Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors
IntroductionSmoking, obesity, and insufficient physical activity are modifiable health risk behaviors. Self-regulation is one fundamental behavior change mechanism often incorporated within digital therapeutics as it varies momentarily across time and contexts and may play a causal role in improving...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2025-02-01
|
| Series: | Frontiers in Digital Health |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fdgth.2025.1467772/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832542296016420864 |
|---|---|
| author | Enzo G. Plaitano Enzo G. Plaitano Daniel McNeish Sophia M. Bartels Sophia M. Bartels Kathleen Bell Jesse Dallery Michael Grabinski Michaela Kiernan Hannah A. Lavoie Hannah A. Lavoie Shea M. Lemley Michael R. Lowe David P. MacKinnon Stephen A. Metcalf Stephen A. Metcalf Lisa Onken Judith J. Prochaska Cady Lauren Sand Cady Lauren Sand Emily A. Scherer Luke E. Stoeckel Haiyi Xie Lisa A. Marsch |
| author_facet | Enzo G. Plaitano Enzo G. Plaitano Daniel McNeish Sophia M. Bartels Sophia M. Bartels Kathleen Bell Jesse Dallery Michael Grabinski Michaela Kiernan Hannah A. Lavoie Hannah A. Lavoie Shea M. Lemley Michael R. Lowe David P. MacKinnon Stephen A. Metcalf Stephen A. Metcalf Lisa Onken Judith J. Prochaska Cady Lauren Sand Cady Lauren Sand Emily A. Scherer Luke E. Stoeckel Haiyi Xie Lisa A. Marsch |
| author_sort | Enzo G. Plaitano |
| collection | DOAJ |
| description | IntroductionSmoking, obesity, and insufficient physical activity are modifiable health risk behaviors. Self-regulation is one fundamental behavior change mechanism often incorporated within digital therapeutics as it varies momentarily across time and contexts and may play a causal role in improving these health behaviors. However, the role of momentary self-regulation in achieving behavior change has been infrequently examined. Using a novel momentary self-regulation scale, this study examined how targeting self-regulation through a digital therapeutic impacts adherence to the therapeutic and two different health risk behavioral outcomes.MethodsThis prospective interventional study included momentary data for 28 days from 50 participants with obesity and binge eating disorder and 50 participants who smoked regularly. An evidence-based digital therapeutic, called Laddr™, provided self-regulation behavior change tools. Participants reported on their momentary self-regulation via ecological momentary assessments and health risk behaviors were measured as steps taken from a physical activity tracker and breathalyzed carbon monoxide. Medical regimen adherence was assessed as daily Laddr usage. Bayesian dynamic mediation models were used to examine moment-to-moment mediation effects between momentary self-regulation subscales, medical regimen adherence, and behavioral outcomes.ResultsIn the binge eating disorder sample, the perseverance [β1 = 0.17, 95% CI = (0.06, 0.45)] and emotion regulation [β1 = 0.12, 95% CI = (0.03, 0.27)] targets of momentary self-regulation positively predicted Laddr adherence on the following day, and higher Laddr adherence was subsequently a positive predictor of steps taken the same day for both perseverance [β2 = 0.335, 95% CI = (0.030, 0.717)] and emotion regulation [β2 = 0.389, 95% CI = (0.080, 0.738)]. In the smoking sample, the perseverance target of momentary self-regulation positively predicted Laddr adherence on the following day [β = 0.91, 95% CI = (0.60, 1.24)]. However, higher Laddr adherence was not a predictor of CO values on the same day [β2 = −0.09, 95% CI = (−0.24, 0.09)].ConclusionsThis study provides evidence that a digital therapeutic targeting self-regulation can modify the relationships between momentary self-regulation, medical regimen adherence, and behavioral health outcomes. Together, this work demonstrated the ability to digitally assess the transdiagnostic mediating effect of momentary self-regulation on medical regimen adherence and pro-health behavioral outcomes.
Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT03774433). |
| format | Article |
| id | doaj-art-30504f46c4d24d6684bea70b8d76ac1a |
| institution | Kabale University |
| issn | 2673-253X |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Digital Health |
| spelling | doaj-art-30504f46c4d24d6684bea70b8d76ac1a2025-02-04T06:32:09ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-02-01710.3389/fdgth.2025.14677721467772Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviorsEnzo G. Plaitano0Enzo G. Plaitano1Daniel McNeish2Sophia M. Bartels3Sophia M. Bartels4Kathleen Bell5Jesse Dallery6Michael Grabinski7Michaela Kiernan8Hannah A. Lavoie9Hannah A. Lavoie10Shea M. Lemley11Michael R. Lowe12David P. MacKinnon13Stephen A. Metcalf14Stephen A. Metcalf15Lisa Onken16Judith J. Prochaska17Cady Lauren Sand18Cady Lauren Sand19Emily A. Scherer20Luke E. Stoeckel21Haiyi Xie22Lisa A. Marsch23Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesThe Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH, United StatesDepartment of Psychology, Arizona State University, Tempe, AZ, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesDepartment of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesDepartment of Psychology, University of Florida, Gainesville, FL, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesStanford Prevention Research Center, Stanford University, Stanford, CA, United StatesDepartment of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, NC, United StatesDepartment of Health Education and Behavior, University of Florida, Gainesville, FL, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesDepartment of Psychological and Brain Sciences, Drexel University, Philadelphia, PA, United StatesDepartment of Psychology, Arizona State University, Tempe, AZ, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom0National Institute on Aging, National Institutes of Health, Bethesda, MD, United StatesStanford Prevention Research Center, Stanford University, Stanford, CA, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States1Apple Inc., Cupertino, CA, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United States0National Institute on Aging, National Institutes of Health, Bethesda, MD, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesCenter for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Lebanon, NH, United StatesIntroductionSmoking, obesity, and insufficient physical activity are modifiable health risk behaviors. Self-regulation is one fundamental behavior change mechanism often incorporated within digital therapeutics as it varies momentarily across time and contexts and may play a causal role in improving these health behaviors. However, the role of momentary self-regulation in achieving behavior change has been infrequently examined. Using a novel momentary self-regulation scale, this study examined how targeting self-regulation through a digital therapeutic impacts adherence to the therapeutic and two different health risk behavioral outcomes.MethodsThis prospective interventional study included momentary data for 28 days from 50 participants with obesity and binge eating disorder and 50 participants who smoked regularly. An evidence-based digital therapeutic, called Laddr™, provided self-regulation behavior change tools. Participants reported on their momentary self-regulation via ecological momentary assessments and health risk behaviors were measured as steps taken from a physical activity tracker and breathalyzed carbon monoxide. Medical regimen adherence was assessed as daily Laddr usage. Bayesian dynamic mediation models were used to examine moment-to-moment mediation effects between momentary self-regulation subscales, medical regimen adherence, and behavioral outcomes.ResultsIn the binge eating disorder sample, the perseverance [β1 = 0.17, 95% CI = (0.06, 0.45)] and emotion regulation [β1 = 0.12, 95% CI = (0.03, 0.27)] targets of momentary self-regulation positively predicted Laddr adherence on the following day, and higher Laddr adherence was subsequently a positive predictor of steps taken the same day for both perseverance [β2 = 0.335, 95% CI = (0.030, 0.717)] and emotion regulation [β2 = 0.389, 95% CI = (0.080, 0.738)]. In the smoking sample, the perseverance target of momentary self-regulation positively predicted Laddr adherence on the following day [β = 0.91, 95% CI = (0.60, 1.24)]. However, higher Laddr adherence was not a predictor of CO values on the same day [β2 = −0.09, 95% CI = (−0.24, 0.09)].ConclusionsThis study provides evidence that a digital therapeutic targeting self-regulation can modify the relationships between momentary self-regulation, medical regimen adherence, and behavioral health outcomes. Together, this work demonstrated the ability to digitally assess the transdiagnostic mediating effect of momentary self-regulation on medical regimen adherence and pro-health behavioral outcomes. Clinical Trial RegistrationClinicalTrials.gov, identifier (NCT03774433).https://www.frontiersin.org/articles/10.3389/fdgth.2025.1467772/fulldigital therapeuticmomentary self-regulationhealth risk behaviorsmokingbinge eating disorderobesity |
| spellingShingle | Enzo G. Plaitano Enzo G. Plaitano Daniel McNeish Sophia M. Bartels Sophia M. Bartels Kathleen Bell Jesse Dallery Michael Grabinski Michaela Kiernan Hannah A. Lavoie Hannah A. Lavoie Shea M. Lemley Michael R. Lowe David P. MacKinnon Stephen A. Metcalf Stephen A. Metcalf Lisa Onken Judith J. Prochaska Cady Lauren Sand Cady Lauren Sand Emily A. Scherer Luke E. Stoeckel Haiyi Xie Lisa A. Marsch Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors Frontiers in Digital Health digital therapeutic momentary self-regulation health risk behavior smoking binge eating disorder obesity |
| title | Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors |
| title_full | Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors |
| title_fullStr | Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors |
| title_full_unstemmed | Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors |
| title_short | Adherence to a digital therapeutic mediates the relationship between momentary self-regulation and health risk behaviors |
| title_sort | adherence to a digital therapeutic mediates the relationship between momentary self regulation and health risk behaviors |
| topic | digital therapeutic momentary self-regulation health risk behavior smoking binge eating disorder obesity |
| url | https://www.frontiersin.org/articles/10.3389/fdgth.2025.1467772/full |
| work_keys_str_mv | AT enzogplaitano adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT enzogplaitano adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT danielmcneish adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT sophiambartels adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT sophiambartels adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT kathleenbell adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT jessedallery adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT michaelgrabinski adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT michaelakiernan adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT hannahalavoie adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT hannahalavoie adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT sheamlemley adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT michaelrlowe adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT davidpmackinnon adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT stephenametcalf adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT stephenametcalf adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT lisaonken adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT judithjprochaska adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT cadylaurensand adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT cadylaurensand adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT emilyascherer adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT lukeestoeckel adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT haiyixie adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors AT lisaamarsch adherencetoadigitaltherapeuticmediatestherelationshipbetweenmomentaryselfregulationandhealthriskbehaviors |