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

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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Cost-effectiveness of a behavioral weight loss intervention for low-income women: The Weight-Wise Program

Preventive Medicine ◽

10.1016/j.ypmed.2009.09.007 ◽

2009 ◽

Vol 49 (5) ◽

pp. 390-395 ◽

Cited By ~ 16

Author(s):

Alison Gustafson ◽

Olga Khavjou ◽

Sally C. Stearns ◽

Thomas C. Keyserling ◽

Ziya Gizlice ◽

...

Keyword(s):

Weight Loss ◽

Cost Effectiveness ◽

Low Income ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention ◽

Low Income Women

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Randomized Trial of a Behavioral Weight Loss Intervention for Low-income Women: The Weight Wise Program

Obesity ◽

10.1038/oby.2009.128 ◽

2009 ◽

Vol 17 (10) ◽

pp. 1891-1899 ◽

Cited By ~ 31

Author(s):

Carmen D. Samuel-Hodge ◽

Larry F. Johnston ◽

Ziya Gizlice ◽

Beverly A. Garcia ◽

Sara C. Lindsley ◽

...

Keyword(s):

Weight Loss ◽

Randomized Trial ◽

Low Income ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Behavioral Weight Loss Intervention ◽

Low Income Women

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Defining Valid Activity Monitor Data: A Multimethod Analysis of Weight-Loss Intervention Participants’ Barriers to Wear and First 100 Days of Physical Activity

Informatics ◽

10.3390/informatics8020039 ◽

2021 ◽

Vol 8 (2) ◽

pp. 39

Author(s):

Stephanie L. Orstad ◽

Lauren Gerchow ◽

Nikhil R. Patel ◽

Meghana Reddy ◽

Christina Hernandez ◽

...

Keyword(s):

Physical Activity ◽

Weight Loss ◽

Low Income ◽

Activity Monitor ◽

Accelerometer Data ◽

Weight Loss Intervention ◽

Behavioral Weight Loss ◽

Self Monitoring ◽

Behavioral Weight Loss Intervention ◽

Monitor Data

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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