Abstract P3091: Participant Perceptions of Diet-Related Feedback Messages: Insights from the SMARTER Trial Focus Groups

Background: Mobile health (mHealth) interventions may provide a more accessible approach to a broader segment of the population needing weight loss treatment. Little is known about individuals’ perceptions of remotely-delivered diet-related feedback (FB) messages. Methods: The aim of this analysis was to assess perceptions of diet-related FB among participants randomized to the FB intervention (n = 251) of SMARTER, a randomized controlled trial that examined the efficacy of a 12-month remotely-delivered mHealth intervention targeting weight loss. Participants were asked to self-monitor (SM) diet using a commercial app and received FB messages in real-time in response to the SM data at least once daily. We conducted six focus groups (N=23) via Zoom to discuss participants’ perceptions of the FB intervention. Trained experts in qualitative research used a semi-structured focus group guide to facilitate discussion on how study participants interacted with technology and the FB they received. Participants were invited to participate in one of two focus groups based on weight loss at 12 months and average step counts during the 30 days prior to their 12-month assessment. After the final study visit, eligible participants were invited to participate in the focus groups and provided noteworthy comments. The data were analyzed using ATLAS.ti (version 9). Results: Four key themes emerged from the content analysis pertaining to FB and broader study issues: timing of the FB notifications, personalization of FB messages, issues with the SM app, and social aspect of the study design. Participants found FB helpful to engage in SM behaviors and reported a desire for more personalized FB messages related to diet. Some participants voiced a desire to set their own schedule for FB message delivery to ensure FB could be viewed when received. They also identified two challenges: the limited selection of foods in the diet SM app which in turn may have affected their SM and FB messaging and the absence of a social community. Conclusions: Our results suggest that giving participants the flexibility for FB notifications to align with their schedules and phone accessibility may improve receipt of FB and engagement. There is a need to enhance the personalization of FB while maintaining the scalability for a broader population reach. Incorporating contact with a coach to supplement remotely-delivered FB may further improve participant engagement in changing nutrition habits.