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Currently submitted to: JMIR Formative Research

Date Submitted: Sep 5, 2020
Open Peer Review Period: Aug 30, 2020 - Oct 25, 2020
(currently open for review)

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Long-Term Evaluation of Counselor Efficiency at Providing Feedback in a Technology-Based Behavioral Weight Loss Intervention

  • Margaret Fahey; 
  • Robert C. Klesges; 
  • Mehmet Kocak; 
  • Leslie Gladney; 
  • Gerald W. Talcott; 
  • Rebecca A. Krukowski; 



Feedback for participants’ self-monitoring is a crucial, and costly, component of technology-based weight loss interventions. Detailed examination of interventionist time when reviewing and providing feedback for online self-monitoring data is unknown.


Study purpose was to longitudinally examine time counselors spent providing feedback on participant self-monitoring data (i.e., diet, physical activity, weight) in a 12-month technology-based weight loss intervention. We hypothesized that counselors would deliver feedback to participants more quickly over time.


Time counselors (N=10) spent reviewing and providing feedback to participants via electronic mail (e-email) was longitudinally examined for all counselors across the three years of study implementation. Descriptives were observed for counselor feedback duration across counselors by 12 annual quarters (i.e., three-month periods). Differences in overall duration times by each consecutive annual quarter were analyzed using Wilcoxon-Mann-Whitney tests.


There was a decrease in counselor feedback duration from first to second quarter [Mean (M) = 53 to 46 minutes], and from second to third (M= 46 to 30). A trend suggested a decrease from third to fourth quarters (M = 30 to 26), but no changes were found in subsequent quarters. Consistent with hypothesis, counselors increased their efficiency in providing feedback. Across 12-months, mean time counselors needed to review participant self-monitoring and provide feedback decreased from 53 to 26 minutes.


Counselors needed increasingly less time to review online self-monitoring data and provide feedback after the initial nine months of study implementation. Results inform counselor costs for future technology-based behavioral weight loss interventions. For example, regardless of increasing counselor efficiency, 25-30 minutes per feedback message is a high cost for interventions. One possibility for reducing costs would be generating computer-automated feedback. Clinical Trial: NCT02063178


Please cite as:

Fahey M, Klesges RC, Kocak M, Gladney L, Talcott GW, Krukowski RA

Long-Term Evaluation of Counselor Efficiency at Providing Feedback in a Technology-Based Behavioral Weight Loss Intervention

JMIR Preprints. 05/09/2020:23974

DOI: 10.2196/preprints.23974


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