None listed
Conditions
Brief summary
Cognitive Bias Modification has elicited some intriguing results in studies of substance addiction or appetite pathology. Training in an experimental setting has been shown to reduce alcohol consumption in binge drinkers, smoking frequency, and decrease preference and intake of palatable foods in people with overweight/obesity. Moreover, they do not require some of the onerous demands of time, energy, and commitment required by traditional obesity prevention-oriented interventions. Response inhibition training, a form of Cognitive Bias Modification, has seen some success in reducing snack food preference and intake, and even weight, although significant results were only seen in short-term, laboratory-based studies. However, the results vary conspicuously based on methodology and training parameters. Additional testing in natural settings was considered beneficial to discern the clinical and real world utility of this type of intervention. The inclusion of a follow up measurement provided the opportunity to detect how long potential changes in appetite control are maintained after training. The primary aim of this study was to investigate whether response inhibition training delivered by smartphone can produce sustained changes in preferences and cravings for energy-dense foods, as well as reward-driven eating in a free-living setting. It was expected that the response inhibition training intervention would lead to a significant reduction in all primary outcomes relative to the control group from baseline to post-training. Although it was expected that all primary outcomes would increase over the 1-week follow-up period, we posited that they would remain significantly different from baseline.
Interventions
A smartphone-based gamified cognitive training app (i.e., 'FoodTrainer' - University of Exeter) was the only intervention arm. The game has an embedded behavioural modification technique called 'Response Inhibition Training' where the user is expected to withhold an approach to any energy-dense, processed foods (associated with a visual signal similar to a red stop light) and approach/select all healthier alternatives (associated with a 'green' light) as they appeared on the screen.
Participant
A smartphone-based gamified cognitive training app (i.e., 'FoodTrainer' - University of Exeter) was the only intervention arm. The game has an embedded behavioural modification technique called 'Response Inhibition Training' where the user is expected to withhold an approach to any energy-dense, processed foods (associated with a visual signal similar to a red stop light) and approach/select all healthier alternatives (associated with a 'green' light) as they appeared on the screen. Participants met with the primary researcher individually by Zoom for approximately 30-45 minutes (dependent on questions posed by the participant) prior to study commencement to discuss the trial, receive their condition assignment, and pose any questions or concerns. A condition-specific information sheet was also provided to each participant that outlined the experimental procedure step-by-step so that the study could be completed autonomously thereafter. The information sheet was specifically designed for this study and only the steps relating to completing the training varied based on group allocation. Participants were able to download the intervention or control apps on their Apple or Android devices at no cost. Participants were informed that they would be randomly assigned to complete one of two apps promoting healthy dietary habits, thus were ostensibly not aware of condition allocation. They were further instructed to complete the intervention 6 times over a training week (i.e., once daily over a 6 day period). Each daily session was recommended to span about 12 minutes. If participants completed a higher or lower frequency of training, they were still included in analyses. All training sessions were recommended to take place in a quiet, familiar environment, particularly at their place of residence if possible. The training was not personalised at any time over the study period. Data on intervention adherence was collected via the app and sent to an online server. Strategies to improve or maintain fidelity to the study procedure were offered during the online consultation, which included setting daily alarms or calendar reminders during the study period, for example.
Sponsors
Queensland University of Technology
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Blinded (masking used) (Subject)
Eligibility
Sex/Gender
All
Age
17 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
Respondents were included if they were aged between 17 and 70 years; resided in Australia; had access to a smartphone and computer with internet access; had access to a weighing scale and a tape measure (to measure anthropometrics); and could be considered overweight/obese as assessed by their BMI (> 25) OR highly food cue responsive as assessed by the Adult Eating Behaviour Questionnaire (Hunot et al., 2016).
Exclusion criteria
Participants were excluded if they were ever diagnosed with an eating disorder; were currently part of a weight loss programme or actively trying to lose weight; were currently taking any prescription or recreational drugs that affect appetite; or currently smoking 5 or more cigarettes per day; or experienced any significant weight changes within the last 3 months (i.e., greater than 10% of their body weight).
Outcome results
None listed