{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T10:47:16Z","timestamp":1790938036801,"version":"4.1.0"},"reference-count":34,"publisher":"JMIR Publications Inc.","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Mhealth Uhealth"],"abstract":"\n Background<\/jats:title>\n Minorities have an increased incidence of early-onset, obesity-related cerebrovascular disease. Unfortunately, effective weight management in this vulnerable population has significant barriers.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n Our objective was to determine the feasibility and preliminary treatment effects of a smartphone-based weight loss intervention versus food journals to monitor dietary patterns in minority stroke patients.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Swipe out Stroke was a pilot prospective randomized controlled trial with open blinded end point. Minority stroke patients and their caregivers were screened for participation using cluster enrollment. We used adaptive randomization for assignment to a behavior intervention with (1) smartphone-based self-monitoring or (2) food journal self-monitoring. The smartphone group used Lose it! to record meals and communicate with us. Reminder messages (first 30 days), weekly summaries plus reminder messages on missed days (days 31-90), and weekly summaries only (days 91-180) were sent via push notifications. The food journal group used paper diaries. Both groups received 4 in-person visits (baseline and 30, 90, and 180 days), culturally competent counseling, and educational materials. The primary outcome was reduced total body weight.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n We enrolled 36 stroke patients (n=23, 64% African American; n=13, 36% Hispanic), 17 in the smartphone group, and 19 in the food journal group. Mean age was 54 (SD 9) years; mean body mass index was 35.7 (SD 5.7) kg\/m2; education, employment status, and family history of stroke or obesity did not differ between the groups. Baseline rates of depression (Patient Health Questionnaire-9 [PHQ-9] score median 5.5, IQR 3.0-9.5), cognitive impairment (Montreal Cognitive Assessment score median 23.5, IQR 21-26), and inability to ambulate (5\/36, 14% with modified Rankin Scale score 3) were similar. In total, 25 (69%) stroke survivors completed Swipe out Stroke (13\/17 in the smartphone group, 12\/19 in the food journal group); 1 participant in the smartphone group died. Median weight change at 180 days was 5.7 lb (IQR \u20132.4 to 8.0) in the smartphone group versus 6.4 lb (IQR \u20132.2 to 12.5; P=.77) in the food journal group. Depression was significantly lower at 30 days in the smartphone group than in the food journal group (PHQ-9 score 2 vs 8; P=.03). Clinically relevant depression rates remained in the zero to minimal range for the smartphone group compared with mild to moderate range in the food journal group at day 90 (PHQ-9 score 3.5 vs 4.5; P=.39) and day 180 (PHQ-9 score 3 vs 6; P=.12).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In a population of obese minority stroke survivors, the use of a smartphone did not lead to a significant difference in weight change compared with keeping a food journal. The presence of baseline depression (19\/36, 53%) was a confounding variable, which improved with app engagement. Future studies that include treatment of poststroke depression may positively influence intervention efficacy.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n ClinicalTrials.gov NCT02531074; https:\/\/www.clinicaltrials.gov\/ct2\/show\/NCT02531074<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/17816","type":"journal-article","created":{"date-parts":[[2020,3,23]],"date-time":"2020-03-23T19:32:36Z","timestamp":1584991956000},"page":"e17816","source":"Crossref","is-referenced-by-count":44,"title":["Use of a Smartphone-Based Mobile App for Weight Management in Obese Minority Stroke Survivors: Pilot Randomized Controlled Trial With Open Blinded End Point"],"prefix":"10.2196","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5013-622X","authenticated-orcid":false,"given":"Nneka L","family":"Ifejika","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7217-5780","authenticated-orcid":false,"given":"Minal","family":"Bhadane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7213-621X","authenticated-orcid":false,"given":"Chunyan C","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4427-7816","authenticated-orcid":false,"given":"Elizabeth A","family":"Noser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3667-4248","authenticated-orcid":false,"given":"James C","family":"Grotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4637-1790","authenticated-orcid":false,"given":"Sean I","family":"Savitz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2020,4,22]]},"reference":[{"key":"ref1","unstructured":"National Institutes of Health, National Heart, Lung, and Blood InstituteObesity Education Initiative: Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults: The Evidence Report. NIH Publication No 98-40831998092019-09-12Washington, DCU.S. Department of Health and Human Serviceshttp:\/\/www.nhlbi.nih.gov\/guidelines\/obesity\/ob_gdlns.pdf"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009445"},{"key":"ref3","unstructured":"National Center for Health StatisticsHealth, United States, 2016: With Chartbook on Long-Term Trends in Health20172019-11-07Hyattsville, MDUS Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statisticshttp:\/\/www.cdc.gov\/nchs\/data\/hus\/hus16.pdf"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000096993.90248.27"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000485"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0b013e31829734f2"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/s0749-3797(00)00129-x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000140493.83607.f1"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1080\/10810730305725"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.4478"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.9436"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.7832"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.2196\/mhealth.6445"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-4949.2012.00972.x"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.2147\/NDT.S67184"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.2196\/jmir.1923"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1177\/1747493016631557"},{"key":"ref18","author":"Borushek, A","year":"2006","journal-title":"The CalorieKing Food & Exercise Journal"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2005.53221.x"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.4158\/EP171764.APPGL"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000230"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-155-7-201110040-00006"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12357"},{"issue":"3","key":"ref24","first-page":"455","volume":"48","author":"Paolucci, S","year":"2012","journal-title":"Eur J Phys Rehabil Med"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.3233\/RNN-150508"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2017.04.050"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1177\/1049732309335395"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1007\/s10865-006-9092-1"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2010.208"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S28889"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1007\/s12529-012-9259-9"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.2196\/15321"},{"key":"ref33","doi-asserted-by":"crossref","DOI":"10.1017\/CBO9780511544231","author":"Robinson, RG","year":"2006","journal-title":"The Clinical Neuropsychiatry of Stroke: Cognitive, Behavioral and Emotional Disorders Following Vascular Brain Injury. 2nd edition"},{"key":"ref34","doi-asserted-by":"publisher","DOI":"10.2196\/15377"}],"container-title":["JMIR mHealth and uHealth"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/mhealth.jmir.org\/2020\/4\/e17816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:21:50Z","timestamp":1782840110000},"score":1,"resource":{"primary":{"URL":"http:\/\/mhealth.jmir.org\/2020\/4\/e17816\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,22]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.2196\/17816","relation":{"has-preprint":[{"id-type":"doi","id":"10.2196\/preprints.17816","asserted-by":"object"}]},"ISSN":["2291-5222"],"issn-type":[{"value":"2291-5222","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,22]]}}}