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BACKGROUND: Youth overweight and obesity is a public health crisis and increases the risk of poor cardiovascular health (CVH) and chronic disease. Health care providers play a key role in weight management, yet few tools exist to support providers in delivering tailored evidence-based behavior change interventions to patients. OBJECTIVE: The goal of this pilot randomized feasibility study was to determine the feasibility of implementing the Patient-Centered Real-Time Intervention (PREVENT) tool in clinical settings, generate implementation data to inform scale-up, and gather preliminary effectiveness data. METHODS: A pilot randomized clinical trial was conducted to examine the feasibility, implementation, and preliminary impact of PREVENT on patient knowledge, motivation, behaviors, and CVH outcomes. The study took place in a multidisciplinary obesity management clinic at a children's hospital within an academic medical center. A total of 36 patients aged 12 to 18 years were randomized to use PREVENT during their routine visit (n=18, 50%) or usual care control (n=18, 50%). PREVENT is a digital health tool designed for use by providers to engage patients in behavior change education and goal setting and provides resources to support change. Patient electronic health record and self-report behavior data were collected at baseline and 3 months after the intervention. Implementation data were collected via PREVENT, direct observation, surveys, and interviews. We conducted quantitative, qualitative, and mixed methods analyses to evaluate pretest-posttest patient changes and implementation data. RESULTS: PREVENT was feasible, acceptable, easy to understand, and helpful to patients. Although not statistically significant, only PREVENT patients increased their motivation to change their behaviors as well as their knowledge of ways to improve heart health and of resources. Compared to the control group, PREVENT patients significantly improved their overall CVH and blood pressure (P<.05). CONCLUSIONS: Digital tools can support the delivery of behavior change counseling in clinical settings to increase knowledge and motivate patients to change their behaviors. An appropriately powered trial is necessary to determine the impact of PREVENT on CVH behaviors and outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT06121193; https://www.clinicaltrials.gov/study/NCT06121193.
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OBJECTIVE: Anorexia nervosa (AN) is often treated in the acute setting, but relapse after treatment is common. Cognitive-behavioral therapy (CBT) is useful in the post-acute period, but access to trained providers is limited. Social support is also critical during this period. This study utilized a user-centered design approach to develop and evaluate the usability of a CBT-based mobile app and social networking component for post-acute AN support. METHOD: Participants (N = 19) were recently discharged from acute treatment for AN. Usability testing of the intervention was conducted over three cycles; assessments included the System Usability Scale (SUS), the Usefulness, Satisfaction, and Ease of Use Questionnaire (USE), the Mobile Application Rating Scale (MARS), a social media questionnaire, and a semi-structured interview. RESULTS: Interview feedback detailed aspects of the app that participants enjoyed and those needing improvement. Feedback converged on three themes: Logistical App Feedback, boosting recovery, and Real-World App/Social Media Use. USE and MARS scores were above average and SUS scores were "good" to "excellent" across cycles. CONCLUSION: This study provides evidence of feasibility and acceptability of an app and social networking feature for post-acute care of AN. The intervention has potential for offering scalable support for individuals with AN in the high-risk period following discharge from acute care.