Counselor Efficiency at Providing Feedback in a Technology-Based Behavioral Weight Loss Intervention: Longitudinal...

Area of Science:

• Behavioral Science
• Health Technology
• Weight Management

Background:

• Self-monitoring feedback is essential but costly in digital weight loss programs.
• Limited data exists on interventionist time spent on feedback for online self-monitoring.
• This study addresses the gap by examining counselor time in a 12-month intervention.

Purpose of the Study:

• To longitudinally analyze counselor time spent providing feedback on self-monitoring data (diet, activity, weight) in a 12-month digital weight loss intervention.
• To test the hypothesis that counselors become more efficient in providing feedback over time.
• To inform cost estimations for future technology-based weight loss interventions.

Main Methods:

• Ten lay counselors' time spent reviewing self-monitoring records and providing email feedback was tracked over three years.
• Counselor feedback duration was analyzed across 12 quarterly periods.
• Wilcoxon-Mann-Whitney tests assessed differences in feedback duration between consecutive quarters.

Main Results:

• Counselor feedback time significantly decreased from quarter 1 to 3 (53 to 30 minutes).
• A trend of decreasing time was observed from quarter 3 to 4 (30 to 26 minutes).
• Overall, counselor efficiency increased, with time decreasing from a mean of 53 to 26 minutes over 12 months.

Conclusions:

• Counselors significantly reduced time spent on self-monitoring feedback after the first 9 months.
• Findings highlight the high cost of manual feedback (25-30 minutes per message) even with increased efficiency.
• Computer-automated feedback is suggested as a potential cost-reduction strategy for digital weight loss interventions.