A Psychology Based Curriculum With Coaching to Promote Lifestyle Modification in a Mobile Setting

Background: Lifestyle diseases account for the worlds leading causes of death and are influenced by behavior. Exchanging healthy for unhealthy lifestyle behaviors plays a substantial role in disease prevention and long term health. Mobile health programs may support this exchange in behaviors. Methods: Changes in lifestyle habits from baseline to 6 and 12 months were measured using the Health Promoting Lifestyle Profile II (HPLP II) in a random subset of users (n=651) who had self-enrolled in a commercial behavior change weight management program (Noom Weight). We then tested whether baseline lifestyle scores predicted retention and engagement in program-measured relevant behaviors. Self-reported weight and program-recorded engagement were extracted from the program database. Results: Users reported an average weight loss of 7.4kg (6.3%) and 6.7kg (5.6%) at 6 and 12 months, respectively. Mixed effects models examined differences in HPLPII scores between baseline, 6, and 12 months. Results indicated a significant increase in each of the 6 HPLPII subscales (health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, stress management) and the summary score (n=394) at 6 months, which remained significant at 12 months for all scales except interpersonal relations. Multiple regression tests indicated that increased levels of nutrition were significantly related to greater weight loss at 12 months (b = -6.89, p =.02). Logistic regressions examining associations between HPLPII scores at baseline and retention at 6 months indicated that physical activity (p =.002) and nutrition (p =.05) behaviors were significantly related to better retention. Conclusions: The results suggest that lifestyle modification can be obtained through psychologically-informed curriculum and coaching in a mobile setting and that baseline habits may be an area to target individuals at risk for lower engagement and drop out.