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

Abstract

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/m2 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.