Feasibility of Smartphone-Based Education Modules and Ecological Momentary Assessment/Intervention in Pre-bariatric Surgery Patients

• Published in: Obesity surgery 2015-10, Vol.25 (10), p.1875-1881
• Main Authors: Mundi, Manpreet S., Lorentz, Paul A., Grothe, Karen, Kellogg, Todd A., Collazo-Clavell, Maria L.
• Format: Article
• Language: English
• Subjects: Adult; Bariatric Surgery - education; Education; Feasibility Studies; Female; Gastrointestinal surgery; Health Behavior; Humans; Life Style; Male; Medicine; Medicine & Public Health; Middle Aged; Mobile Applications; Obesity, Morbid - epidemiology; Obesity, Morbid - psychology; Obesity, Morbid - surgery; Original Contributions; Patient Education as Topic - methods; Patients; Preoperative Period; Smartphone; Smartphones; Studies; Surgery; Telemedicine - methods
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-015-1617-7

Background Bariatric surgery is the most effective means of long-term weight loss. Knowledge gaps and lack of engagement in pre-operative patients can result in suboptimal outcome after surgery. Mobile technology, utilizing ecological momentary assessment (EMA)/intervention (EMI), has shown tremendous promise in changing behaviors. The primary objective of the study is to assess feasibility of using smartphone app with EMA/EMI functionality to prepare patients for bariatric surgery. Methods Subjects seeking primary bariatric surgery were provided a smartphone app containing video-based education modules with linked assessments to evaluate mastery of topic. Subjects received algorithmic EMA text messages soliciting a response regarding lifestyle behavior. Upon answering, subjects received tailored EMI text messaging supporting healthy lifestyle. Results Thirty subjects (27 female and 3 male), with age of 41.3 ± 11.4 years and BMI of 46.3 ± 7.4 kg/m 2 were enrolled. Twenty subjects completed the study. Ten subjects withdrew. On average, seven out of nine education modules were completed (70.9 ± 27.3 %), and 37.8/123 EMA were answered (30.7 ± 21.7 %), with response time of 17.4 ± 4.4 min. Subjects reported high satisfaction with the app. Many felt that the app fit into their routine “somewhat easily” or “very easily” ( n  = 12), had “perfect” amount of EMA messages ( n  = 8), and was very helpful in preparing for surgery ( n  = 7). Conclusions This study is the first to reveal the feasibility of using a smartphone app in the education and engagement of patients prior to bariatric surgery. The app was well-received based on subject satisfaction scores and revealed trends toward positive behavior change and increased weight loss. Randomized trials are necessary to delineate true efficacy.