Objective: The goal of the present study was to deconstruct the 17 treatment arms used in the Early Adult Reduction of weight through LifestYle (EARLY) weight management trials. Methods: Intervention materials were coded to reflect behavioral domains and behavior change techniques (BCTs) within those domains planned for each treatment arm. The analytical hierarchy process was employed to determine an emphasis profile of domains in each intervention. Results: The intervention arms used BCTs from all of the 16 domains, with an average of 29.3 BCTs per intervention arm. All 12 of the interventions included BCTs from the six domains of Goals and Planning, Feedback and Monitoring, Social Support, Shaping Knowledge, Natural Consequences, and Comparison of Outcomes; 11 of the 12 interventions shared 15 BCTs in common across those six domains. Conclusions: Weight management interventions are complex. The shared set of BCTs used in the EARLY trials may represent a core intervention that could be studied to determine the required emphases of BCTs and whether additional BCTs add to or detract from efficacy. Deconstructing interventions will aid in reproducibility and understanding of active ingredients.
Bibliographical noteFunding Information:
Funding agencies: This work was supported by the following National Heart, Lung, and Blood Institute research grants: HL122144 (to DFT and SHB), HL096760 (to CMO), HL096770 (to JMJ), HL096628 (to KCJ), HL096767 (to LL), HL096715 (to KP), HL096720 (to LPS), HL090864 (to RRW), and HL090875. Disclosure: DFT and JMJ report being members of the Scientific Advisory Board for Weight Watchers International. The other authors declared no conflict of interest. Clinical trial registration: All of the trials are registered as clinical trials. ClinicalTrials.gov identifiers are as follows: NCT01134783 (CHOICES), NCT01092364 (CITY), NCT01331564 (e-MomsRoc), NCT01121871 (IDEA), NCT01200459 (SMART), NCT01183689 (SNAP), and NCT01199185 (TARGIT). Additional Supporting Information may be found in the online version of this article. Received: 10 October 2018; Accepted: 10 March 2019; Published online 28 May 2019. doi:10.1002/oby.22506