Real-world effectiveness of digital and group-based lifestyle interventions as compared with usual care to reduce type 2 diabetes risk - A stop diabetes pragmatic randomised trial.

Background: No real-world randomised controlled trials (RCTs) have explored the effectiveness of lifestyle interventions based on multiple behaviour change theories and using combined digital and group-based face-to-face delivery to improve risk factors for type 2 diabetes (T2D).

Methods: We conducted a one-year, multi-centre, unblinded, pragmatic RCT in primary healthcare using the habit formation, self-determination, and self-regulation theories among 2907 adults aged 18-74 years at increased T2D risk randomised into a digital lifestyle intervention group (DIGI, = 967), a combined digital and group-based lifestyle intervention group (DIGI+GROUP, = 971), and a control group receiving usual care (CONTROL, = 969). We collected data on primary outcomes (diet quality by Healthy Diet Index [HDI], physical activity, body weight, fasting plasma glucose, 2-hour plasma glucose) and secondary outcomes (sedentary time, waist circumference, fasting plasma insulin) using digital questionnaires, clinical examinations, fasting blood tests, and 2-hour oral glucose tolerance tests.

Users' Experiences With the NoHoW Web-Based Toolkit With Weight and Activity Tracking in Weight Loss Maintenance: Long-term Randomized Controlled Trial.

Background: Digital behavior change interventions (DBCIs) offer a promising channel for providing health promotion services. However, user experience largely determines whether they are used, which is a precondition for effectiveness.

Objective: The primary aim of this study is to evaluate user experiences with the NoHoW Toolkit (TK)-a DBCI that targets weight loss maintenance-over a 12-month period by using a mixed methods approach and to identify the main strengths and weaknesses of the TK and the external factors affecting its adoption.

A Theory- and Evidence-Based Digital Intervention Tool for Weight Loss Maintenance (NoHoW Toolkit): Systematic Development and Refinement Study.

Background: Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer a promising means of delivering behavior change approaches at low costs and on a wide scale. The Navigating to a Healthy Weight (NoHoW) project, which was funded by the European Union's Horizon 2020 research and innovation program, aimed to develop, test, and evaluate a digital toolkit designed to promote successful long-term weight management.

Multiomics and digital monitoring during lifestyle changes reveal independent dimensions of human biology and health.

We explored opportunities for personalized and predictive health care by collecting serial clinical measurements, health surveys, genomics, proteomics, autoantibodies, metabolomics, and gut microbiome data from 96 individuals who participated in a data-driven health coaching program over a 16-month period with continuous digital monitoring of activity and sleep. We generated a resource of >20,000 biological samples from this study and a compendium of >53 million primary data points for 558,032 distinct features. Multiomics factor analysis revealed distinct and independent molecular factors linked to obesity, diabetes, liver function, cardiovascular disease, inflammation, immunity, exercise, diet, and hormonal effects.

Comparison of Communication Channels for Large-Scale Type 2 Diabetes Risk Screening and Intervention Recruitment: Empirical Study.

Background: Clinical trials have shown that type 2 diabetes (T2D) is preventable through lifestyle interventions targeting high-risk people. Nevertheless, large-scale implementation of risk identification followed by preventive interventions has proven to be challenging. Specifically, recruitment of participants into preventive interventions is an important but often overlooked part of the intervention.

Sleep-time physiological recovery is associated with eating habits in distressed working-age Finns with overweight: secondary analysis of a randomised controlled trial.

Background: Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e.

Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project.

Background: Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.

Internet-Based Lifestyle Intervention to Prevent Type 2 Diabetes Through Healthy Habits: Design and 6-Month Usage Results of Randomized Controlled Trial.

Background: Type 2 diabetes can be prevented through lifestyle changes, but sustainable and scalable lifestyle interventions are still lacking. Habit-based approaches offer an opportunity to induce long-term behavior changes.

Objective: The purposes of this study were to describe an internet-based lifestyle intervention for people at risk for type 2 diabetes targeted to support formation of healthy habits and explore its user engagement during the first 6 months of a randomized controlled trial (RCT).

The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers: a Randomized Controlled Trial.

Background: Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity.

Method: Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements).

Health timeline: an insight-based study of a timeline visualization of clinical data.

Background: The increasing complexity and volume of clinical data poses a challenge in the decision-making process. Data visualizations can assist in this process by speeding up the time required to analyze and understand clinical data. Even though empirical experiments show that visualizations facilitate clinical data understanding, a consistent method to assess their effectiveness is still missing.

Exploring Associations Between the Self-Reported Values, Well-Being, and Health Behaviors of Finnish Citizens: Cross-Sectional Analysis of More Than 100,000 Web-Survey Responses.

Background: Understanding the relationship between personal values, well-being, and health-related behavior could facilitate the development of engaging, effective digital interventions for promoting well-being and the healthy lifestyles of citizens. Although the associations between well-being and values have been quite extensively studied, the knowledge about the relationship between health behaviors and values is less comprehensive.

Objective: The aim of this study was to assess retrospectively the associations between self-reported values and commitment to values combined with self-reported well-being and health behaviors from a large cross-sectional dataset.

Digitally supported program for type 2 diabetes risk identification and risk reduction in real-world setting: protocol for the StopDia model and randomized controlled trial.

Background: The StopDia study is based on the convincing scientific evidence that type 2 diabetes (T2D) and its comorbidities can be prevented by a healthy lifestyle. The need for additional research is based on the fact that the attempts to translate scientific evidence into actions in the real-world health care have not led to permanent and cost-effective models to prevent T2D. The specific aims of the StopDia study following the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework are to 1) improve the Reach of individuals at increased risk, 2) evaluate the Effectiveness and cost-effectiveness of the digital lifestyle intervention and the digital and face-to-face group lifestyle intervention in comparison to routine care in a randomized controlled trial (RCT), and 3) evaluate the Adoption and Implementation of the StopDia model by the participants and the health care organizations at society level.

Citizen-Centric Web-Based Health Profiling Service: A Service Concept and a Profiling Method.

Personalization of health interventions has been shown to increase their effectiveness. In digital services, user profiles enable this personalization. We introduce a web-based user profiling service, where citizens can 1) create various personal profiles, specific to certain health topics, by providing their personal data, 2) get summarized feedback on their health and behavioral determinants regarding each profile, and 3) share their profiles with health service providers.

Correlation between symptoms and functioning in psychiatric patients and temporal patterns of medication refills derived from pharmacy prescription claims.

Objectives:: Pharmacy dispensing claims data provide longitudinal records of prescriptions and refill events. Previous studies in psychiatric patients have utilised these data to derive indicators of medication adherence based on information regarding the amount of medication supplied and its dosage. An alternative approach was developed in which the regularity of medication refill events was analysed as a potential indicator of psychiatric patient symptoms and functioning.

The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial.

Background: Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects.

Methods: Secondary analysis of unblinded randomized controlled trial in three Finnish cities.

Accelerometry-based assessment and detection of early signs of balance deficits.

Falls are the cause for more than half of the injury-related hospitalizations among older people. Accurate assessment of individuals' fall risk could enable targeted interventions to reduce the risk. This paper presents a novel method for using wearable accelerometers to detect early signs of deficits in balance from gait.

Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions.

Objective: Despite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches.

Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App: Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial.

Background: Mobile phone apps offer a promising medium to deliver psychological interventions. A mobile app based on Acceptance and Commitment Therapy (ACT) was developed and studied in a randomized controlled trial (RCT).

Objective: To study usage metrics of a mobile ACT intervention and dose-response relationship between usage and improvement in psychological flexibility.

Process and Effects Evaluation of a Digital Mental Health Intervention Targeted at Improving Occupational Well-Being: Lessons From an Intervention Study With Failed Adoption.

Background: Digital interventions have the potential to serve as cost-effective ways to manage occupational stress and well-being. However, little is known about the adoption of individual-level digital interventions at organizations.

Objectives: The aim of this paper is to study the effects of an unguided digital mental health intervention in occupational well-being and the factors that influence the adoption of the intervention.

High perceived stress is associated with unfavorable eating behavior in overweight and obese Finns of working age.

Stress-related eating may be a potential factor in the obesity epidemic. Rather little is known about how stress associates with eating behavior and food intake in overweight individuals in a free-living situation. Thus, the present study aims to investigate this question in psychologically distressed overweight and obese working-aged Finns.

The shape of health: A comparison of five alternative ways of visualizing personal health and wellbeing.

The combination of clinical and personal health and wellbeing data can tell us much about our behaviors, risks and overall status. The way this data is visualized may affect our understanding of our own health. To study this effect, we conducted a small experiment with 30 participants in which we presented a holistic overview of the health and wellbeing of two modeled individuals, one of them with metabolic syndrome.

The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing: the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress.

Background: Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management.

Weight rhythms: weight increases during weekends and decreases during weekdays.

Background/aims: The week's cycle influences sleep, exercise, and eating habits. An accurate description of weekly weight rhythms has not been reported yet - especially across people who lose weight versus those who maintain or gain weight.

Methods: The daily weight in 80 adults (BMI 20.

Accelerometry-based berg balance scale score estimation.

The objective of the study was to investigate the validity of 3-D-accelerometry-based Berg balance scale (BBS) score estimation. In particular, acceleration patterns of BBS tasks and gait were the targets of analysis. Accelerations of the lower back were measured during execution of the BBS test and corridor walking for 54 subjects, consisting of neurological patients, older adults, and healthy young persons.

Mobile mental wellness training for stress management: feasibility and design implications based on a one-month field study.

Background: Prevention and management of work-related stress and related mental problems is a great challenge. Mobile applications are a promising way to integrate prevention strategies into the everyday lives of citizens.

Objective: The objectives of this study was to study the usage, acceptance, and usefulness of a mobile mental wellness training application among working-age individuals, and to derive preliminary design implications for mobile apps for stress management.