The ENGAGE study: Integrating neuroimaging, virtual reality and smartphone sensing to understand self-regulation for managing depression and obesity in a precision medicine model

Abstract Precision medicinemodels for personalizing achieving sustained behavior changeare largely outside of current clinical practice. Yet, changing self-regulatory behaviors is fundamental to the self-management of complex lifestyle-related chronic conditions such as depression and obesity - two top contributors to the global burden of disease and disability. To optimize treatments and address these burdens, behavior changeand self-regulation must be better understood in relation to their neurobiological underpinnings. Here, we present the conceptual framework and protocol for a novel study, “Engaging self-regulation targets to understand the mechanisms of behavior changeand improve mood and weight outcomes (ENGAGE)”. The ENGAGE study integrates neurosciencewith behavioral science to better understand the self-regulation related mechanisms of behavior changefor improving mood and weight outcomes among adults with comorbid depression and obesity. We collect assays of three self- regulationtargets ( emotion, cognition, and self-reflection) in multiple settings: neuroimaging and behavioral lab-based measures, virtual reality, and passive smartphone sampling. By connecting human neuroscience and behavioral science in this manner within the ENGAGE study, we develop a prototype for elucidating the underlying self-regulation mechanisms of behavior changeoutcomes and their application in optimizing intervention strategies for multiple chronic diseases.