Precision Behavioural Support in Weight Management: A Real-World Evaluation of a Novel Precision Health Behavioural Change Architecture for Initiating and Maintaining Sustainable Health-Promoting Behaviours in People with Obesity (Preprint)

BACKGROUND Over 1.9 billion people are diagnosed as being obese or overweight. Digital technologies have varying effects in affecting weight loss in participants. Precision health exploits the benefits of digital health and data by being able to provide highly tailored, or personalised, pathways to service users. Obesity is a multi-morbid condition caused in part by lifestyle risk factors including dietary choices, sleep hygiene, exercise and mental health. OBJECTIVE The objective was to assess the effect of participants choosing their health “focus” on joining the NHS-certified Gro Health app to support holistic remote weight management. METHODS Participants were invited to engage with a precision behavioural change tool that addresses the four pillars of health; mental health/wellbeing, nutrition, sleep and exercise “Gro Health” by their primary care team or local authority and invited to use the tool’s education programmes, access MDT health coaching and track their health. Gro Health onboards users to self-select where they would like to place their health “Focus” on either; Sleep, Exercise, Nutrition or Wellbeing which tailors their experience of the digital tool. Outcome variables; weight, HbA1c, PHQ8, Karolinska Sleepiness Scale, and Patient Activation Measure (PAM) compared users across “focus” groups. RESULTS 438 participants downloaded the Gro Health app. Mean age 41.9 (± 13 years) and body weight on sign up was 95.59kg (SD 5.6). The majority of participants identified as female (51.1%) with mostly users of white ethnicity (71.2%). 72% of participants chose nutrition as their focus, with the greatest weight loss between baseline and 12-month recordings (MD=7.01, ±2.83) observed for these individuals, compared to those who selected exercise, sleep or wellbeing as their focus. The largest improvement in sleepiness and depression was for individuals who chose sleep as their focus. CONCLUSIONS Allowing a participant to self-select their focus influences their health outcomes and can support multiple therapeutic benefits. A precision behavioural change tool can support holistic health management and the continuum of obesity management and is an effective way to deliver scalable and engaging precision behavioural change.