Perceived barriers and facilitators of initiation of behavioral weight loss interventions among adults with obesity: a qualitative study

Abstract Objectives Obesity in adolescence has reached epidemic proportions around the world, with the prevalence of severe obesity increasing at least four-fold over the last 35 years. Provision of evidence-based treatment options that are tailored and relevant to the needs of adolescents is paramount, yet difficult to tailor because little is known regarding barriers and facilitators to adolescent weight loss. Thus, identification of barriers and facilitators to weight loss among adolescents with overweight/obesity (OW/OB) is needed. The objective of this qualitative study was to assess perceived barriers and facilitators to a healthy lifestyle and weight loss among adolescents with OW/OB. Methods Using 2018–2019 data from eleven focus groups among adolescents aged 14–19 with OW/OB (n = 41; n = 11 boys and n = 30 girls), a moderated, semi-structured focus group guide was used to identify perceived barriers and facilitators to a healthy lifestyle and weight loss. Results Adolescents reported time, access to healthful foods, food cravings, stress, and weight stigma/shaming as barriers to weight loss. Themes around internal and external psychosocial states (support, motivation) and behaviors including modeling, sports, and other physical activities were identified as both barriers and facilitators. Parents were recognized by teens as both helping and hindering weight loss, but overall teens felt their parents were more so facilitators than barriers, particularly as it related to modeling behaviors. Differences were noted by sex, among which girls reported experiencing weight struggles, whereas boys generally stated they did not struggle with weight, despite all participants meeting criterion for OW/OB. Conclusions Adolescent boys and girls with OW/OB perceive their weight status differently and identify a variety of barriers and facilitators to a healthy lifestyle and weight loss. Tailoring adolescent weight management interventions to address these perceived barriers and facilitators, along with noted sex differences, has the potential to improve the quality and effectiveness of adolescent obesity interventions. Funding Sources National Heart, Lung, and Blood Institute, National Institute of Health, WellCare Health Plans.

Download Full-text

A Qualitative Study: Perceived Barriers and Facilitators to Nutrition Standard Adherence by In-home Childcare Providers

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2021.08.104 ◽

2021 ◽

Author(s):

Dawn Earnesty ◽

Getrude Mphwanthe ◽

Kaitlyn Rau ◽

Lorraine Weatherspoon

Keyword(s):

Qualitative Study ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Childcare Providers

Download Full-text

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

Download Full-text

Views and Experiences of Adults who are Overweight and Obese on the Barriers and Facilitators to Weight Loss in Southeast Brazil: A Qualitative Study

International Journal of Qualitative Studies on Health and Well-Being ◽

10.1080/17482631.2020.1852705 ◽

2020 ◽

Vol 15 (1) ◽

pp. 1852705

Author(s):

Caroline Morgan ◽

Gilles de Wildt ◽

Renata Billion Ruiz Prado ◽

Nisha Thanikachalam ◽

Marcos Virmond ◽

...

Keyword(s):

Weight Loss ◽

Qualitative Study ◽

Barriers And Facilitators ◽

Southeast Brazil

Download Full-text

Perceived barriers and facilitators to participation in physical activity for children with disability: a qualitative study

BMC Pediatrics ◽

10.1186/s12887-016-0544-7 ◽

2016 ◽

Vol 16 (1) ◽

Cited By ~ 52

Author(s):

Nora Shields ◽

Anneliese Synnot

Keyword(s):

Physical Activity ◽

Qualitative Study ◽

Perceived Barriers ◽

Barriers And Facilitators ◽

Children With Disability

Download Full-text

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.

Download Full-text