Translation of a behavioral weight loss intervention for mid-life, low-income women in local health departments

Abstract Background: Fundamental to successfully translating evidence-based interventions to real life settings with diverse populations is achieving fidelity to the intervention within the given public health setting. Health departments may be key in addressing the obesity epidemic given their unique position to deliver obesity prevention services in community settings. We developed the Weight-Wise II Program from four evidenced-based interventions for implementation in local health departments. For this study, we conducted a process evaluation of the implementation of the Weight-Wise II Program, an intensive evidence-based behavioral weight loss program for low-income, mid-life women. Methods: The Weight-Wise II Program, a 16-week group-based weight loss program, was implemented in six local health departments. The RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) served as a guide to conduct a comprehensive process evaluation. Process data were collected and analyzed using quantitative and qualitative methods. Results: The Weight-Wise II Program reached low-income and mid-life women, a high-risk population, and was effective in achieving modest weight loss. Attendance and self-monitoring were positively associated with weight loss. Interventionists delivered the program as intended and it was well received by participants. Planned adaptations enhanced program implementation by being responsive to participant and health department needs. Despite implementation by health department staff, the program was not routinely maintained three years post-intervention. Conclusion: Evidence-based weight loss interventions can be successfully implemented in local health departments. RE-AIM is a useful framework for systematically evaluating the process of implementation and impact of a behavioral weight loss intervention offered in public health settings. The addition of complementary implementation frameworks may help in identification of contextual factors influencing subsequent maintenance of evidence-based interventions in public health settings. Trial registration: ClinicalTrials.gov Identifier: NCT01141348. Registered 9 June 2010 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01141348 Contributions to the literature The Weight-Wise II Program is an evidence-based weight loss intervention translated for implementation in local health departments serving a diverse low-income population. This study provides an approach and tools for comprehensively monitoring and evaluating evidenced-based programs implemented in public health settings. The study findings address gaps in the literature by providing guidance on program adaptations while maintaining fidelity including organizational contexts, participant engagement, and sustainability.

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Randomized Trial of a Behavioral Weight Loss Intervention for Low-income Women: The Weight Wise Program

Obesity ◽

10.1038/oby.2009.128 ◽

2009 ◽

Vol 17 (10) ◽

pp. 1891-1899 ◽

Cited By ~ 31

Author(s):

Carmen D. Samuel-Hodge ◽

Larry F. Johnston ◽

Ziya Gizlice ◽

Beverly A. Garcia ◽

Sara C. Lindsley ◽

...

Keyword(s):

Weight Loss ◽

Randomized Trial ◽

Low Income ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention ◽

Low Income Women

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Process evaluation of an evidence-based weight loss program for low-income, mid-life women implemented in local health departments: Application of the RE-AIM framework

10.21203/rs.3.rs-31070/v2 ◽

2020 ◽

Author(s):

Arnita F. Norwood ◽

Laura Linnan ◽

Alice S. Ammerman ◽

Jianwen Cai ◽

Dianne S. Ward ◽

...

Keyword(s):

Public Health ◽

Weight Loss ◽

Process Evaluation ◽

Low Income ◽

Weight Loss Program ◽

Evidence Based ◽

Local Health ◽

Health Departments ◽

Local Health Departments ◽

Behavioral Weight Loss

Abstract Background: Fundamental to successfully translating evidence-based interventions to real life settings with diverse populations is achieving fidelity to the intervention within the given public health setting. Health departments may be key in addressing the obesity epidemic given their unique position to deliver obesity prevention services in community settings. We developed the Weight-Wise II Program from four evidenced-based interventions for implementation in local health departments. For this study, we conducted a process evaluation of the implementation of the Weight-Wise II Program, an intensive evidence-based behavioral weight loss program for low-income, mid-life women. Methods: The Weight-Wise II Program, a 16-week group-based weight loss program, was implemented in six local health departments. The RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) served as a guide to conduct a comprehensive process evaluation. Process data were collected and analyzed using quantitative and qualitative methods. Results: The Weight-Wise II Program reached low-income and mid-life women, a high-risk population, and was effective in achieving modest weight loss. Attendance and self-monitoring were positively associated with weight loss. Interventionists delivered the program as intended and it was well received by participants. Planned adaptations enhanced program implementation by being responsive to participant and health department needs. Despite implementation by health department staff, the program was not routinely maintained three years post-intervention. Conclusion: Evidence-based weight loss interventions can be successfully implemented in local health departments. RE-AIM is a useful framework for systematically evaluating the process of implementation and impact of a behavioral weight loss intervention offered in public health settings. The addition of complementary implementation frameworks may help in identification of contextual factors influencing subsequent maintenance of evidence-based interventions in public health settings. Trial registration: ClinicalTrials.gov Identifier: NCT01141348. Registered 9 June 2010 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01141348

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Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women

JMIR Formative Research ◽

10.2196/formative.9597 ◽

2018 ◽

Vol 2 (2) ◽

pp. e18 ◽

Cited By ~ 7

Author(s):

Valerie J Silfee ◽

Andrea Lopez-Cepero ◽

Stephenie C Lemon ◽

Barbara Estabrook ◽

Oanh Nguyen ◽

...

Keyword(s):

Weight Loss ◽

Low Income ◽

Postpartum Women ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Defining Valid Activity Monitor Data: A Multimethod Analysis of Weight-Loss Intervention Participants’ Barriers to Wear and First 100 Days of Physical Activity

Informatics ◽

10.3390/informatics8020039 ◽

2021 ◽

Vol 8 (2) ◽

pp. 39

Author(s):

Stephanie L. Orstad ◽

Lauren Gerchow ◽

Nikhil R. Patel ◽

Meghana Reddy ◽

Christina Hernandez ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Low Income ◽

Activity Monitor ◽

Accelerometer Data ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Self Monitoring ◽

Behavioral Weight Loss Intervention ◽

Monitor Data

Despite the popularity of commercially available wearable activity monitors (WAMs), there is a paucity of consistent methodology for analyzing large amounts of accelerometer data from these devices. This multimethod study aimed to inform appropriate Fitbit wear thresholds for physical activity (PA) outcomes assessment in a sample of 616 low-income, majority Latina patients with obesity enrolled in a behavioral weight-loss intervention. Secondly, this study aimed to understand intervention participants’ barriers to Fitbit use. We applied a heart rate (HR) criterion (≥10 h/day) and a step count (SC) criterion (≥1000 steps/day) to 100 days of continuous activity monitor data. We examined the prevalence of valid wear and PA outcomes between analytic subgroups of participants who met the HR criterion, SC criterion, or both. We undertook qualitative analysis of research staff notes and participant interviews to explore barriers to valid Fitbit data collection. Overall, one in three participants did not meet the SC criterion for valid wear in Weeks 1 and 13; however, we found the SC criterion to be more inclusive of participants who did not use a smartphone than the HR criterion. Older age, higher body mass index (BMI), barriers to smartphone use, device storage issues, and negative emotional responses to WAM-based self-monitoring may predict higher proportions of invalid WAM data in weight-loss intervention research.

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Psychological and behavioral pathways between perceived stress and weight change in a behavioral weight loss intervention

Journal of Behavioral Medicine ◽

10.1007/s10865-021-00231-z ◽

2021 ◽

Author(s):

Kristine Molina ◽

Monica L. Baskin ◽

Dustin Long ◽

Tiffany L. Carson

Keyword(s):

Weight Loss ◽

Perceived Stress ◽

Weight Change ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

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Abstract P249: A Behavioral Weight Loss Intervention is Effective for Change in CVD Risk Factors in Young Adults: The IDEA Study

Circulation ◽

10.1161/circ.131.suppl_1.p249 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

John M Jakicic ◽

Kelliann K Davis ◽

Bethany Barone Gibbs ◽

Diane Helsel ◽

Wendy C King ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Weight Loss ◽

Young Adults ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Introduction: Few studies have examined behavioral weight loss interventions with respect to change in cardiovascular disease risk factors in young adults (aged 18 to 35 years). Hypothesis: We tested the hypothesis that a 6 month behavioral weight loss intervention resulted in significant improvements in selective cardiovascular disease risk factors in young adults. Methods: Data are presented as median [25 th , 75 th percentiles]. 470 participants (age: 30.9 [27.8, 33.7] years); BMI: 31.2 [28.4, 34.3] kg/m 2 ) were enrolled in a 6 month behavioral weight loss intervention that included weekly group sessions and prescribed an energy restricted diet and moderate-to-vigorous physical activity. Assessments included weight using a standardized protocol, resting blood pressure, and fasting lipids, glucose, and insulin. Statistical significance of change was according to tests of symmetry or the Wilcoxon matched pairs signed ranks test. Results: The primary outcome (weight) was available for 424 of the 470 participants (90.2%). Weight significantly decreased (-7.8 kg [-12.2, -3.7]) (p<0.0001). Systolic (-4.0 mmHg [-8.5, 0.5] and diastolic blood pressure (-3.0 mmHg [-6.5, 1.0]) decreased (p<0.0001). Total cholesterol (-13 mg/dl [-28.0, 2.0]), LDL cholesterol (-9.5 mg/dl [-21.7, 2.0]), triglycerides (-8.5 mg/dl [-44.0, 9.0]), glucose (-4.0 mg/dl [-8.0, 1.0]), and insulin (-2.6 mIU/L [-5.9, 0.7]) decreased (p<0.0001, n=416). There was not a significant change in HDL cholesterol (p=0.72). Conclusions: In conclusion, after 6 months, weight loss was observed in young adults assigned to this behavioral intervention that focused on physical activity and diet modification. They tended to also have improved cardiovascular disease risk factors. This may demonstrate an approach to reducing cardiovascular disease risk in young adults. Supported by NIH (U01HL096770) and AHA (12BGIA9410032)

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