Mobile Regulation of Craving Training (mROC-T) to Improve Dietary Intake in Rural Adolescent Girls
Trial Snapshot
- Phase
- Not Applicable
- Status
- Active, not recruiting
- Sponsor
- University of Wyoming
- Enrollment
- 150
- Locations
- 1
- Primary Endpoint
- Healthy eating index (HEI)
Study Overview
Brief Summary
The goal of this clinical trial is to test if a regulation of craving training intervention in the form of a mobile phone app can increase fruit and vegetable intake in adolescent girls ages 14-18 years of age. The main questions it aims to answer are:
- What is the effect of a mobile app version of the regulation of craving training intervention on healthy eating index scores over one year?
- What is the effect of a mobile app version of the regulation of craving training intervention on body mass index, waist circumference, and blood glucose over one year? Researchers will compare the active regulation of craving training arm to a control fun food fact arm to see if the regulation of craving training improves HEI scores, BMI, and blood glucose over a year. Participants will be asked to play the regulation of craving training mobile app twice a week for a year.
Detailed Description
Randomization: Participants will be randomized to either an active mROC-T group (mROC-T+ or mROC-Tc) or a craving rating only (CRO) control group stratified by race/ethnicity and BMI%. We will use urn randomization for participant assignment.
Baseline and 1-year follow up in-person visit measures Oral glucose tolerance test (OGTT): We will use a standard NHANES oral glucose tolerance test (OGTT) to assess the participants' glucose disposal. Participants will be fasted for at least eight hours. A fasted blood draw will be performed via finger stick. We will analyze glucose concentration using the HemoCue Glucose 201 analyzer and HbA1c using Abbott Afinion™ HbA1c analyzer. The participants will then drink a glucose bolus dosed at 1.75g glucose/kg body weight. Subsequent samples will be taken at 30, 60, 90, and 120-minutes. During which time the participant will play the mROC-T game and record their diet recall of the previous day. Participants will complete the puberty development scale (PDS), which has shown good epidemiological validity and is a suitable control variable. We will also measure height, weight, waist circumference using NHANES protocols. We will measure trait food craving using the Food Craving Questionnaire (trait).
Overall model for aims 1 and 2: For both aims we will use mixed-effect models (MEM, allows us to model random intercepts for participants by location and random slopes for the intervention by time) and estimated marginal means (EMM, corrects for potential imbalanced data). Covariates (COV) are baseline PDS, FCQT, race/ethnicity, and age. Intervention is a categorical variable representing intervention group.
Aim1 assesses the effect of the intervention over 1 year compared to baseline in the mROC-T and CRO groups on HEI calculated monthly. Fixed effects will be considered significant at p≤ 0.02. HEI1-year ~ Intervention*x(time) + HEIbaseline + COV; where x() is the time function (see note below)
Time note: we plan on modeling time using linear, power polynomials (square and cubic), and logistic functions. We will compare the different time powered models using ANOVAs and consider p ≤ 0.05 a significant difference between models, and Akaike information criterion (AIC) to assess model parsimony.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Prevention
- Masking
- None
Eligibility Criteria
- Ages
- 15 Years to 18 Years (Child, Adult)
- Sex
- Female
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •Biologically female
- •Female gender
- •Between the ages of 15y and 18y
Exclusion Criteria
- •Biologically male
- •Self-identify as male
- •BMI percentile (for age and sex) < 5th%
- •Diagnosis from a medical profession of any of the following conditions, syndromes, diseases that may affect growth, glucose metabolism, blood clotting, cognitive development*:
- •Any form of or history of cancer
- •Any form of diabetes (type I, II, insipidus)
- •Precocious puberty
- •Crohn's disease
- •Congenital heart defect
- •Cystic fibrosis
- •Cerebral palsy
- •Anorexia nervosa
- •Bulimia nervosa
- •Active infection
- •Hemophilia
- •Hydrocephalus
- •intestinal atresia
- •Jeune syndrome
- •Klippel-Trénaunay syndrome
- •Legg-Calvé-Perthes
- •Long QT syndrome
- •Muenke syndrome
- •Myelomeningocele
- •Necrotizing Enterocolitis
- •Neutropenia
- •Non-alcholoic fatty liver diease
- •Pfeiffer Syndrome
- •Saethre-Chotzen syndrome
- •Shwachman-Diamond syndrome
- •Spinal muscular atrophy
- •Sturge-Weber syndrome
- •Ulcerative Colitis
- •von Willebrand disease
- •Pancreatitis
- •Hurler syndrome
- •Niemann-Pick disease
- •Tay-Sachs disease
- •Gaucher disease
- •Krabbe disease
- •Zellweger syndrome
- •Wilson disease
- •Brachial Plexus Palsy
- •Brain Abscess or Spinal Abscess
- •Coarctation of the Aorta
- •Aortic stenosis
- •Ventricular septal defect
- •Patent ductus arteriosus or mitral valve abnormalities
- •Congenital Adrenal Hyperplasia
- •Craniofacial Microsomia
- •Duchenne Muscular Dystrophy
- +10 more not shown
Arms & Interventions
Positive regulation of craving training
Participants randomized into the active mROC-T intervention (mROC-T+) will:
- Read a brief essay about the social justice benefits of eating healthy foods
- Participants complete six free-response questions to ensure that they understood the essays.
- Participants are instructed to use the information from the essay. They are shown a cue matching the essay: "Think Positive"
- They are shown an image of a healthy food (no added sugar and < 2g/serving saturated fat) OR an image of an unhealthy food (contain added sugar and/or >4.5g/serving saturated fat).
- The participant is asked to rate how strong their craving is for the pictured food. The participant indicates their craving on a VAS from 1 (No craving at all) to 5 (Very high craving)
Intervention: Regulation of craving training (Behavioral)
Critical regulation of craving training
Participants randomized into the active mROC-T intervention (mROC-Tc) will:
- Read a brief essay about the social justice consequences of eating unhealthy foods (CIRITCAL, mROCTc)
- Participants complete six free-response questions to ensure that they understood the essays.
- Participants are instructed to use the information from the essay. They are shown a cue matching the essay: "Think Critical"
- They are shown an image of a healthy food (no added sugar and < 2g/serving saturated fat) OR an image of an unhealthy food (contain added sugar and/or >4.5g/serving saturated fat).
- The participant is asked to rate how strong their craving is for the pictured food. The participant indicates their craving on a VAS from 1 (No craving at all) to 5 (Very high craving)
Intervention: Regulation of craving training (Behavioral)
Control
Participants randomized to the control (CRO) group will:
- Read a brief essay about fun food trivia (unrelated to any aspects of perceived healthiness). The essays are matched on structure/word count to the mROC-T essays.
- Participants complete six free-response questions to ensure that they understood the essays.
- Participants are instructed to use the information from the essay. They are shown a cue matching the essay, either: "Think Relaxed" or "Think Serene".
- They are shown an image of a healthy food (no added sugar and < 2g/serving saturated fat) OR an image of an unhealthy food (contain added sugar and/or >4.5g/serving saturated fat).
- The participant is asked to rate how strong their craving is for the pictured food. The participant indicates their craving on a VAS from 1 (No craving at all) to 5 (Very high craving)
Intervention: Regulation of craving training (Behavioral)
Outcomes
Primary Outcomes
Healthy eating index (HEI)
Time Frame: 1 year
Participants will provide diet recalls twice per month. The participants will complete the diet recalls using the Automated Self Administered 24 hour recall (ASA-24) platform. The ASA-24 computes the necessary variables to calculate the healthy eating index (HEI). HEI is a measure of overall diet quality according to the Dietary Guidelines for Americans and is scored from 0-100 (100 being the best possible diet). HEI scores will be calculated per month (mean of diet recalls per person) using the most recent HEI scoring algorithm as recommended for intervention studies.
Secondary Outcomes
- Blood sugar(1 year)
- Body mass index(1 year)
Investigators
Grace Elisabeth Shearrer
Assistant Professor
University of Wyoming