scholarly journals Translating evidence-based behavioral weight loss into a multi-level, community intervention within a community-based participatory research framework: the Wellness Engagement (WE) Project

2021 ◽  
Author(s):  
Jessica Gokee LaRose ◽  
Autumn Lanoye ◽  
Dwala Ferrell ◽  
Juan Lu ◽  
Maghboeba Mosavel
Keyword(s):  
Weight Loss ◽  
Community Intervention ◽  
Community Based Participatory Research ◽  
Black Communities ◽  
Evidence Based ◽  
Behavioral Weight Loss ◽  
Community Members ◽  
Predominantly Black ◽  
Pilot Work ◽  
Viable Approach

Abstract Black Americans and individuals from economically disadvantaged backgrounds are at disproportionate risk for obesity, yet are underrepresented in behavioral weight loss (BWL) trials and experience less benefit from traditional programs. The Wellness Engagement (WE) Project sought to translate evidence-based BWL within a CBPR framework to promote change across multiple domains of influence in an under-resourced, predominantly Black community. The purpose of this paper is to describe the efforts we undertook to translate data from our extensive formative phase into programming well suited to meet the needs of the Petersburg community. In addition, we present data from our pilot work on feasibility and acceptability. Formative data were collected using a variety of methods including a community-wide survey, asset mapping, house chats, focus groups, and key informant interviews. In collaboration with key stakeholders and community members, evidence-based approaches to weight loss were adapted to meet the needs of the community with respect to both content and delivery modality. Materials were adapted to focus on small, realistic changes appropriate for the specific context. Behavioral groups, experiential nutrition and exercise sessions, and walking groups leveraged existing assets and were open to all community members. Feasibility and acceptability ratings were promising. Furthermore, the WE Project appeared to contribute to a culture of wellness. CBPR might be a viable approach for engaging under-resourced Black communities in behavioral weight management; larger scale implementation and evaluation efforts are needed.

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

2017 ◽  
Author(s):  
Valerie J. Silfee ◽  
Andrea Lopez-Cepero ◽  
Stephenie C. Lemon ◽  
Barbara Estabrook ◽  
Oanh Nguyen ◽  
...  
Keyword(s):  
Weight Loss ◽  
Low Income ◽  
Retention Rate ◽  
Future Research ◽  
Postpartum Women ◽  
Evidence Based ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Weight Loss Interventions

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.

scholarly journals Adding Evidence-Based Behavioral Weight Loss Strategies to a Statewide Wellness Campaign: A Randomized Clinical Trial

2014 ◽  
Vol 104 (7) ◽  
pp. 1300-1306 ◽  
Author(s):  
Tricia M. Leahey ◽  
Graham Thomas ◽  
Joseph L. Fava ◽  
Leslee L. Subak ◽  
Michael Schembri ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Weight Loss ◽  
Randomized Clinical Trial ◽  
Evidence Based ◽  
Behavioral Weight Loss ◽  
Weight Loss Strategies

scholarly journals 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

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 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.

scholarly journals 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

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

scholarly journals A web-based intervention to increase weight loss treatment initiation: results of a cluster randomized feasibility and acceptability trial

2019 ◽  
Author(s):  
Megan A McVay ◽  
William S Yancy ◽  
Gary G Bennett ◽  
Erica Levine ◽  
Seung-Hye Jung ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Treatment Initiation ◽  
Primary Care Providers ◽  
Feasibility Trial ◽  
Care Providers ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Primary Care Patients ◽  
Cluster Randomized

Abstract Evidence-based behavioral weight loss treatment is under-utilized. To increase initiation of treatment, we developed a single-session, online, primary care-based intervention (“mobilization tool”). We evaluated the mobilization tool's acceptability for primary care patients with obesity, trial design feasibility, and signal of an effect of the tool on treatment initiation. In this cluster randomized feasibility trial, primary care providers (PCPs) were randomized to a mobilization tool or comparator tool arm. Patients with obesity and a scheduled appointment with a randomized PCP were assigned to complete the mobilization or comparator tool prior to their appointment. The online mobilization tool asks patients to answer questions about a variety of weight-related topics and then provides automated, tailored feedback that addresses psychosocial determinants of weight loss treatment initiation. The comparator tool provided a nontailored description of treatments. All participants were offered free enrollment in behavioral weight loss treatments. Six PCPs were randomized. Sixty patients (57% female; 66% white; aged 55 ± 13 years) participated in this study of 296 contacted for eligibility evaluation (20.2%). Six-month follow-up assessments were completed by 65% (22/34) of the mobilization and 73% (19/26) of comparator tool participants. Participants completing the acceptability survey reported that the mobilization tool was usable, enjoyable, informative, and useful. Weight loss treatment was initiated by 59% (n = 19) of mobilization and 33% (n = 8) of comparator tool participants. The mobilization tool shows promise for increasing treatment initiation among primary care patients, which may increase population weight loss. Trial Registration: Clinicaltrials.gov identifier: NCT02708121.

scholarly journals Evidence-Based Digital Tools for Weight Loss Maintenance: The NoHoW Project

Obesity Facts ◽  
2021 ◽  
pp. 1-14
Author(s):  
R. James Stubbs ◽  
Cristiana Duarte ◽  
António L. Palmeira ◽  
Falko F. Sniehotta ◽  
Graham Horgan ◽  
...  
Keyword(s):  
Weight Loss ◽  
Behaviour Change ◽  
Digital Health ◽  
Self Regulation ◽  
Self Management ◽  
Behaviour Change Techniques ◽  
Evidence Based ◽  
Behavioural Science ◽  
Digital Architecture

<b><i>Background:</i></b> Effective interventions and commercial programmes for weight loss (WL) are widely available, but most people regain weight. Few effective WL maintenance (WLM) solutions exist. The most promising evidence-based behaviour change techniques for WLM are self-monitoring, goal setting, action planning and control, building self-efficacy, and techniques that promote autonomous motivation (e.g., provide choice). Stress management and emotion regulation techniques show potential for prevention of relapse and weight regain. Digital technologies (including networked-wireless tracking technologies, online tools and smartphone apps, multimedia resources, and internet-based support) offer attractive tools for teaching and supporting long-term behaviour change techniques. However, many digital offerings for weight management tend not to include evidence-based content and the evidence base is still limited. <b><i>The Project:</i></b> First, the project examined why, when, and how many European citizens make WL and WLM attempts and how successful they are. Second, the project employed the most up-to-date behavioural science research to develop a digital toolkit for WLM based on 2 key conditions, i.e., self-management (self-regulation and motivation) of behaviour and self-management of emotional responses for WLM. Then, the NoHoW trial tested the efficacy of this digital toolkit in adults who achieved clinically significant (≥5%) WL in the previous 12 months (initial BMI ≥25). The primary outcome was change in weight (kg) at 12 months from baseline. Secondary outcomes included biological, psychological, and behavioural moderators and mediators of long-term energy balance (EB) behaviours, and user experience, acceptability, and cost-effectiveness. <b><i>Impact:</i></b> The project will directly feed results from studies on European consumer behaviour, design and evaluation of digital toolkits self-management of EB behaviours into development of new products and services for WLM and digital health. The project has developed a framework and digital architecture for interventions in the context of EB tracking and will generate results that will help inform the next generation of personalised interventions for effective self-management of weight and health.

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