scholarly journals Adapting evidence-based behavioral weight loss programs for emerging adults: A pilot randomized controlled trial

2017 ◽  
Vol 24 (7) ◽  
pp. 870-887 ◽  
Author(s):  
Jessica Gokee LaRose ◽  
Deborah F Tate ◽  
Autumn Lanoye ◽  
Joseph L Fava ◽  
Elissa Jelalian ◽  
...  
Keyword(s):  
Weight Loss ◽  
Emerging Adults ◽  
Controlled Trial ◽  
Behavioral Weight Loss ◽  
Self Monitoring ◽  
Web Based ◽  
Face To Face ◽  
Weight Losses ◽  
Weight Loss Programs ◽  
Intent To Treat

Emerging adults are at high risk of obesity but behavioral weight loss programs do not meet their needs. Emerging adults ( N = 52, age = 22.3 ± 2 years, body mass index = 34.2 ± 5.5 kg/m2, 46.2% non-Hispanic White) were randomly assigned to one of three behavioral weight loss programs adapted based on formative work: face-to-face behavioral weight loss, web-based behavioral weight loss, or web plus optional community sessions (Hybrid). Assessments occurred at 0 and 3 months. Engagement and self-monitoring were highest in Hybrid. Intent-to-treat weight losses were −2.8 ± 2.9 percent in face-to-face behavioral weight loss, −2.2 ± 4.5 percent in web-based behavioral weight loss, and 4.8 ± 4.9 percent in Hybrid. Percent achieving ⩾5 percent weight loss was highest in Hybrid (63%). Findings suggest potential for adapted behavioral weight loss to promote engagement and weight loss in emerging adults.

scholarly journals Implementation of an Internet Weight Loss Program in a Worksite Setting

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Kathryn M. Ross ◽  
Rena R. Wing
Keyword(s):  
Weight Loss ◽  
Wellness Programs ◽  
Weight Loss Program ◽  
Worksite Wellness ◽  
Behavioral Weight Loss ◽  
Self Monitoring ◽  
Management Intervention ◽  
Weight Losses ◽  
Clinically Significant ◽  
Intent To Treat

Background.Worksite wellness programs typically produce modest weight losses. We examined whether an efficacious Internet behavioral weight loss program could be successfully implemented in a worksite setting.Methods.Participants were 75 overweight or obese employees/dependents of a large healthcare system who were given access to a 12-week Internet-based, multicomponent behavioral weight loss program. Assessments occurred at baseline, Month 3 (end of intervention), and Month 6 (follow-up).Results.Retention was excellent (93% at Month 3 and 89% at Month 6). Intent-to-treat analyses demonstrated that participants lost an average (±SE) of-5.8±.60 kg from baseline to Month 3 and regained1.1±.31 kg from Month 3 to Month 6; overall, weight loss from baseline to Month 6 was-4.7±.71 kg,p<.001. Men lost more weight than women,p=.022, and individuals who had a college degree or higher lost more weight than those with less education,p=.005. Adherence to viewing lessons (8 of 12) and self-monitoring (83% of days) was excellent and significantly associated with weight loss,ps<.05.Conclusions.An Internet-based behavioral weight management intervention can be successfully implemented in a worksite setting and can lead to clinically significant weight losses. Given the low costs of offering this program, it could easily be widely disseminated.

BestFIT Sequential Multiple Assignment Randomized Trial Results: A SMART Approach to Developing Individualized Weight Loss Treatment Sequences

2021 ◽  
Author(s):  
Nancy E Sherwood ◽  
A Lauren Crain ◽  
Elisabeth M Seburg ◽  
Meghan L Butryn ◽  
Evan M Forman ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Trial ◽  
Controlled Trial ◽  
Response Assessment ◽  
Optimal Time ◽  
Behavioral Weight Loss ◽  
Weight Loss Treatment ◽  
Adaptive Intervention ◽  
Weight Losses ◽  
Multiple Assignment

Abstract Background State-of-the-art behavioral weight loss treatment (SBT) can lead to clinically meaningful weight loss, but only 30–60% achieve this goal. Developing adaptive interventions that change based on individual progress could increase the number of people who benefit. Purpose Conduct a Sequential Multiple Assignment Randomized Trial (SMART) to determine the optimal time to identify SBT suboptimal responders and whether it is better to switch to portion-controlled meals (PCM) or acceptance-based treatment (ABT). Method The BestFIT trial enrolled 468 adults with obesity who started SBT and were randomized to treatment response assessment at Session 3 (Early TRA) or 7 (Late TRA). Suboptimal responders were re-randomized to PCM or ABT. Responders continued SBT. Primary outcomes were weight change at 6 and 18 months. Results PCM participants lost more weight at 6 months (−18.4 lbs, 95% CI −20.5, −16.2) than ABT participants (−15.7 lbs, 95% CI: −18.0, −13.4), but this difference was not statistically significant (−2.7 lbs, 95% CI: −5.8, 0.5, p = .09). PCM and ABT participant 18 month weight loss did not differ. Early and Late TRA participants had similar weight losses (p = .96), however, Early TRA PCM participants lost more weight than Late TRA PCM participants (p = .03). Conclusions Results suggest adaptive intervention sequences that warrant further research (e.g., identify suboptimal responders at Session 3, use PCMs as second-stage treatment). Utilizing the SMART methodology to develop an adaptive weight loss intervention that would outperform gold standard SBT in a randomized controlled trial is an important next step, but may require additional optimization work. Clinical Trial information ClinicalTrials.gov identifier; NCT02368002

Participation of Female Emerging Adults in a Theory- and Evidence-Based Behavioral Weight Loss Program

2020 ◽  
Vol 41 (1) ◽  
pp. 45-53 ◽  
Author(s):  
Ping H. Johnson ◽  
James J. Annesi
Keyword(s):  
Weight Loss ◽  
Emerging Adults ◽  
Time Management ◽  
Online Survey ◽  
Weight Loss Program ◽  
Drop Out ◽  
Management Decision ◽  
Behavioral Weight Loss ◽  
Weight Loss Programs ◽  
Tangible Rewards

Emerging adults are less likely to participate in and more likely to drop out of behavioral weight loss programs. Thirty-five female emerging adults who dropped out of a behavioral weight loss program, Weight Loss For Life, completed an online survey. Main reasons for dropout relate to insufficient behavioral skills and unique characteristics of emerging adults, especially when in college (e.g., citing working and getting good grades to be more important than losing weight). Most desired >50% of program online, having virtual groups, and using small groups to model desirable behaviors. Around $140 and $180 seemed sufficient to them to encourage participation in all scheduled treatment sessions and reaching overall weight loss goal, respectively. Future behavioral weight loss programs for emerging adults may consider helping develop time management and task management, decision-making that focuses on longer term outcomes, and immediate tangible rewards similar to what college students typically receive after they complete each class assignment.

scholarly journals Slip Buddy App for Weight Management: Randomized Feasibility Trial of a Dietary Lapse Tracking App (Preprint)

2020 ◽  
Author(s):  
Sherry Pagoto ◽  
Bengisu Tulu ◽  
Molly E Waring ◽  
Jared Goetz ◽  
Jessica Bibeau ◽  
...  
Keyword(s):  
Weight Loss ◽  
Contextual Factors ◽  
Pilot Trial ◽  
Common Type ◽  
Feasibility Trial ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Self Monitoring ◽  
Web Based ◽  
Tracking Condition

BACKGROUND Although calorie tracking is one of the strongest predictors of weight loss in behavioral weight loss interventions, low rates of adherence are common. OBJECTIVE This study aims to examine the feasibility and acceptability of using the Slip Buddy app during a 12-week web-based weight loss program. METHODS We conducted a randomized pilot trial to evaluate the feasibility and acceptability of using the Slip Buddy app compared with a popular commercial calorie tracking app during a counselor-led, web-based behavioral weight loss intervention. Adults who were overweight or obese were recruited on the web and randomized into a 12-week web-based weight loss intervention that included either the Slip Buddy app or a commercial calorie tracking app. Feasibility outcomes included retention, app use, usability, slips reported, and contextual factors reported at slips. Acceptability outcomes included ratings of how helpful, tedious, taxing, time consuming, and burdensome using the assigned app was. We described weight change from baseline to 12 weeks in both groups as an exploratory outcome. Participants using the Slip Buddy app provided feedback on how to improve it during the postintervention focus groups. RESULTS A total of 75% (48/64) of the participants were female and, on average, 39.8 (SD 11.0) years old with a mean BMI of 34.2 (SD 4.9) kg/m2. Retention was high in both conditions, with 97% (31/32) retained in the Slip Buddy condition and 94% (30/32) retained in the calorie tracking condition. On average, participants used the Slip Buddy app on 53.8% (SD 31.3%) of days, which was not significantly different from those using the calorie tracking app (mean 57.5%, SD 28.4% of days), and participants who recorded slips (30/32, 94%) logged on average 17.9 (SD 14.4) slips in 12 weeks. The most common slips occurred during snack times (220/538, 40.9%). Slips most often occurred at home (297/538, 55.2%), while working (153/538, 28.4%), while socializing (130/538, 24.2%), or during screen time (123/538, 22.9%). The conditions did not differ in participants’ ratings of how their assigned app was tedious, taxing, or time consuming (all values of P>.05), but the calorie tracking condition gave their app higher helpfulness and usability ratings (all values of P<.05). Technical issues were the most common type of negative feedback, whereas simplicity was the most common type of positive feedback. Weight losses of ≥5% of baseline weight were achieved by 31% (10/32) of Slip Buddy participants and 34% (11/32) of calorie tracking participants. CONCLUSIONS Self-monitoring of dietary lapses and the contextual factors associated with them may be an alternative for people who do not prefer calorie tracking. Future research should examine patient characteristics associated with adherence to different forms of dietary self-monitoring. CLINICALTRIAL Clinicaltrials.gov NCT02615171; https://clinicaltrials.gov/ct2/show/NCT02615171.

scholarly journals Slip Buddy App for Weight Management: Randomized Feasibility Trial of a Dietary Lapse Tracking App

10.2196/24249 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e24249
Author(s):  
Sherry Pagoto ◽  
Bengisu Tulu ◽  
Molly E Waring ◽  
Jared Goetz ◽  
Jessica Bibeau ◽  
...  
Keyword(s):  
Weight Loss ◽  
Contextual Factors ◽  
Pilot Trial ◽  
Common Type ◽  
Feasibility Trial ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Self Monitoring ◽  
Web Based ◽  
Tracking Condition

Background Although calorie tracking is one of the strongest predictors of weight loss in behavioral weight loss interventions, low rates of adherence are common. Objective This study aims to examine the feasibility and acceptability of using the Slip Buddy app during a 12-week web-based weight loss program. Methods We conducted a randomized pilot trial to evaluate the feasibility and acceptability of using the Slip Buddy app compared with a popular commercial calorie tracking app during a counselor-led, web-based behavioral weight loss intervention. Adults who were overweight or obese were recruited on the web and randomized into a 12-week web-based weight loss intervention that included either the Slip Buddy app or a commercial calorie tracking app. Feasibility outcomes included retention, app use, usability, slips reported, and contextual factors reported at slips. Acceptability outcomes included ratings of how helpful, tedious, taxing, time consuming, and burdensome using the assigned app was. We described weight change from baseline to 12 weeks in both groups as an exploratory outcome. Participants using the Slip Buddy app provided feedback on how to improve it during the postintervention focus groups. Results A total of 75% (48/64) of the participants were female and, on average, 39.8 (SD 11.0) years old with a mean BMI of 34.2 (SD 4.9) kg/m2. Retention was high in both conditions, with 97% (31/32) retained in the Slip Buddy condition and 94% (30/32) retained in the calorie tracking condition. On average, participants used the Slip Buddy app on 53.8% (SD 31.3%) of days, which was not significantly different from those using the calorie tracking app (mean 57.5%, SD 28.4% of days), and participants who recorded slips (30/32, 94%) logged on average 17.9 (SD 14.4) slips in 12 weeks. The most common slips occurred during snack times (220/538, 40.9%). Slips most often occurred at home (297/538, 55.2%), while working (153/538, 28.4%), while socializing (130/538, 24.2%), or during screen time (123/538, 22.9%). The conditions did not differ in participants’ ratings of how their assigned app was tedious, taxing, or time consuming (all values of P>.05), but the calorie tracking condition gave their app higher helpfulness and usability ratings (all values of P<.05). Technical issues were the most common type of negative feedback, whereas simplicity was the most common type of positive feedback. Weight losses of ≥5% of baseline weight were achieved by 31% (10/32) of Slip Buddy participants and 34% (11/32) of calorie tracking participants. Conclusions Self-monitoring of dietary lapses and the contextual factors associated with them may be an alternative for people who do not prefer calorie tracking. Future research should examine patient characteristics associated with adherence to different forms of dietary self-monitoring. Trial Registration ClinicalTrials.gov NCT02615171; https://clinicaltrials.gov/ct2/show/NCT02615171

scholarly journals Comparing Self-Monitoring Strategies for Weight Loss in a Smartphone App: Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Michele L Patel ◽  
Christina M Hopkins ◽  
Taylor L Brooks ◽  
Gary G Bennett
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Mobile App ◽  
Self Report ◽  
Smartphone App ◽  
Weight Loss Intervention ◽  
Behavioral Weight Loss ◽  
Self Monitoring ◽  
Randomized Controlled

BACKGROUND Self-monitoring of dietary intake is a valuable component of behavioral weight loss treatment; however, it declines quickly, thereby resulting in suboptimal treatment outcomes. OBJECTIVE This study aimed to examine a novel behavioral weight loss intervention that aims to attenuate the decline in dietary self-monitoring engagement. METHODS GoalTracker was an automated randomized controlled trial. Participants were adults with overweight or obesity (n=105; aged 21-65 years; body mass index, BMI, 25-45 kg/m2) and were randomized to a 12-week stand-alone weight loss intervention using the MyFitnessPal smartphone app for daily self-monitoring of either (1) both weight and diet, with weekly lessons, action plans, and feedback (Simultaneous); (2) weight through week 4, then added diet, with the same behavioral components (Sequential); or (3) only diet (App-Only). All groups received a goal to lose 5% of initial weight by 12 weeks, a tailored calorie goal, and automated in-app reminders. Participants were recruited via online and offline methods. Weight was collected in-person at baseline, 1 month, and 3 months using calibrated scales and via self-report at 6 months. We retrieved objective self-monitoring engagement data from MyFitnessPal using an application programming interface. Engagement was defined as the number of days per week in which tracking occurred, with diet entries counted if ≥800 kcal per day. Other assessment data were collected in-person via online self-report questionnaires. RESULTS At baseline, participants (84/100 female) had a mean age (SD) of 42.7 (11.7) years and a BMI of 31.9 (SD 4.5) kg/m2. One-third (33/100) were from racial or ethnic minority groups. During the trial, 5 participants became ineligible. Of the remaining 100 participants, 84% (84/100) and 76% (76/100) completed the 1-month and 3-month visits, respectively. In intent-to-treat analyses, there was no difference in weight change at 3 months between the Sequential arm (mean −2.7 kg, 95% CI −3.9 to −1.5) and either the App-Only arm (−2.4 kg, −3.7 to −1.2; P=.78) or the Simultaneous arm (−2.8 kg, −4.0 to −1.5; P=.72). The median number of days of self-monitoring diet per week was 1.9 (interquartile range [IQR] 0.3-5.5) in Sequential (once began), 5.3 (IQR 1.8-6.7) in Simultaneous, and 2.9 (IQR 1.2-5.2) in App-Only. Weight was tracked 4.8 (IQR 1.9-6.3) days per week in Sequential and 5.1 (IQR 1.8-6.3) days per week in Simultaneous. Engagement in neither diet nor weight tracking differed between arms. CONCLUSIONS Regardless of the order in which diet is tracked, using tailored goals and a commercial mobile app can produce clinically significant weight loss. Stand-alone digital health treatments may be a viable option for those looking for a lower intensity approach. CLINICALTRIAL ClinicalTrials.gov NCT03254953; https://clinicaltrials.gov/ct2/show/NCT03254953 (Archived by WebCite at http://www.webcitation.org/72PyQrFjn).

scholarly journals Engagement and Weight Loss in a Web and Mobile Program for Low-Income Postpartum Women: Fit Moms/Mamás Activas

2019 ◽  
Vol 46 (2_suppl) ◽  
pp. 114S-123S ◽  
Author(s):  
Julianne M. Power ◽  
Suzanne Phelan ◽  
Karen Hatley ◽  
Anna Brannen ◽  
Karen Muñoz-Christian ◽  
...  
Keyword(s):  
Weight Loss ◽  
Low Income ◽  
Controlled Trial ◽  
Discussion Forum ◽  
Self Monitoring ◽  
Face To Face ◽  
Predominantly Hispanic ◽  
Postpartum Weight ◽  
Weight Loss Outcomes ◽  
Cluster Randomized

Internet-based weight loss programs can be effective in promoting weight loss and are less-intensive than traditional face-to-face approaches, which may provide more flexibility for postpartum, low-income women to engage in such programs. Few studies have examined patterns of engagement in internet-based programs for this population. This article used data from the internet-based Fit Moms/ Mamás Activas intervention, a 12-month cluster randomized controlled trial that was effective in promoting postpartum weight loss among low-income, predominantly Hispanic women. The overall objectives of this study were to (1) characterize patterns of engagement with the Fit Moms/ Mamás Activas website among intervention participants and (2) explore associations between engagement and 12-month weight loss outcomes among study completers (87.4%). A number of engagement variables were calculated for each participant, including website logins; time spent on the website; number of posts to the “Discussion Forum;” number of days tracking weight, diet, and physical activity; number of page visits to various website components; and number of in-person visits attended. The average number of logins was 70.74 (approximately once weekly), and average total time spent on the website was 185.35 minutes (approximately 3 hours) over 1 year. Self-monitoring (“Web Diary”) and social support (“Discussion Forum”) were the most frequently visited components of the website, and more frequent engagement with these components, as well as greater attendance at in-person group sessions, predicted greater percent weight loss at 12 months. Interventions highlighting these features may be particularly effective for weight loss in this population.

Social Jetlag and Emerging Adults’ Performance in a Behavioral Weight Loss Trial

2020 ◽  
pp. 216769682098243
Author(s):  
Autumn Lanoye ◽  
Jessica Gokee LaRose
Keyword(s):  
Weight Loss ◽  
Emerging Adults ◽  
Life Transitions ◽  
Behavioral Weight Loss ◽  
Fat Percentage ◽  
Sleep Timing ◽  
Social Jetlag ◽  
Suboptimal Weight Loss ◽  
Weight Loss Outcomes ◽  
Program Engagement

Social jetlag (SJ)—the shift in sleep timing between workdays and free days—is linked to deleterious cardiometabolic outcomes. SJ is greatest among emerging adults, who are already at high risk for overweight/obesity and experience suboptimal weight loss outcomes. Goals of this ancillary study were to assess SJ among emerging adults enrolled in a 6-month behavioral weight loss trial and examine the association between SJ and treatment outcomes. Bedtime/waketime were self-reported at baseline, and program engagement was monitored throughout the intervention. Weight, waist circumference, and body fat percentage were measured at baseline and post-treatment. Participants (N = 282) reported 1.5 hours of SJ on average, with 30.5% reaching the threshold for clinical significance. There were no significant associations between SJ and program engagement nor between SJ and change in adiposity. Life transitions and chaotic schedules are common during emerging adulthood; thus, further research is needed to capture nuanced patterns of sleep disruption.

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