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Original research
Game of Stones: feasibility randomised controlled trial of how to engage men with obesity in text message and incentive interventions for weight loss
  1. Stephan U Dombrowski1,2,
  2. Matthew McDonald3,
  3. Marjon van der Pol4,
  4. Mark Grindle5,
  5. Alison Avenell6,
  6. Paula Carroll7,
  7. Eileen Calveley3,
  8. Andrew Elders8,
  9. Nicola Glennie3,
  10. Cindy M Gray9,
  11. Fiona M Harris3,
  12. Adrian Hapca10,
  13. Claire Jones11,
  14. Frank Kee12,
  15. Michelle C McKinley12,
  16. Rebecca Skinner2,
  17. Martin Tod13,
  18. Pat Hoddinott3
  1. 1Department of Kinesiology, University of New Brunswick Fredericton, Fredericton, New Brunswick, Canada
  2. 2Division of Psychology, University of Stirling, Stirling, UK
  3. 3Nursing, Midwifery and Allied Health Professional Research Unit, University of Stirling, Stirling, UK
  4. 4Health Economics Research Unit, University of Aberdeen, Aberdeen, UK
  5. 5Institute for Health Research and Innovation, University of the Highlands and Islands, Inverness, Highland, UK
  6. 6Health Services Research Unit, University of Aberdeen, Aberdeen, UK
  7. 7Mens Health Forum in Ireland, Dublin, Ireland
  8. 8Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
  9. 9Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
  10. 10Tayside Clinical Trials Unit, University of Dundee, Dundee, UK
  11. 11Health Informatics Centre, University of Dundee, Dundee, UK
  12. 12Centre for Public Health, Queen’s University Belfast, Belfast, UK
  13. 13Men's Health Forum, London, UK
  1. Correspondence to Dr Stephan U Dombrowski; stephan.dombrowski{at}unb.ca

Abstract

Objectives To examine the acceptability and feasibility of narrative text messages with or without financial incentives to support weight loss for men.

Design Individually randomised three-arm feasibility trial with 12 months’ follow-up.

Setting Two sites in Scotland with high levels of disadvantage according to Scottish Index for Multiple Deprivation (SIMD).

Participants Men with obesity (n=105) recruited through community outreach and general practitioner registers.

Interventions Participants randomised to: (A) narrative text messages plus financial incentive for 12 months (short message service (SMS)+I), (B) narrative text messages for 12 months (SMS only), or (C) waiting list control.

Outcomes Acceptability and feasibility of recruitment, retention, intervention components and trial procedures assessed by analysing quantitative and qualitative data at 3, 6 and 12 months.

Results 105 men were recruited, 60% from more disadvantaged areas (SIMD quintiles 1 or 2). Retention at 12 months was 74%. Fewer SMS+I participants (64%) completed 12-month assessments compared with SMS only (79%) and control (83%). Narrative texts were acceptable to many men, but some reported negative reactions. No evidence emerged that level of disadvantage was related to acceptability of narrative texts. Eleven SMS+I participants (31%) successfully met or partially met weight loss targets. The cost of the incentive per participant was £81.94 (95% CI £34.59 to £129.30). Incentives were acceptable, but improving health was reported as the key motivator for weight loss. All groups lost weight (SMS+I: −2.51 kg (SD=4.94); SMS only: −1.29 kg (SD=5.03); control: −0.86 kg (SD=5.64) at 12 months).

Conclusions This three-arm weight management feasibility trial recruited and retained men from across the socioeconomic spectrum, with the majority from areas of disadvantage, was broadly acceptable to most participants and feasible to deliver.

Trial registration number NCT03040518.

  • obesity
  • men
  • feasibility
  • trial
  • SMS
  • weight loss
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Footnotes

  • Twitter @sdombrowski, @markgrindle, @Elders, @CindyGrayGlas

  • Contributors SUD co-led the study with PH as joint chief investigator and co-led the design and overall conduct of the study and led the writing of the manuscript, overseen by PH. MM undertook the study set up, recruitment and data collection, coordinated various PPI activities and contributed substantially to qualitative and quantitative data analysis and interpretation. MvdP was a coinvestigator, contributed to the design and the interpretation of findings and led the DCE and health economic analysis. MG was a coinvestigator, contributed to the design and the interpretation of findings and led the development of the narrative SMS component, and the related PPI. AA was a coinvestigator and contributed to the design and the interpretation of findings. PC and MT linked to PPI networks and contributed to the design and interpretation of the findings. AE was a coinvestigator, contributed to the design and the interpretation of findings and oversaw the statistical analysis. NG and EC contributed to the analysis and interpretation of the qualitative data. CG was a coinvestigator, facilitated PPI and contributed to the design and interpretation of findings. FH was a coinvestigator, oversaw the qualitative data collection and analysis and contributed to the interpretation of findings. AH undertook the statistical analysis at Tayside Clinical Trials Unit. CJ was a coinvestigator, contributed to the design and the interpretation of findings and oversaw the automated SMS delivery system, recruitment tracking, the study website and integration of data with databases at Tayside Clinical Trials Unit. FK and MCM were coinvestigators and contributed to the design and the interpretation of findings. RS contributed to recruitment, data collection and undertaking qualitative interviews and contributed to the interpretation of findings.

  • Funding This report presents independent research commissioned by the NIHR. The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, MRC, CCF, NETSCC, the Public Health Research programme or the Department of Health. The views and opinions expressed by the interviewees in this publication are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, MRC, CCF, NETSCC, the Public Health Research programme or the Department of Health.The Nursing Midwifery and Allied Health Professionals Research Unit, the Health Services Research Unit and Health Economics Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorate.

  • Competing interests MG is director of Eos Digital Health Ltd, which holds all rights to DNA, The Digital Narrative Approach, deployed to design and write the narrative text intervention.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. Access to data can be arranged through the coprincipal investigators of the study: Professor Pat Hoddinott (University of Stirling, p.m.hoddinott@stir.ac.uk) and Dr Stephan Dombrowski (University of New Brunswick, stephan.dombrowski@unb.ca) to discuss data sharing, data requirements and conflicts of interest, in line with any EU and other regulations, including ethics approvals.

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