{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:51:41Z","timestamp":1777420301114,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T00:00:00Z","timestamp":1733270400000},"content-version":"unspecified","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hong Kong Research Grants Council","award":["17115422"],"award-info":[{"award-number":["17115422"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,18]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>The communication of information about the risk of type 2 diabetes (T2D) alone has not been associated with changes in habitual behaviours among individuals of European ancestry. In contrast, the use of wearable devices that monitor physical activity (PA) has been associated with behavioural changes in some studies. It is uncertain whether risk communication might enhance the effects of wearable devices. We aim to assess the effects of communicating genetic risk for T2D alone or in combination with wearable device functions on wearable device-measured PA among overweight or obese East Asians.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>In a parallel group, randomised controlled trial, 355 overweight or obese East Asian individuals aged 40\u201360 years are allocated into one of three groups: one control and two intervention groups. Blood samples will be used for estimation of T2D genetic risk and analysis of metabolic risk markers. Genetic risk of T2D will be estimated based on 113 single-nucleotide polymorphisms associated with T2D among East Asians. All three groups receive a Fitbit device. Both intervention groups will receive T2D genetic risk estimates along with lifestyle advice, but one of the intervention groups additionally uses Fitbit\u2019s step goal setting and prompt functions. Questionnaires and physical measurements are administered at baseline, immediately after intervention delivery, and 6 and 12 months post intervention. The primary outcome is time spent in moderate-to-vigorous PA from the Fitbit, which will be assessed at baseline, immediately post intervention, 12 months post intervention and at 6-month follow-up. Secondary outcomes include other wearable device-measured parameters, sedentary time, and sleep, blood pressure, metabolic risk markers, hand grip strength, self-reported PA, fruit and vegetable consumption, smoking, and psychological variables. Between-group differences in the continuous and categorical variables collected at baseline will be examined using Analysis of Variance (ANOVA) and \u03c7<jats:sup>2<\/jats:sup> tests, respectively. A series of linear mixed effects models with fixed effects of time, group and interaction between time and group will be performed, with adjustment for potential confounders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study protocol has undergone review and received approval from the ethics committee of the University of Hong Kong. Findings from our trial will be disseminated through publication in peer-reviewed research journals and presented at international academic conferences.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ClinicalTrials.gov, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT05524909\">NCT05524909<\/jats:ext-link>. <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/register.clinicaltrials.gov\/\">https:\/\/register.clinicaltrials.gov\/<\/jats:ext-link> (11 November 2024).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-082635","type":"journal-article","created":{"date-parts":[[2024,12,4]],"date-time":"2024-12-04T20:45:27Z","timestamp":1733345127000},"page":"e082635","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of communicating genetic risk of type 2 diabetes and wearable technologies on wearable device-measured behavioural outcomes in East Asians: protocol of a randomised controlled trial"],"prefix":"10.1136","volume":"14","clinical-trial-number":[{"clinical-trial-number":"nct05524909","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Youngwon","family":"Kim","sequence":"first","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Job G","family":"Godino","sequence":"additional","affiliation":[{"name":"Exercise and Physical Activity Resource Center, Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flora Lai Tung","family":"Cheung","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Multhaup","sequence":"additional","affiliation":[{"name":"Guardant Health, Redwood City, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8200-0263","authenticated-orcid":false,"given":"Derwin King Chung K C","family":"Chan","sequence":"additional","affiliation":[{"name":"The Education University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0176-8685","authenticated-orcid":false,"given":"Ziyuan","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harrison Hin Sheung","family":"Ho","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsz Him Timothy","family":"Tse","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiu Lun Ryan","family":"Au Yeung","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shan","family":"Lou","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joni H","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyao","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, The University of Hong Kong, HKSAR, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Griffin","sequence":"additional","affiliation":[{"name":"The Primary Care Unit, University of Cambridge, Cambridge, UK"},{"name":"MRC Epidemiology Unit, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,4]]},"reference":[{"key":"2025101814574182000_14.12.e082635.1","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S2213-8587(13)70112-8","article-title":"Diabetes: a 21st century challenge","volume":"2","author":"Zimmet","year":"2014","journal-title":"Lancet Diabetes Endocrinol"},{"key":"2025101814574182000_14.12.e082635.2","doi-asserted-by":"publisher","DOI":"10.1900\/RDS.2012.9.6"},{"key":"2025101814574182000_14.12.e082635.3","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)00618-8"},{"key":"2025101814574182000_14.12.e082635.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60646-1"},{"key":"2025101814574182000_14.12.e082635.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003052","article-title":"Secular trends in incidence of type 1 and type 2 diabetes in Hong Kong: A retrospective cohort study","volume":"17","author":"Luk","year":"2020","journal-title":"PLoS Med"},{"key":"2025101814574182000_14.12.e082635.6","unstructured":"World Health Organization . Global report on diabetes. Geneva World Health Organization; 2016."},{"key":"2025101814574182000_14.12.e082635.7","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1038\/s41586-020-2263-3","article-title":"Identification of type 2 diabetes loci in 433,540 East Asian individuals","volume":"582","author":"Spracklen","year":"2020","journal-title":"Nature New Biol"},{"key":"2025101814574182000_14.12.e082635.8","unstructured":"CredenceResearch . Direct-to-consumer (dtc) genetic testing market by sales channel (online sales, otc sales, doctor\u2019s office), by business model (genome data bank material model, individual health planning model, comprehensive genome tests model, medical precision tests model, restricted trait tests model) - growth, future propects and competitive analysis, 2018 - 2026. United States Credence Research; 2018."},{"key":"2025101814574182000_14.12.e082635.9","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31693"},{"key":"2025101814574182000_14.12.e082635.10","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i1102","article-title":"The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis","volume":"352","author":"Hollands","year":"2016","journal-title":"BMJ"},{"key":"2025101814574182000_14.12.e082635.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-017-4375-8","article-title":"Awareness, knowledge, perceptions, and attitudes towards genetic testing for cancer risk among ethnic minority groups: a systematic review","volume":"17","author":"Hann","year":"2017","journal-title":"BMC Public Health"},{"key":"2025101814574182000_14.12.e082635.12","doi-asserted-by":"publisher","DOI":"10.1097\/01.gim.0000195884.86201.a0"},{"key":"2025101814574182000_14.12.e082635.13","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1001\/jamacardio.2020.3994","article-title":"Multichannel Electrocardiograms Obtained by a Smartwatch for the Diagnosis of ST-Segment Changes","volume":"5","author":"Spaccarotella","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2025101814574182000_14.12.e082635.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.14781"},{"key":"2025101814574182000_14.12.e082635.15","doi-asserted-by":"crossref","DOI":"10.2196\/11819","article-title":"Consumer-Based Wearable Activity Trackers Increase Physical Activity Participation: Systematic Review and Meta-Analysis","volume":"7","author":"Brickwood","year":"2019","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025101814574182000_14.12.e082635.16","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001953","article-title":"The Rise of Consumer Health Wearables: Promises and Barriers","volume":"13","author":"Piwek","year":"2016","journal-title":"PLoS Med"},{"key":"2025101814574182000_14.12.e082635.17","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e7586","article-title":"SPIRIT 2013 explanation and elaboration: guidance for protocols of clinical trials","volume":"346","author":"Chan","year":"2013","journal-title":"BMJ"},{"key":"2025101814574182000_14.12.e082635.18","unstructured":"Agena Bioscience . The massarray system San Diego. CA Agena Bioscience; 2020. Available: https:\/\/agenabio.com\/products\/massarray-system"},{"key":"2025101814574182000_14.12.e082635.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1002185","article-title":"Lifestyle Advice Combined with Personalized Estimates of Genetic or Phenotypic Risk of Type 2 Diabetes, and Objectively Measured Physical Activity: A Randomized Controlled Trial","volume":"13","author":"Godino","year":"2016","journal-title":"PLoS Med"},{"key":"2025101814574182000_14.12.e082635.20","unstructured":"Multhaup ML , Kita R , Krock B , et al . White paper 23-19 the science behind 23andme\u2019s type 2 diabetes report. estimating the likelihood of developing type 2 diabetes with polygenic models. 23andMe; 2019."},{"key":"2025101814574182000_14.12.e082635.21","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-12-444","article-title":"Effect of communicating genetic and phenotypic risk for type 2 diabetes in combination with lifestyle advice on objectively measured physical activity: protocol of a randomised controlled trial","volume":"12","author":"Godino","year":"2012","journal-title":"BMC Public Health"},{"key":"2025101814574182000_14.12.e082635.22","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/81.24.1879"},{"key":"2025101814574182000_14.12.e082635.23","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.516"},{"key":"2025101814574182000_14.12.e082635.24","unstructured":"WHO . WHO strategic communications framework for effective communications. 2017."},{"key":"2025101814574182000_14.12.e082635.25","unstructured":"Multhaup M , Kita R , Krock B , et al . White paper 23-19: the science behind 23andme\u2019s type 2 diabetes report. 2019."},{"key":"2025101814574182000_14.12.e082635.26","doi-asserted-by":"publisher","DOI":"10.1002\/oby.21619"},{"key":"2025101814574182000_14.12.e082635.27","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afr051"},{"key":"2025101814574182000_14.12.e082635.28","doi-asserted-by":"publisher","DOI":"10.2337\/dc12-0884"},{"key":"2025101814574182000_14.12.e082635.29","unstructured":"Cohen J . Statistical power analysis for the behavioral sciences. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988."},{"key":"2025101814574182000_14.12.e082635.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2010.02.012"},{"key":"2025101814574182000_14.12.e082635.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2015.01.020"},{"key":"2025101814574182000_14.12.e082635.32","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-035168","article-title":"Definitions of blinding in randomised controlled trials of interventions published in high-impact anaesthesiology journals: a methodological study and survey of authors","volume":"10","author":"Peni\u0107","year":"2020","journal-title":"BMJ Open"},{"key":"2025101814574182000_14.12.e082635.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12966-015-0314-1","article-title":"Systematic review of the validity and reliability of consumer-wearable activity trackers","volume":"12","author":"Evenson","year":"2015","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2025101814574182000_14.12.e082635.34","doi-asserted-by":"publisher","DOI":"10.1177\/009286150804200402"},{"key":"2025101814574182000_14.12.e082635.35","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-genom-092010-110722"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-082635","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T21:57:53Z","timestamp":1760824673000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-082635"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":35,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,4]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bmjopen-2023-082635"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-082635","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}