PD05-11: Use of mini sip^IT Behavioral Intervention Increases Fluid Intake in Patients with Kidney Stones

Necole Streeper*, James Marks, Jason Fairbourn, Hershey, PA, Emily Frith, University Park, PA, Edison Thomaz, Austin, TX, Nilam Ram, Stanford, CA, David Conroy, University Park, PA

Introduction: Wearable technology is both increasingly prevalent and successfully improving a variety of health behaviors. We previously showed that digital tools are capable of identifying lapses in drinking behavior and delivering just-in-time messages to promote fluid consumption. The purpose of this study was to determine the feasibility, acceptability and impact of mini sipIT, a context-sensitive reminder system that incorporates a connected water bottle and mobile app with text messaging, for kidney stone patients – a population that often has poor adherence to increasing fluid intake for prevention.

Methods: Patients with a history of kidney stones and urine volume less than 2 liters/day were recruited to participate in a 1-month feasibility trial. Patients were given an H2OPal connected water bottle and received hourly text message reminders when they were not meeting fluid intake goals. Perceptions of drinking behavior, intervention acceptability and 24-hour urine volumes were obtained at baseline and after the 1-month mini sipIT behavioral intervention.

Results: Patients with a history of kidney stones were enrolled (n = 26, 77% female, age = 50.4 ± 14.2 years). There was a significant increase in 24-hour urine volume at the end of the 1-month mini sipIT behavioral intervention compared to baseline (2006.5 ± 980.8 mL vs. 1352.7 ± 449.9 mL, t (25) = 3.66, p = .001, d = 0.84). 24-hour urine volumes increased at the end of the 1-month trial for 73% of participants. Most participants perceived that mini sipIT intervention helped them to increase their fluid intake (85%) and reach their fluid intake goals (65%). The majority used the connected water bottle and mobile app every day of the intervention (92%). However, 35% of participants reported that carrying the water bottle was cumbersome.

Conclusions: Mini sipIT behavioral intervention is feasible and provides automated lapse-detection that improves fluid intake with a significant increase in 24- hour urine volume. Although patients found the intervention acceptable, reports that carrying the water bottle was cumbersome suggest use of a different water bottle design or multimodal intake monitoring systems may be necessary to reduce patient burden. Digital tools in combination with behavioral science may help to improve adherence to fluid intake recommendations for kidney stone prevention.

Source of Funding: Keith and Lynda Harring Fund for Kidney Research at Penn State Health and National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK124469).