Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: To tackle the problem of obesity and related diseases in Switzerland cost-efficient, effective, innovative primary health care interventions for weight management are required. In this context Oviva has developed a scalable technology for dietitians to counsel overweight and obese patients via a smartphone-app. Objective: Evaluate the effectiveness and feasibility of dietitian’s weight loss counselling using a smartphone-app for patients with overweight/obesity. Methods: In this pre-post test pilot study, overweight and obese adults participated in a one-year behavioral intervention to lose weight through remote counselling by dietitians. The study started in April 2016 and finished in May 2018 in the German-speaking part of Switzerland. Participants received individual counselling through the app and the exchange with the dietitian had a focus on regular feedback on photo-based food-log, motivation and education. The contents were tailored the individual life style goal set. The pre-defined intensity of remote counselling decreased during the year. Group chat could be used. Following outcomes were examined: weight change (primary outcome), HBA1c; fasting glucose; fasting insulin, triglyceride, HDL-cholesterol, blood pressure, BMI, waist circumference, body fat, and by a self-administered questionnaire: physical activity, dietary assessment, health related quality of life. Changes are tested between the beginning and after 3 months / after 12 months as well as between the 3rd month and the 12th month. Results: 36 women and 7 men participated with a mean age of 40.6 years and 36 participants (30 completed the study. Results showed weight change in kilogram after the first 12 weeks (Phase I): median: -3.8kg (range -15, 2.4) p<.001; between week 12 and week 52 median -1.1kg (range -9.7, 7) p=.08 and throughout the entire intervention -4.9kg (range -21.9, 7.5) p<.001. Further the clinical parameters Body Mass Index, waist circumference, body fat, blood pressure also demonstrated significant positive results over one-year intervention. The analysis of the self-administered questionnaire showed less significant results. Certain eating habits showed positive significant effects (higher frequency of vegetable, fruit, breakfast consumption, lower frequency of alcohol, sweet, fat consumption). Conclusions: The present study has shown that in addition to the professional skills of RD a profession specific application like Oviva can provide effective support that meets the needs of the individual (registered dietitians and clients) on the long path of behavioral change and sustainable weight reduction. Clinical Trial: ClinicalTrials.gov (NCT02694614) https://clinicaltrials.gov/ct2/show/NCT02694614

Background: The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. Objective: The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score [mMDS]), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. Methods: All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5% α level of error. Results: Prevalence of non-health-enhancing PA was 37.1%, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1%. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3%. Prevalence of low sleeping quality was 44.7%, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. Conclusions: In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. Trial Registration: ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108

Background: SARS-CoV-2, a novel coronavirus strain, has resulted in the COVID-19 pandemic since early 2020. To contain the transmission of this virus, the Swiss Federal Council ordered a nationwide lockdown of all nonessential businesses. Accordingly, students and employees of institutions for higher education were informed to continue their academic programs through home-office settings and online lectures. Objective: This longitudinal survey aims to evaluate various lifestyle habits such as physical activity, nutritional habits, and sleep behavior among students and employees of a Swiss University of Applied Sciences during a 2-month period of confinement and social distancing due to the COVID-19 pandemic and 1 year thereafter. Methods: This paper describes a protocol for a retrospective and prospective observational cohort study. Students and employees of Bern University of Applied Sciences, Department of Health Professions, were invited to anonymously complete a web-based survey during the COVID-19 confinement period. This will be followed by a second survey, scheduled 1 year after the lockdown. Information on various lifestyle aspects, including physical activity, nutritional habits, and sleep behavior, will be collected using adaptations of existing validated questionnaires. Results: This longitudinal study started during the government-ordered confinement period in Switzerland in mid-April 2020 and will end in mid-2021. Conclusions: The findings of this survey will provide information about the impact of confinement during the COVID-19 crisis on the physical activity, nutritional habits, and sleep behavior of students and employees of a Swiss institute. Trial Registration: ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108

Mobile health (mHealth) interventions can transform health care delivery and improve public health. At the same time, the evidence on lifestyle interventions continues to grow. They show promising results in preventing and treating noncommunicable diseases and enhancing health-related quality of life. These factors highlight the potential of multidomain mHealth interventions for lifestyle management. This viewpoint paper focuses on drawing valuable lessons from past experiences and providing guidance to developers of mHealth interventions for lifestyle management. We underscore the critical role of sharing practical insights to advance innovation in the field of mHealth interventions. We used an iterative consensus process to derive lessons learned, identify challenges, and reflect on possible actions. Our insights are based on our experience in developing 2 smartphone-based lifestyle interventions. Challenges and corresponding options in the following areas are presented: target population (preferences, personalization, and delivery), user involvement and testing, human support, and multidomain interventions (interdisciplinarity, flexibility, and core team). The development of multidomain mHealth interventions for lifestyle management requires a participatory and iterative approach involving relevant stakeholders (including end users) so that the right people get the right content at the right time. Additionally, it is crucial to consider established frameworks, guidelines, and regulations; allocate appropriate resources; and form a core team committed to the project’s aims and open to working in an interdisciplinary team.

Background: Sarcopenia, characterized by loss of muscle mass, reduced strength, and increasing frailty, is common in older adults and is often the result of underlying diseases such as advanced stages of heart failure (HF). Protein intake is crucial for maintaining muscle mass and strength. However, older adults typically consume less protein compared to younger individuals. It has recently been shown that the time of the first refrigerator opening in the morning, indicated by a door sensor, may be correlated with frailty in older individuals living alone. Objective: The aim of this study is to determine whether the time of the first refrigerator opening in the morning can serve as a potential indicator of protein intake in older patients (age ≥70 years) after hospitalization for HF decompensation over a period of 6 months. Methods: This is a substudy of a prospective interventional cohort study that aims to identify changes in digital biomarkers derived from an ambient sensor system, which may support the early detection of HF decompensation. In this substudy, the frequency and timing of refrigerator door openings in participants’ homes will be measured. To assess associations between protein intake and refrigerator openings, dietary intake will be evaluated using 24-hour dietary recalls at 3 different timepoints: at 1, 3, and 6 months after hospital discharge. All 24-hour dietary recalls will be conducted by trained dietitians in face-to-face interviews on weekdays. The primary outcome of this study will be the correlation between protein intake and the time (in minutes after midnight) of the first refrigerator door opening at each of the 3 assessment points. Results: The study is currently in the data collection phase. Recruitment began in February 2024. Data analysis will begin after all data have been collected. As of manuscript submission, 12 patients have been recruited. Results are expected to be published by the end of 2025. Conclusions: Considering that protein-rich foods are typically stored in the refrigerator, the relationship between frailty and refrigerator usage may be a relevant indicator for nutritional assessment, particularly regarding protein intake. In addition, sarcopenia and frailty may also be linked to protein distribution across meals. This study will explore whether monitoring refrigerator openings can serve as a simple method for identifying increased risk of frailty and sarcopenia. Early detection through such monitoring could facilitate timely interventions and potentially reduce the risk of these conditions. Trial Registration: ClinicalTrials.gov NCT06126848; https://clinicaltrials.gov/study/NCT06126848 International Registered Report Identifier (IRRID): DERR1-10.2196/66299

BACKGROUND The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. OBJECTIVE The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score [mMDS]), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. METHODS All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5% α level of error. RESULTS Prevalence of non-health-enhancing PA was 37.1%, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1%. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3%. Prevalence of low sleeping quality was 44.7%, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. CONCLUSIONS In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. CLINICALTRIAL ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT04502108