Developing Health Promotion Interventions: A Multisource Method Applied to Weight Loss Among Low-Income Postpartum Women

Most low-income Americans fail to meet physical activity recommendations. Inactivity and poor diet contribute to obesity, a risk factor for multiple chronic diseases. Health promotion activities have the potential to improve health outcomes for low-income populations. Measuring the effectiveness of these activities, however, can be challenging in community settings. A “Biking for Health” study tested the impact of a bicycling intervention on overweight or obese low-income Latino and African American adults to reduce barriers to cycling and increase physical activity and fitness. A randomized controlled trial was conducted in Milwaukee, Wisconsin, in summer 2015. A 12-week bicycling intervention was implemented at two sites with low-income, overweight, or obese Latino and African American adults. We found that randomized controlled trial methodology was suboptimal for use in this small pilot study and that it negatively affected participation. More discussion is needed about the effectiveness of using traditional research methods in community settings to assess the effectiveness of health promotion interventions. Modifications or alternative methods may yield better results. The aim of this article is to discuss the effectiveness and feasibility of using traditional research methods to assess health promotion interventions in community-based settings.

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Health Promotion Interventions for Low-Income Californians Through Medi-Cal Managed Care Plans, 2012

Preventing Chronic Disease ◽

10.5888/pcd12.150269 ◽

2015 ◽

Vol 12 ◽

Cited By ~ 2

Author(s):

Desiree R. Backman ◽

Neal D. Kohatsu ◽

Brian M. Paciotti ◽

Jennifer V. Byrne ◽

Kenneth W. Kizer

Keyword(s):

Health Promotion ◽

Managed Care ◽

Low Income ◽

Care Plans ◽

Health Promotion Interventions

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

10.2196/preprints.9597 ◽

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.

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Overcoming Health Promotion Barriers in Rural Health: A Qualitative Analysis

Innovation in Aging ◽

10.1093/geroni/igab046.492 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 128-128

Author(s):

John Batsis

Keyword(s):

Older Adults ◽

Health Promotion ◽

Weight Loss ◽

Qualitative Analysis ◽

Rural Areas ◽

Team Member ◽

Adult Weight ◽

Health Promotion Interventions ◽

Weight Loss Interventions ◽

Weight Loss Study

Abstract Weight loss interventions are fraught with difficulties for older adults in rural areas due to transportation difficulties, reduced availability of staff, and lack of programs. Telemedicine can overcome these barriers. A qualitative analysis of data from 44 exit-interviews from a rural-based, older adult weight loss study, informed by thematic analysis, was conducted. Participant’s age was 73 years (73% female) and BMI was 36.5kg/m2. Distance to the site was 24 miles (31 min). Key themes included: a) telemedicine can help improve one’s health, is more practical than in-person visits, is less costly, and time efficient; b) the majority (60%) were initially apprehensive about using telemedicine, a fear that resolved quickly; c) setting up telemedicine was easy and acceptable, despite a quick learning curve; d) having a team member for troubleshooting was important. Using telemedicine in older adults with obesity residing in rural areas should be considered in health promotion interventions.

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

JAMA ◽

10.1001/jama.2017.7119 ◽

2017 ◽

Vol 317 (23) ◽

pp. 2381 ◽

Cited By ~ 42

Author(s):

Suzanne Phelan ◽

Todd Hagobian ◽

Anna Brannen ◽

Karen E. Hatley ◽

Andrew Schaffner ◽

...

Keyword(s):

Weight Loss ◽

Low Income ◽

Postpartum Women

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The Impact of Health Promotion Interventions on Telomere Length: A Systematic Review

American Journal of Health Promotion ◽

10.1177/0890117120906958 ◽

2020 ◽

Vol 34 (6) ◽

pp. 633-647

Author(s):

Shan Qiao ◽

Yanping Jiang ◽

Xiaoming Li

Keyword(s):

Health Promotion ◽

Weight Loss ◽

Telomere Length ◽

Intervention Studies ◽

Data Extraction ◽

Meta Analysis ◽

Health Promotion Intervention ◽

Exclusion Criteria ◽

Telomere Shortening ◽

Health Promotion Interventions

Objectives: The aim of this study was to evaluate the effectiveness of health promotion interventions in delaying telomere shortening (a biomarker for aging). Data Source: PubMed, PsychINFO, EMBASE, CINAHL, and Cochrane Library databases. Study Inclusion and Exclusion Criteria: Inclusion criteria: (1) empirical studies involving human subjects; (2) health promotion intervention studies including both randomized control trials (RCTs) and non-RCTs.; (3) measured telomere length as an intervention outcome; and (4) were written in English. Exclusion criteria: (1) observational studies without any health promotion intervention practices and (2) did not report intervention effects. Data Extraction: Data extraction was performed by two reviewers following the preferred reporting items for systematic reviews and meta-analysis guidelines. Data Synthesis: Substantial heterogeneity in intervention type and study design in the included studies precluded a meta-analysis. We conducted a narrative synthesis instead. Results: Thirty studies were included in the review, of which 16 were RCTs. One-third of the included studies reported significant intervention impacts in delaying telomere shortening, with relatively consistent significant results emerged from weight-loss interventions and interventions involving multiple lifestyle modification components (eg, diet and exercise). Most of supplement intervention studies observed null effects in telomere length. Conclusions: Weight-loss and comprehensive lifestyle intervention strategies show encouraging impacts in delaying telomere shortening. More rigorous studies targeting populations at different age stages through life span are needed.

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