Design and development of LiveLighter TODAY: a digital weight management intervention (Preprint)

BACKGROUND LiveLighter© is an Australian government health education and social marketing campaign, specifically targeting obesity. LiveLighter Tailored Diet and Activity (LLToDAy) study aims to build on the campaign, by the addition of a digital intervention with the potential to provide wide-reaching, cost-effective weight management support. OBJECTIVE This paper describes the qualitative study and iterative process used to inform the design and message development of LiveLighter Tailored Diet and Activity (LLToDAy), a digital weight management intervention. The main objectives were to 1) identify behavior change techniques for diet and physical activity change for weight loss and 2) explore preferences for digital intervention features that would be effective in changing diet and physical activity behaviors. METHODS This qualitative study used the principles of the person-based approach to intervention development, the behavioral intervention technology framework and capability, opportunity, motivation and behavior (COM-B) framework. Focus groups and telephone interviews were conducted with 56 adults in Western Australia.. Open-ended questions and example intervention features were used to explore the usability and acceptability of the self-monitoring tools, knowledge about effective weight-loss strategies and acceptability of the tailored feedback. Focus group and interview findings were analyzed using thematic analysis. RESULTS Qualitative findings revealed an awareness of key public health messages but a lack of confidence in how to perform these behaviors to help manage their weight. Four major themes were identified and mapped to the domains of the COM-B framework: 1. Misinformation; 2. Environmental support; 3. Social norms and 4. Confidence. CONCLUSIONS This study explored users' capability, opportunity and motivation to perform the target behaviors for weight loss. Findings suggest that a digital weight management interventions using mobile food records and activity trackers to inform tailored feedback, may be an acceptable and feasible. Participants expressed a preference for simple expert advice, digital self-monitoring tools and visual feedback. CLINICALTRIAL