Short-term efficacy of a mobile-assisted screening and brief intervention for multiple health behaviors: An interventional randomized controlled study in medical settings (Preprint)

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Abstract
BACKGROUND Chronic diseases share common behavioral risk factors, including unbalanced diet, physical inactivity, tobacco use, and alcohol consumption. Digital tools may help clinicians screen for and address these risk factors within routine care, but evidence of their short-term efficacy remains limited. OBJECTIVE To estimate the short-term efficacy of CliniCAP, a partially automated mobile-assisted screening and brief intervention (m-SBI), on adherence to 18 health prevention recommendations among patients with chronic conditions, and to examine variation in readiness to change across multiple health behaviors METHODS A prospective randomized controlled study was conducted in four departments of two academic University Hospitals, including one Cancer treatment Centre. Adult outpatients with stabilized chronic disease or localized cancer in post-treatment follow-up were randomized to receive either the intervention (experimental group) or routine lifestyle advice (control group). The primary outcome was the number of health prevention recommendations followed (range 0-18, covering dietary habits, physical activity, alcohol and tobacco use), assessed at baseline, 1 and 3-month follow-up using mixed-effects logistic models. Stage of change (precontemplation, contemplation, preparation, action/maintenance) was also assessed for each behavior. RESULTS Among 164 participants (82 per group), the number of prevention recommendations followed increased by 10.0% in the experimental group versus 3.4% in the control group. The improvement in the experimental group was significantly greater than in the control group at both one month (OR = 1.29; 95% CI: 1.03–1.61) and three months (OR = 1.30; 95% CI: 1.03–1.64). A significantly higher proportion of experimental-group participants progressed to the action/maintenance stage for dietary behaviors compared to control (37% vs. 23%). No significant between-group differences emerged for physical activity, alcohol, or tobacco use. CONCLUSIONS A brief, partially automated m-SBI significantly improved overall adherence to health prevention recommendations and dietary behavior change over three months, supporting its feasibility and clinical relevance as a scalable tool for routine clinical practice. CLINICALTRIAL NCT06616064, registered on September 24, 2024. https://clinicaltrials.gov/study/NCT06616064

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