Effect of an Internet-Based Program on Weight Loss for Low-Income Postpartum Women

BACKGROUND Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income postpartum women have resulted in poor intervention attendance and high attrition. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions. OBJECTIVE The objective of this study was to adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. METHODS This study comprised 3 single-group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program for Facebook delivery by translating the protocol to a content library of Facebook posts with additional posts from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, Massachusetts. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first 8 weeks, Facebook intervention posts were delivered 2 times per day, with additional posts from coaches aiming to stimulate interaction among participants or respond to participants’ questions and challenges. For the following 8 weeks, posts were delivered once per day without additional coaching. Feasibility outcomes were engagement (defined by number of likes, comments, and posts measured throughout intervention delivery), acceptability, and retention (survey at follow-up and assessment completion rate, respectively). Changes in weight were also assessed at baseline and follow-up. RESULTS Pilot 1 had a retention rate of 89% (24/27), and on average, 62% (17/27) of women actively engaged with the group each week during the 8-week coached phase. Mean weight loss was 2.6 (SD 8.64) pounds, and 79% (19/27) would recommend the program to a friend. Pilot 2 had a retention rate of 83% (20/24), and on average, 55% (13/24) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 2.5 (SD 9.23) pounds, and 80% (16/24) would recommend the program to a friend. Pilot 3 had a retention rate of 88% (14/16), and on average, 67% (11/16) of women actively engaged with the group weekly during the 8-week coached phase. Mean weight loss was 7.0 (SD 11.6) pounds, and 100% (16/16) would recommend the program to a friend. CONCLUSIONS Our findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to low-income postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.

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Weight-Loss Resilience Among Low-Income Postpartum Women: Association With Health Habits

Western Journal of Nursing Research ◽

10.1177/0193945918824598 ◽

2019 ◽

Vol 41 (12) ◽

pp. 1709-1723 ◽

Cited By ~ 1

Author(s):

Lorraine O. Walker ◽

Sookja Kang ◽

Bobbie S. Sterling

Keyword(s):

Physical Activity ◽

Social Support ◽

Weight Loss ◽

Perceived Stress ◽

Low Income ◽

Group Intervention ◽

Dietary Habits ◽

Control Group ◽

Postpartum Women ◽

Health Habits

Using a weight resilience framework, health habits of diet and physical activity, social support, and perceived stress were compared in women who lost weight (resilient) and those who did not lose or gained weight (nonresilient) during a weight-loss intervention. Participants were low-income postpartum women participating in a 13-week randomized treatment-control group intervention, with 20 of 50 classified as resilient in losing weight. Measures included the Postpartum Support Scale, the Perceived Stress Scale, and health habit items from the Self Care Inventory. Weight-loss resilient women showed significantly more frequent healthful dietary habits, such as eating a nutritious breakfast, and less frequent unhealthy habits, such as substituting junk food for meals, and less perceived stress than their nonresilient counterparts at both the midpoint and end of the study. Weight-loss resilient women also showed significantly more frequent physical activity habits at the end of the study. No social support differences were found.

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