Get Social: Randomized Trial of a Social Network Delivered Lifestyle Intervention

Lifestyle interventions have had established efficacy for over a decade but are still not
widely disseminated, largely due to high cost and patient and provider burden. Online social
networks are an alternative way to deliver lifestyle counseling and delivery via this
modality may virtually eliminate patient visits, the main source of cost and burden in
traditional modalities. Interactions in online social networks are frequent, brief, and
asynchronous because users login to their online communities during downtime during work and
leisure time, or when they simply feel a need for social connection. As such, social media
becomes embedded into people's daily lives. This provides an opportunity to embed health
behavior change programming into people's daily lives. Thus far in the literature, existing
online social networks have been used as component of web- or mobile app-based lifestyle
interventions but not as the primary modality for intervention delivery. The purpose of this
work is to conduct a non-inferiority trial to compare a lifestyle intervention delivered
entirely via private groups on the online social network Twitter to a traditional in-person
group-based lifestyle intervention. Using a randomized trial (N=328), investigators will test
whether a lifestyle intervention delivered via an online social network (Get Social
condition) will result in a mean percent weight loss at 12 months that is not appreciably
worse than the gold-standard in-person group-based lifestyle intervention (Traditional
condition), i.e., the social network arm will not lose on average 2% less than the in-person
arm. Secondary non-inferiority outcomes include weight loss at 12 months, and dietary intake
and physical activity at 12-months. Investigators hypothesize that the Get Social condition
will be less expensive than the Traditional condition. To understand for whom an online
social network modality is most suited, investigators will test predictors of weight loss in
the Get Social condition including engagement, age, sociability, neuroticism, openness, and
smartphone and social network use. Investigators hypothesize that people who are younger,
more sociable, engage more on the social network, higher in neuroticism/openness, and heavier
overall smartphone and social network users will lose more weight in the Get Social
condition. Findings from this study may support an intervention delivery modality that is
more conducive to settings like worksites, health plans, and clinics that serve large
populations but have limited space, staffing, and resources for traditional in person
interventions.

Inclusion: Smartphone users ages 18-65 with a BMI 27-45 will be recruited for this study.
Participants must currently log into a social media platform on a daily basis basis and
engage (like, reply, post) at least 4 days per week.

Participants will be excluded if they:

1. Do not have a smartphone;

2. Are unable to get medical clearance from their PCP;

3. Have plans to move during study;

4. Are not interested in losing weight;

5. Have Type 1 or uncontrolled 2 Diabetes (as determined by PCP);

6. Have medical conditions that would prevent increasing physical activity or making
dietary changes;

7. Are pregnant/lactating or plans to become pregnant during study;

8. Are currently taking medication affecting weight;

9. Currently participating in a weight loss program or using an online social network to
assist them with weight loss (e.g. Weight Watchers, Sparkpeople, etc);

10. Unable to walk at least ¼ mile unaided without stopping;

11. Experienced a weight loss of 5% or more in past 3 month;

12. A history of/or plans on having bariatric surgery;

13. Did not complete the baseline measures;

14. Not willing to use Twitter, or if a current Twitter user, not willing to create a new
account specifically for study purposes;

15. Participated in another weight loss study under the direction of the PI of this study;

16. Current smoker (smokes 3 or more cigarettes per day);

17. Unavailable to attend weekly group meetings;

18. Prefers one condition over another;

19. Score of 30 or higher on the BDI or endorsement of 2 or 3 on BDI #9 indicating
suicidal thoughts;

20. Did not complete the orientation webinar;

21. Are unable to provide consent due to mental illness or a cognitive impairment;

22. Does not speak English; or

23. Are a prisoner.