methodologies. By leveraging technology and evidence-based practices, I help identify new opportunities to address challenges in healthcare delivery, improve patient outcomes, and drive efficiency.
Nurses need more opportunity to innovate so that they can better care for patients and their families. I see my role as empowering nurses to thrive as changemakers.
In addition, I teach classes in health informatics and research methods, and mentor students and trainees to become the next generation of health scientists and clinicians.
Leah L Zullig
Leah L. Zullig, PhD, MPH is a health services researcher and an implementation scientist. She is a Professor in the Duke Department of Population Health Sciences and an investigator with the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham Veterans Affairs Health Care System. Dr. Zullig leads INTERACT, the Implementation Science Research Collaborative, and is co-leader of Duke Cancer Institute's cancer prevention and control program.
Dr. Zullig’s overarching research interests address three domains: improving cancer care delivery and quality; promoting cancer survivorship and chronic disease management; and improving medication adherence. Throughout these three area of foci Dr. Zullig uses an implementation science lens with the goal of providing equitable care for all by implementing evidence-based practices in a variety of health care environments. She has authored over 200 peer-reviewed publications.
Dr. Zullig completed her BS in Health Promotion, her MPH in Public Health Administration, and her PhD in Health Policy.
Areas of expertise: Implementation Science, Health Measurement, Health Policy, Health Behavior, Telehealth, and Health Services Research
Hayden Barry Bosworth
Dr. Bosworth is a health services researcher and Deputy Director of the Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT) at the Durham VA Medical Center. He is also Vice Chair of Education and Professor of Population Health Sciences. He is also a Professor of Medicine, Psychiatry, and Nursing at Duke University Medical Center and Adjunct Professor in Health Policy and Administration at the School of Public Health at the University of North Carolina at Chapel Hill. His research interests comprise three overarching areas of research: 1) clinical research that provides knowledge for improving patients’ treatment adherence and self-management in chronic care; 2) translation research to improve access to quality of care; and 3) eliminate health care disparities.
Dr. Bosworth is the recipient of an American Heart Association established investigator award, the 2013 VA Undersecretary Award for Outstanding Achievement in Health Services Research (The annual award is the highest honor for VA health services researchers), and a VA Senior Career Scientist Award. In terms of self-management, Dr. Bosworth has expertise developing interventions to improve health behaviors related to hypertension, coronary artery disease, and depression, and has been developing and implementing tailored patient interventions to reduce the burden of other chronic diseases. These trials focus on motivating individuals to initiate health behaviors and sustaining them long term and use members of the healthcare team, particularly pharmacists and nurses. He has been the Principal Investigator of over 30 trials resulting in over 400 peer reviewed publications and four books. This work has been or is being implemented in multiple arenas including Medicaid of North Carolina, private payers, The United Kingdom National Health System Direct, Kaiser Health care system, and the Veterans Affairs.
Areas of Expertise: Health Behavior, Health Services Research, Implementation Science, Health Measurement, and Health Policy
Constance Margaret Johnson
Dr. Johnson is an Associate Professor with tenure and a health informatician with interdisciplinary training in nursing and health informatics, and is the Faculty Coordinator of the Systems Programs at the Duke University School of Nursing. She has a secondary appointment in the Department of Community and Family Medicine in the Duke University School of Medicine and is an adjunct associate professor at the University of Texas at Houston Health Science Center, School of Biomedical Informatics. She earned her BSN from the University of Connecticut and her MS and PhD from the School of Biomedical Informatics at the University of Texas at Houston. She has over 25 years of experience in research and informatics in the area of health promotion and disease prevention.
Dr. Johnson’s current research interests in health informatics include human-computer interaction, and how the representation and visualization of information impacts health care decisions in the area of disease prevention and health promotion. As a Primary Investigator, she has received research funding from the National Cancer Institute, National Library of Medicine, National Heart, Lung and Blood Institute, AHRQ, and RENCI. She is also a Co-Investigator and Co-PI on various other grants in the area of Health Informatics. Dr. Johnson also mentors Master’s, DNP, and PhD students.
Linda Lindsey Davis
My research interests are grounded in my early experiences as an adult nurse practitioner and are around elder care,family stress, coping and adaptation, and methods and measures for clinical research around those issues.
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