None listed
Conditions
Brief summary
Obesity is a major health concern both globally and in Australia. A key contributor to excess weight gain is unhealthy food choices, which are deeply ingrained and difficult to change due to underlying cognitive mechanisms. Two of these mechanisms are approach bias (a tendency to think about and move toward unhealthy foods) and steep delay discounting (a preference for smaller, immediate rewards over larger, delayed rewards), which can be modified using cognitive training techniques, i.e., approach-avoidance training (AAT) and episodic future thinking (EFT). This study aims to test the effects of these two cognitive training techniques (i.e., AAT and EFT) compared to a control (i.e., no-training) group, on cognition (approach bias, delay discounting), and behaviour (healthy food choices) in people with excess-weight. The primary aim is to compare each of the active interventions with a control to establish their cognitive mechanisms and determine which of them has a greater impact on food choice. It is hypothesized that compared to participants in the control condition, participants in the: 1) AAT condition will show a greater increase in approach bias for healthy food and a decrease in approach bias for unhealthy food, 2) EFT condition will show a greater decrease in delay discounting rates, and 3) AAT and EFT condition will choose a greater proportion of healthy foods.
Interventions
This study is a 6-week pilot trial of two smartphone-based interventions (Arm 1: Approach-Avoidance training; Arm 2: Episodic Future Thinking) that aim to improve cognition (and therefore, healthy food choice) in 60 overweight or obese participants.
Intervention Arm 1 - Approach-Avoidance training. Participants allocated to Arm 1 will complete approach-avoidance training on a novel iPhone application (developed by the researchers). In this app, participants will be instructed to tilt their phon
This study is a 6-week pilot trial of two smartphone-based interventions (Arm 1: Approach-Avoidance training; Arm 2: Episodic Future Thinking) that aim to improve cognition (and therefore, healthy food choice) in 60 overweight or obese participants. Intervention Arm 1 - Approach-Avoidance training. Participants allocated to Arm 1 will complete approach-avoidance training on a novel iPhone application (developed by the researchers). In this app, participants will be instructed to tilt their phone toward or away from themselves based on the format of a food image (i.e., portrait or landscape). These instructions will be counterbalanced. Image size increases when tilting toward (simulating approach) and decreases when tilting away (simulating avoidance). Each image (20 healthy; 20 unhealthy foods) is shown twice, which results in a total of 80 trials. Contingencies are manipulated to train approach of healthy (tilt: toward 90%; away 10%) and avoidance of unhealthy food (tilt: toward 10%; away 90%). The training will take approximately 5mins per day for one week. Participants completed the training on their smartphone daily for one week (7 sessions) and each session took approximately 5 minutes to complete. Participants completed the training outside of the laboratory. To assess intervention adherence, the number of sessions completed by each participant was recorded via the app. To improve adherence rates, participants are sent a daily push notification (via the app) at 12pm AEST as a reminder to complete the training. Intervention Arm 2 - Episodic future thinking: A researcher will help participants to create three personalised episodic future thinking cues. Participants will be given a calendar and asked to: (1) list 3 future health goals they would like to achieve and (2) list 3 future events they anticipate in the following 4 weeks. The researcher uses open-ended questions to obtain location, time, emotion(s), and a context for the future events. Subsequently, the researcher helps the participant to pair their goals with their events to form an ‘EFT cue’ that encourages participants to imagine themselves achieving their health goals at their events. The development of the EFT cues will take place in a single 20 minute face-to-face session with the researcher at baseline. To improve adherence rates, participants will receive a daily text-message (via SEMA - an existing smartphone app) with their EFT cue (which will take approx. 5 mins to read) at 12pm AEST daily for one week. To assess intervention adherence, the number of text messages read by the participant was recorded via the SEMA app.
Sponsors
Monash Institute of Cognitive and Clinical Neurosciences, Monash University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
Excess weight adults: Aged between 18 and 45; Body Mass Index (BMI) between 25 kg/m2 – 40kg/m2
Exclusion criteria
1. Do not own an iPhone: Participants need an iOS smartphone (iPhone) as the smartphone applications are only compatible with the iOS operating system 2. Undertaking other weight loss programs 3. Pregnancy 4. Lost more than 4.5kgs in the last 6 months 5. Currently taking medications that may affect or be affected by weight loss 6. Illnesses associated with excess weight (e.g., diabetes) 7. Self-reported history of eating disorders, brain trauma, neurological or substance use disorders 8. Self-reported current psychiatric diagnosis (e.g., depression) 9. Vegan/Vegetarian 10. Smoker
Outcome results
None listed