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
Ryan J. Shaw, PhD, RN, FAAN, serves as Chief Nurse Innovation Officer for Duke University Health System and Professor at the Duke University School of Nursing. He works at the intersection of nursing, technology, and healthcare innovation, leading efforts to design and evaluate new models of care that improve patient outcomes, support the healthcare workforce, and advance health system performance.
In his faculty role, Prof. Shaw leads interdisciplinary research focused on digital health, artificial intelligence, virtual care, and nurse-led models of care. His work has been supported by the National Institutes of Health (NIH), National Science Foundation (NSF), and other federal and foundation sponsors. He is committed to mentoring the next generation of scientists, innovators, and healthcare leaders.
Leah L Zullig
Leah L. Zullig, PhD, MPH is a health services researcher and implementation scientist whose work focuses on accelerating the adoption of evidence-based practices to improve healthcare delivery and population health. She is a Professor in the Duke University 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 is a recognized leader in implementation science. She directs INTERACT, the Implementation Science Research Collaborative, which fosters interdisciplinary collaborations across Duke University and with external partners to accelerate the translation of research into practice. She also leads the Dissemination and Implementation Catalyst within Duke's Clinical and Translational Science Award (CTSA) program and serves as Co-Leader of the Duke Cancer Institute's Cancer Prevention and Control Research Program.
Dr. Zullig's research spans three interconnected areas: improving the quality and delivery of cancer care; advancing cancer survivorship and chronic disease management; and enhancing medication adherence. Across these domains, she applies implementation science methods to develop, evaluate, and scale evidence-based interventions that promote equitable, high-quality care across diverse healthcare settings. Her research is characterized by strong partnerships with healthcare systems, ensuring that findings extend beyond publication to inform clinical practice, health system transformation, and policy.
Dr. Zullig has authored more than 200 peer-reviewed publications and has established a national reputation for leading pragmatic, health system-embedded research that improves patient outcomes and advances the science of implementation.
Dr. Zullig earned her Bachelor of Science in Health Promotion, Master of Public Health in Public Health Administration, and PhD in Health Policy.
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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