RMR Monitoring Feasibility and Acceptability

Study visits: Participants will be asked to refrain from food and calorie- or caffeine-containing beverages for at least 12 hours, alcohol for at least 24 hours, and vigorous-intensity exercise for at least 48 hours before each study visit. Baseline study visit (\~3-3.5 hours): Prior to the baseline study visit, participants will meet with a member of the study team to review the consent form to establish participation status. Participants will be required to confirm their body weight using a digital scale. Participants will then be randomized using online software (http://www.randomization.com) in a 1:1 fashion for the order of RMR measurement device (i.e., starting with Breezing than Parvo or vice versa). RMR will be measured with the Parvo for 15-20 minutes after a period of 25-30 minutes of quiet rest. RMR will be measured with the Breezing for 6-10 minutes using the Breezing mobile application. In addition, participants will be provided a series of validated and standard questionnaires to assess psychological and behavioural related parameters during this visit. Finally, participants will be asked to create an account for the Breezing mobile application, will be provided with a activPAL activity monitoring device, and will be instructed as to how to complete the 3-day diet record. Follow-up study visit (\~3-3.5 hours, 6-8 weeks post baseline visit): Repeat measures will be taken for body weight, RMR (using both devices), and behavioural questionnaires. In addition, Dual X-ray absorptiometry (DEXA; Hologic Model A) will measure participant's fat-mass, fat-free mass, body fat percentage and bone mineral density. Body composition variables will be expressed in absolute terms and controlling for height (e.g., FM index: FM \[kg\]/height \[m2\]); FFM will also be expressed in relation to FM (FM:FFM). Study team members will then conduct 5-10-minute user satisfaction interviews, where participants will be asked to comment on a few open-ended statements. The interviews will be descriptively examined and will not be analyzed in-depth or used to create themes. Repeated RMR assessment (\~20-30 minutes/week, for six consecutive weeks post baseline study visit): Participants will be instructed to use Breezing one time/week on the same day of the week (± one day) and at the same time each morning for six consecutive weeks. Participants will be asked to use Breezing after a night of their typical sleep quality and quantity, immediately after waking while lying down and in a fasted state. Participants will send weekly Breezing measurements to study team via email. Breezing RMR results will be recorded in secure OneDrive, separate from personal identifying data and the email and pdf will be deleted. If the participants Breezing RMR values are outside of an error range of 15% lesser or greater than baseline values for two consecutive weeks a study team member will email the participant to check if the RMR measurement protocol is being adhered to and possibly schedule a Zoom call with study team member using UBC secure Zoom link to review the Breezing device measurement protocol. Each week participants will be emailed a link to a Qualtrics survey as a weekly check-in for measurement adherence. On weeks 1, 3 and 6 participants will be asked to complete the Systems Usability Scale 47 to assess the usability of the Breezing device and Breezing mobile application. Physical activity behaviour: Physical activity will be quantified using activPAL activity monitors (PALTechnologies: Glasgow, Scotland) worn on the mid-thigh for seven days after the baseline study visit and for seven days before the follow-up study visit. This device is a type of accelerometer that records information about time spent sitting, lying, standing, and stepping. Data on total step count, time spent in activities of different intensities, sedentary time, and sleep time will be delineated using the activPAL software, PALanalysis. Participants will be asked to track time in bed and napping, exercise and activPAL removal (if applicable) to help interpret the data. Feasibility and acceptability outcomes will be assessed using descriptive statistics.