• Ryan J Shaw, Hayden B Bosworth, Susan S Silva, Isaac M Lipkus, Linda L Davis, Ronald S Sha, and Constance M Johnson.
• Duke University School of Nursing, Durham, NC; Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC. Electronic address: ryan.shaw@duke.edu.
• Am. J. Med. 2013 Nov 1; 126 (11): 100210091002-9.

BackgroundUsing regulatory focus theory, an intervention of daily weight loss-sustaining messages was developed and tested for acceptability, feasibility, and efficacy on helping people sustain weight loss.MethodsParticipants (n = 120) were randomized to a promotion, prevention, or an attention-control text message group after completion of a weight loss program. Participants completed baseline assessments, and reported their weight at 1 and 3 months postbaseline.ResultsParticipants found the message content and intervention acceptable and valuable. A minimum of one message per day delivered at approximately 8:00 am was deemed the optimal delivery time and frequency. The sustained weight loss rate at month 3 for the control, promotion, and prevention groups was 90%, 95%, and 100%, respectively. Medium-to-large effects were observed for the promotion and prevention groups at month 1 and for prevention at month 3 relative to controls. The mean weight loss for promotion and prevention was 15 pounds, compared with 10 in the controls at month 3.ConclusionA clinically significant decrease in mean weight, higher rate of sustained weight loss, and medium-to-large effects on sustained weight loss occurred in the promotion and prevention interventions. Tools such as this text message-based intervention that are constructed and guided by evidence-based content and theoretical constructs show promise in helping people sustain healthy behaviors that can lead to improved health outcomes.Copyright © 2013 Elsevier Inc. All rights reserved.

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