Human-Centered Design of a Behavioral Intervention to Reverse Small Weight Regains during Weight Loss Maintenance - PROJECT SUMMARY/ABSTRACT Weight loss maintenance (WLM) is the most pressing issue in current obesity treatments. WLM programs mitigate, but do not prevent, weight regain and individuals who lose weight have trouble re-instating weight loss efforts despite having used them effectively during weight loss. Active intervention to return to weight loss behaviors immediately following a small regain may prevent further regain and aid in long-term WLM, but has not been systematically tested. The Maintain study examined whether a brief telephone-based coaching intervention could help reverse small weight regains following participation in a behavioral weight loss intervention (BWLI) compared to no intervention control. The coaching group showed statistically-significant improvements in weight compared to the control group from pre- to post-coaching, but weights were not significantly different at the 12-month study end point. Thus, additional research is warranted to inform intervention modifications to maximize the long-term effectiveness of providing coaching at the point of initial regain. This R03 small grant program for NIDDK K recipients proposal seeks to optimize and refine the Maintain phone coaching intervention to promote recovery from small weight regain during WLM. Specifically, the Double Diamond Model, a 4-phase human-centered design (HCD) process, will be used to guide intervention refinement to support recovery from regains in the short and long-term. HCD focuses on enhancing the usability of a product to improve effectiveness, efficiency, and satisfaction and can be utilized to optimize behavioral interventions. As part of this process, for Aim 1 the research team will examine the psychological and behavioral mechanisms of coaching and how long coaching effects persist following intervention in the Maintain study. They will also engage in qualitative interviews with individuals with lived experience regaining weight and recovering from weight regain. Next for Aim 2, the Maintain intervention will be refined using data-driven design choices and HCD principles. The product of this project will be a revised Maintain intervention protocol and materials for efficacy testing in a future fully powered randomized-controlled trial. The research activities proposed in this R03 award will provide the opportunity to fine-tune skills Dr. Hayes has developed through the K23, including skills related to longitudinal data analysis and intervention development, and facilitate their application to WLM. This award will be integral to completing her transition to independence by opening up a new, but related, program of research that will directly lead to an R01 submission and a potentially unique and promising model for the management of obesity as a chronic disease.
