PATH to Health: An Exploration of Digital Behavioral Weight Loss Approaches

Weight Change- Percent weight change from baseline to 3 months

Percent weight change from baseline to 3 months will be calculated ((3 month weight - baseline weight)/100). Weight will be objectively measured on a scale in the participant's home.

Time frame: Baseline, 3 months

Weight Change- Percent weight change from baseline to 4 weeks

Percent weight change from baseline to 4 weeks will be calculated ((4 week weight - baseline weight)/100). Weight will be objectively measured on a scale in the participant's home

Time frame: Baseline, 4 weeks

Weight Change- Percent weight change from 4 weeks to 3 months

Percent weight change from 4 weeks to 3 months will be calculated ((3 month weight - 4 week weight)/100). Weight will be objectively measured on a scale in the participant's home

Time frame: 4 weeks, 3 months

Acceptability- Rate of attendance at human support sessions

The rate of attendance at human support sessions will be calculated as the number of human sessions completed divided by the number of human sessions assigned.

Time frame: Up to 3 months

Acceptability- Attrition

Attrition will be calculated as the number of intervention participants who did not complete 3-month weight measures divided by the number randomized to treatment.

Time frame: Up to 3 months

Acceptability- Overall program satisfaction rating

Overall program satisfaction will be assessed using a single item, which asks participants to rate their overall satisfaction with the program on a 4-point Likert scale that ranges from "very dissatisfied" to "very satisfied," in which higher scores indicate greater levels of satisfaction.

Time frame: 3 months

Weighing Self-Monitoring Adherence

Number of days of self-weighing over the 3 month period, measured by use of the scale in the participant's home.

Time frame: Baseline to 3 months (daily)

Dietary Self-Monitoring Adherence

Number of days of complete dietary tracking summed over the 3-month study period, as measured by app use data.

Time frame: Baseline to 3 months (daily)

Physical Activity Self-Monitoring Adherence

Number of days of physical activity tracking over the 3 month period, as measured by Fitbit tracker wear.

Time frame: Baseline to 3 months (daily)

Dietary Goal Adherence

Number of days the participant met their daily calorie goal over the 3 month period, as measured by app data.

Time frame: Baseline to 3 months (daily)

Activity Goal Adherence

Number of days the participant met their active minutes goal over the 3 month period, as measured by app data.

Time frame: Baseline to 3 months (daily)

Change in Diet

Change in daily caloric intake from baseline to 3 months, as measured using the self- administered National Cancer Institute's Automated Self- Administered 24-hour Recall (ASA-24), a 24-hour recall that is self-administered on one day at each timepoint.

Time frame: Baseline, 3 months

Change in Physical Activity

Change in physical activity from baseline to 3 months, as measured using the Paffenbarger Physical Activity Questionnaire (PPAQ). The PPAQ assesses amount of planned and lifestyle associated physical activity performed during a typical week. The PPAQ consists of three components: (1) stair climbing, (2) walking, and (3) sports and recreation. Participants report the frequency and duration of physical activity in the past week. Scoring yields energy expenditure from physical activity per week (kcal/kg/week). Higher scores translate into greater energy expenditure per week (i.e.,better outcome). Range is 0 - no theoretical maximum.

Time frame: Baseline, 3 months

Change in Motivation

Change in motivation from baseline to 4 weeks and 3 months, as measured using the Treatment Self-Regulation Questionnaire (TSRQ). The TSRQ assesses autonomous and controlled motivation for weight management. Six items assess autonomous motivation and six assess controlled motivation using a 7 point Likert scale, in which 1 corresponds to "not at all true" and 7 corresponds to "very true." Items will be averaged to produce scores for autonomous motivation and controlled motivation ranging from 1-7. Higher values on each sub-scale indicate greater levels of that type of motivation. A Relative Autonomous Index (RAI) score will be separately calculated by subtracting the controlled motivation score from the autonomous motivation score. The range of possible RAI scores is -6 to 6.

Time frame: Baseline, 1 week, 4 weeks, 3 months