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. 2017 Oct 23;6(10):e205. doi: 10.2196/resprot.6059

Table 1.

Main characteristics and findings of included studies.

Study Study design Quality rating Digital intervention Sample N Main findings
Brindal et al, 2012 [50] RCTa 7/8 Web-based total well-being diet; targets weight loss. 3 groups:

  1. Information-based: dietary and activity-related information provided in a static noninteractive format.

  2. Supportive: social interactive website (offers social support in addition to basic information).

  3. Personalized-supportive: supportive version with a personalized meal planner.

 Adults (18 years or over), BMIb>25 8112 Inclusion of social networking features and personalized meal planning did not promote user weight loss or retention but increased average number of user engagement days. In the supportive website, greater use of weight tracker tool led to greater weight loss.
Collins et al, 2013 [51] RCT 7/8 12-week Web-based weight loss program: The Biggest Loser Club.

  1. Basic program: targets self-efficacy, goal setting, self-monitoring, outcome expectations, and social support.

  2. Enhanced program: includes all basic features plus personalized features (in response to a behavioral survey), weekly personalized feedback, and an escalating reminder schedule.

 Adults (18-60 years), BMI 25 to 40 301 Personalized e-feedback in the enhanced program provided limited additional benefits compared with a standard Web-based weight loss program. However, it supported greater engagement or greater usage, which was related to weight loss.
Dennison et al, 2014 [54] RCT 8/8 Web-based management intervention: POWeR.

  • Aims to empower users through the development of new self-regulation skills.

  • Coaching calls used to promote continued usage of the POWeR website and adherence to the recommendations within the website.

 Adults, BMI>23 786 Usage of POWeR was poor. However, supplementing Web-based weight management with brief human support improved adherence and health outcomes.
Gorton et al, 2011 [47] Mixed-methods study 4/4 Telephone survey (comprised questions exploring the nature or acceptability of any potential mobile weight loss program). Focus groups explored issues of acceptability. Individuals over 16 years 306 survey, 54 in focus groups Participants valued ready access to weight loss information, along with customized feedback and encouragement. Social support, tailored content, and practicality were also identified as features likely to predict engagement.
Lyden et al, 2013 [48] Qualitative study 6/8 Web-based evidence-based lifestyle intervention. Adults, BMI>25 50 Participants valued Web-based lifestyle coaching, self-monitoring tools, and structured lesson features. Moderated chat sessions and Web-based resources were rarely used.
McConnon et al, 2009 [55] Questionnaire-based evaluation of an RCT 8/8 Web-based weight management intervention.

  • The website encourages healthy lifestyle changes, provides information, tools, and support on nutrition and physical activity, as well as behavioral components.

 Adults (18-65 years), BMI>30 111 The support sections were used least often and rated most negatively by users. However, poor Internet access may have limited use, thereby reducing the support available to participants.
Mhurchu et al, 2014 [56] RCT 8/8 12-week weight management program. Comprised of 3 modules (designed to be integrated):

  1. Text messaging: Participants sent an average of 2 texts per day over the intervention period. All messages were personalized or tailored toward specific needs (eg, whether they had children).

  2. A hard copy toolkit: served as a source of detailed information (able to support personal plans and behavior monitoring).

  3. Website: provided a blog to enable participants to share their stories and experiences.

 Adults, BMI>25 36 Participants reported that they valued text messages; they found them motivational and liked their clear practical tips and reminders. However, others indicated that they found the messages impersonal, generic, or repetitive.
Morrison et al, 2014 [49] Mixed-methods study 8/8 POWeR Tracker (weight management app) and POWeR (Web-based weight management intervention). Offers a flexible to foster autonomy and support users to adopt healthy behaviors. Adults (18-52 years), BMI>23 13 Participants found it convenient to access information on-the-go via their mobiles compared with a computer. However, participants varied in their usage of the Web- versus app-based components.
Patrick et al, 2009 [53] RCT 7/8 The intervention included personalized short message service and multimedia messaging service messages (sent 2-5 daily) and phone calls (monthly) from a health counselor. Adults (25-55 years), BMI>25 to 39.9 65 Overall, satisfaction with the intervention was high. Specifically, users found texting their weight every week useful, as it “kept them focused.”
Tang et al, 2015 [22] Qualitative study 4/4 Semistructured interviews to explore participant experiences of using weight loss apps. Adults (18-40 years) 19 Participants valued an attractive user interface. Structure, ease of use, personalized features, and accessibility (including dual phone-computer access) were important, and users indicated that continued use depended on these features.
Watson et al, 2015 [52] RCT 7/8 Imperative health consists of a Web-based program.

  • Designed to assist with lifestyle change (specific focus on diet and nutrition, physical activity, and managing weight).

 Adults (over 18 years), BMI 27 to 40 65 Interactivity was essential for engagement. Indeed, the authors argued that the provision of individualized support rather than automated feedback may have helped engagement levels.

aRCT: randomized controlled trial.

bBMI: body mass index.