University of North Carolina, Chapel Hill: NIH funds $2.8 million Gillings research on personalized messaging for weight management app

Mobile health apps, fitness trackers, and smartwatches have made access to health data easier than ever, but users often don’t receive personalized support and specific strategies to help them change their behavior. Nutrition researchers at the UNC Gillings School of Global Public Health are working to realize the promise of digital health tools by studying what types of personalized messages and guidance can best help users modify their behavior to meet their goals.

The National Institutes of Health has awarded a grant of more than $2.8 million to the Gillings School to support research on a variety of intervention messages that can provide users the right type of support at the right time to encourage behavior change.

Through use of a mobile app called “Nudge,” researchers are using an innovative micro-randomized trial design to test daily messages that leverage data from connected health devices to help people meet goals, such as eating more healthful foods, getting active and keeping tabs on their weight. By understanding the types of support users need and when, and by nudging them toward meeting goals more often, the project aims to optimize the delivery of highly personalized messages and behavioral nudges.

“We know there are individual differences in when and what types of support people might need to meet their goals related to activity, nutrition and weight,” said Carmina Valle, assistant professor in the Department of Nutrition and Member of the UNC Lineberger Cancer Center. “Our work will help us systematically identify what, when and for whom these personalized messages work best.”

Valle will lead this four-year study along with co-investigators Deborah Tate, professor of nutrition and health behavior; assistant professors of nutrition Brooke Nezamiand Heather Wasser; and Nisha Gottfredson, associate professor of health behavior.

The study will test the effects of seven different types of messages that target weighing, activity and nutrition behaviors among approximately 200 young adults seeking to lose weight.

Participants will use the Nudge mobile app for six months, which offers evidence-based weekly lessons, tailored feedback, self-monitoring and daily messages. Participants will also receive a wireless scale and activity tracker. They will track “red” (high calorie) foods in the app and have three daily goals: weigh, maintain an active minutes goal that gradually increases if met and limit red foods. At three decision points each day, participants will be micro-randomized to receive or not receive one of seven types of messages that target specific behavior change techniques.

“Ultimately, our work can guide development of future health-related apps by identifying what types of messages and when are the best times to provide support throughout the day,” said Valle. “Results of this study will not only inform our understanding of which intervention messages are efficacious for helping people meet daily behavioral goals, but also when they are efficacious, for whom, and under what environmental conditions. Our work is rooted in the promise of the precision medicine initiative by developing highly adaptive, just-in-time mobile intervention messaging that is personalized to individuals.”

This work builds on a Gillings Innovation Lab first funded in 2016, titled “Precision Public Health: Enhancing Connections to Develop Just-in-Time Adaptive Intervention Strategies,” which aims to develop the science and infrastructure at UNC to enable the construction and evaluation of innovative and scalable just-in-time adaptive interventions. In addition to this recently awarded grant, the NIH previously awarded the research team a grant of more than $3.7 million to support the optimization of a mHealth behavioral weight loss intervention for young adults.