Motivation and Its Relationship to Adherence to Self-monitoring and Weight Loss in a 16-week Internet Behavioral Weight Loss Intervention

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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A cost analysis of implementing a behavioral weight loss intervention in community mental health settings: Results from the ACHIEVE trial

Obesity ◽

10.1002/oby.21836 ◽

2017 ◽

Vol 25 (6) ◽

pp. 1006-1013 ◽

Cited By ~ 2

Author(s):

Ellen M. Janssen ◽

Gerald J. Jerome ◽

Arlene T. Dalcin ◽

Joseph V. Gennusa ◽

Stacy Goldsholl ◽

...

Keyword(s):

Mental Health ◽

Weight Loss ◽

Community Mental Health ◽

Cost Analysis ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Mental Health Settings ◽

Behavioral Weight Loss Intervention ◽

Community Mental Health Settings

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Long-Term Evaluation of Counselor Efficiency at Providing Feedback in a Technology-Based Behavioral Weight Loss Intervention (Preprint)

10.2196/preprints.23974 ◽

2020 ◽

Cited By ~ 1

Author(s):

Margaret Fahey ◽

Robert C. Klesges ◽

Mehmet Kocak ◽

Leslie Gladney ◽

Gerald W. Talcott ◽

...

Keyword(s):

Weight Loss ◽

Electronic Mail ◽

Detailed Examination ◽

Monitoring Data ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Self Monitoring ◽

Future Technology ◽

Study Implementation ◽

Weight Loss Interventions

BACKGROUND Feedback for participants’ self-monitoring is a crucial, and costly, component of technology-based weight loss interventions. Detailed examination of interventionist time when reviewing and providing feedback for online self-monitoring data is unknown. OBJECTIVE Study purpose was to longitudinally examine time counselors spent providing feedback on participant self-monitoring data (i.e., diet, physical activity, weight) in a 12-month technology-based weight loss intervention. We hypothesized that counselors would deliver feedback to participants more quickly over time. METHODS Time counselors (N=10) spent reviewing and providing feedback to participants via electronic mail (e-email) was longitudinally examined for all counselors across the three years of study implementation. Descriptives were observed for counselor feedback duration across counselors by 12 annual quarters (i.e., three-month periods). Differences in overall duration times by each consecutive annual quarter were analyzed using Wilcoxon-Mann-Whitney tests. RESULTS There was a decrease in counselor feedback duration from first to second quarter [Mean (M) = 53 to 46 minutes], and from second to third (M= 46 to 30). A trend suggested a decrease from third to fourth quarters (M = 30 to 26), but no changes were found in subsequent quarters. Consistent with hypothesis, counselors increased their efficiency in providing feedback. Across 12-months, mean time counselors needed to review participant self-monitoring and provide feedback decreased from 53 to 26 minutes. CONCLUSIONS Counselors needed increasingly less time to review online self-monitoring data and provide feedback after the initial nine months of study implementation. Results inform counselor costs for future technology-based behavioral weight loss interventions. For example, regardless of increasing counselor efficiency, 25-30 minutes per feedback message is a high cost for interventions. One possibility for reducing costs would be generating computer-automated feedback. CLINICALTRIAL NCT02063178

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Behavioral Weight Loss Intervention for Migraine: A Randomized Controlled Trial

Obesity ◽

10.1002/oby.22069 ◽

2017 ◽

Vol 26 (1) ◽

pp. 81-87 ◽

Cited By ~ 16

Author(s):

Dale S. Bond ◽

J. Graham Thomas ◽

Richard B. Lipton ◽

Julie Roth ◽

Jelena M. Pavlovic ◽

...

Keyword(s):

Weight Loss ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Randomized Controlled ◽

Behavioral Weight Loss Intervention

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Discrepancies Between Clinician and Participant Intervention Adherence Ratings Predict Percent Weight Change During a Six-Month Behavioral Weight Loss Intervention

Translational Behavioral Medicine ◽

10.1093/tbm/ibab011 ◽

2021 ◽

Vol 11 (4) ◽

pp. 1006-1014

Author(s):

Michael P Berry ◽

Elisabeth M Seburg ◽

Meghan L Butryn ◽

Robert W Jeffery ◽

Melissa M Crane ◽

...

Keyword(s):

Weight Loss ◽

Weight Change ◽

Weight Control ◽

Calorie Intake ◽

Behavioral Weight Loss ◽

Weight Loss Treatment ◽

Self Monitoring ◽

Weight Control Behaviors ◽

Behavioral Weight Loss Intervention ◽

Behavioral Weight Loss Treatment

Abstract Background Individuals receiving behavioral weight loss treatment frequently fail to adhere to prescribed dietary and self-monitoring instructions, resulting in weight loss clinicians often needing to assess and intervene in these important weight control behaviors. A significant obstacle to improving adherence is that clinicians and clients sometimes disagree on the degree to which clients are actually adherent. However, prior research has not examined how clinicians and clients differ in their perceptions of client adherence to weight control behaviors, nor the implications for treatment outcomes. Purpose In the context of a 6-month weight-loss treatment, we examined differences between participants and clinicians when rating adherence to weight control behaviors (dietary self-monitoring; limiting calorie intake) and evaluated the hypothesis that rating one’s own adherence more highly than one’s clinician would predict less weight loss during treatment. Methods Using clinician and participant-reported measures of self-monitoring and calorie intake adherence, each assessed using a single item with a 7- or 8-point scale, we characterized discrepancies between participant and clinician adherence and examined associations with percent weight change over 6 months using linear mixed-effects models. Results Results indicated that ratings of adherence were higher when reported by participants and supported the hypothesis that participants who provided higher adherence ratings relative to their clinicians lost less weight during treatment (p < 0.001). Conclusions These findings suggest that participants in weight loss treatment frequently appraise their own adherence more highly than their clinicians and that participants who do so to a greater degree tend to lose less weight.

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Abstract MP27: Cellphone Intervention for You (CITY): A Randomized, Controlled Trial of Behavioral Weight Loss Intervention by Cellphone or Personal Coaching for Young Adults

Circulation ◽

10.1161/circ.131.suppl_1.mp27 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Laura P Svetkey ◽

Stephen S Intille ◽

Bryan C Batch ◽

Leonor Corsino ◽

Crystal C Tyson ◽

...

Keyword(s):

Weight Loss ◽

Young Adults ◽

Controlled Trial ◽

Personal Contact ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

National Guidelines ◽

Personal Coaching ◽

Behavioral Weight Loss Intervention

Background: Obesity affects young adults, leading to future morbidity and mortality. Early behavioral intervention may promote long-term weight control. Mobile technology-based (mHealth) interventions may be particularly effective in young adults. We compared both an mHealth behavioral weight loss intervention and a personal coaching weight loss intervention to no intervention (and to each other) in overweight/obese young adults. Methods: We randomized 365 generally healthy adults age 18-35 years with BMI > 25 kg/m2 (overweight or obese) to 24-months of intervention delivered primarily via investigator-designed cell phone (CP) or intervention delivered primarily via in-person (6 weekly) and by phone (23 monthly) coaching (PC), compared to usual care control group (Control). Primary outcome was weight change from baseline to 24 months. This study was conducted as part of the Early Adult Reduction of weight through LifestYle (EARLY) cooperative trials. Results: Randomized participants (N=365) had mean BMI 35 kg/m2, mean age 29yrs, were 70% women, 36% African American, 6% Latino. Final weight was obtained in 86%; missing weight was multiply imputed. At 24 months, weight loss was not different in either PC or CP vs Control (see Figure). Weight loss in PC was significantly greater than Control at 6 months. From baseline to 24 months, clinically significant weight loss (> 3% per national guidelines) occurred in 40% of PC, 34% of CP, and 30% of Control. Conclusions: mHealth alone may not be sufficient for weight loss in young adults but mHealth-enhanced contact with an interventionist has a modest short-term effect. Future interventions should maximize the complementarity of mHealth and personal contact to achieve larger and more sustained effect.

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Results of the Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) Trial: A Behavioral Weight Loss Intervention in Overweight or Obese Breast Cancer Survivors

Journal of Clinical Oncology ◽

10.1200/jco.2015.61.1095 ◽

2015 ◽

Vol 33 (28) ◽

pp. 3169-3176 ◽

Cited By ~ 98

Author(s):

Cheryl L. Rock ◽

Shirley W. Flatt ◽

Tim E. Byers ◽

Graham A. Colditz ◽

Wendy Demark-Wahnefried ◽

...

Keyword(s):

Breast Cancer ◽

Blood Pressure ◽

Weight Loss ◽

Breast Cancer Mortality ◽

Intervention Group ◽

Good Health ◽

Control Group ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention

Purpose Obesity increases risk for all-cause and breast cancer mortality and comorbidities in women who have been diagnosed and treated for breast cancer. The Exercise and Nutrition to Enhance Recovery and Good Health for You (ENERGY) study is the largest weight loss intervention trial among survivors of breast cancer to date. Methods In this multicenter trial, 692 overweight/obese women who were, on average, 2 years since primary treatment for early-stage breast cancer were randomly assigned to either a group-based behavioral intervention, supplemented with telephone counseling and tailored newsletters, to support weight loss or a less intensive control intervention and observed for 2 years. Weight and blood pressure were measured at 6, 12, 18, and 24 months. Longitudinal mixed models were used to analyze change over time. Results At 12 months, mean weight loss was 6.0% of initial weight in the intervention group and 1.5% in the control group (P < .001). At 24 months, mean weight loss in the intervention and control groups was 3.7% and 1.3%, respectively (P < .001). Favorable effects of the intervention on physical activity and blood pressure were observed. The weight loss intervention was more effective among women older than 55 years than among younger women. Conclusion A behavioral weight loss intervention can lead to clinically meaningful weight loss in overweight/obese survivors of breast cancer. These findings support the need to conduct additional studies to test methods that support sustained weight loss and to examine the potential benefit of intentional weight loss on breast cancer recurrence and survival.

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