Publications by authors named "Deborah F Tate"

112 Publications

Behavioral weight loss in emerging adults: Design and rationale for the Richmond Emerging Adults Choosing Health (REACH) randomized clinical trial.

Contemp Clin Trials 2021 May 24:106426. Epub 2021 May 24.

UNC Lineberger Comprehensive Cancer Center, UNC Weight Research Center, 1700 Martin Luther King Jr. Blvd, Suite 136, Chapel Hill, NC 27514, United States of America.

Background: In the U.S., over 40% of 18-25 year olds meet criteria for overweight or obesity. Yet, no large-scale trials have targeted this age group for behavioral weight loss (BWL). Formative data revealed that existing BWL programs do not meet their unique needs and identified motivation as a fundamental barrier for weight management. The goal of the Richmond Emerging Adults Choosing Health (REACH) trial was to test the efficacy of two mHealth lifestyle interventions specifically focused on enhancing motivation, relative to adapted standard.

Methods: Participants (N = 381, 18-25 years, body mass index 25-45 kg/m) will be randomized to 1) adapted BWL (aBWL), 2) aBWL + self-determination theory (aBWL+SDT), or 3) aBWL + behavioral economics (aBWL+BE). All arms will receive a 6-month intervention, delivered via one group session and one individual session, followed by an mHealth platform. Assessments will occur at baseline, 3-months, 6-months (post-treatment) and 12-months (following a no-contact period). The primary aim is to compare weight loss outcomes at 6 months. Secondary aims include changes at 6-months in physical and behavioral cardiometabolic risk factors, as well as psychosocial measures. We will also explore weight loss maintenance, change in putative mediators, and moderators of treatment response.

Discussion: REACH is the first large-scale BWL trial designed for emerging adults. Further, it will be the first trial to compare a lifestyle intervention grounded in self-determination theory to one rooted in behavioral economics. If clinically significant reductions in adiposity are achieved, findings could inform a scalable treatment model to meet the needs of this vulnerable population.

Trial Registration: NCT02736981.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cct.2021.106426DOI Listing
May 2021

Predictors and Outcomes of Digital Weighing and Activity Tracking Lapses Among Young Adults During Weight Gain Prevention.

Obesity (Silver Spring) 2021 04;29(4):698-705

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Objectives: Self-monitoring is critical for weight management, but little is known about lapses in the use of digital self-monitoring. The objectives of this study were to examine whether lapses in self-weighing and wearing activity trackers are associated with weight and activity outcomes and to identify objective predictors of lapses.

Methods: Participants (N = 160, BMI = 25.5 ± 3.3 kg/m , 33.1 ± 4.6 years old) were drawn from a sample of young adults in the Study of Novel Approaches to Prevention-Extension (SNAP-E) weight gain prevention trial. Analyses evaluated associations between weighing and tracker lapses and changes in weight and steps/day during the first 90 days after receiving a smart scale and activity tracker.

Results: On average, participants self-weighed 49.6% of days and wore activity trackers 75.2% of days. Every 1-day increase in a weighing lapse was associated with a 0.06-lb gain. Lapses in tracker wear were not associated with changes in steps/day or weight between wear days. Weight gain predicted a higher likelihood of starting a lapse in weighing and tracker wear, whereas lower steps predicted a higher likelihood of a tracker lapse.

Conclusions: Weight gain may discourage adherence to self-monitoring. Future research could examine just-in-time supports to anticipate and reduce the frequency or length of self-monitoring lapses.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.23123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7995618PMC
April 2021

Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial.

Contemp Clin Trials 2021 Apr 27;103:106293. Epub 2021 Jan 27.

Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Introduction: Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS.

Purpose: To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS.

Methods: A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures.

Conclusions: IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cct.2021.106293DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8089056PMC
April 2021

Changes in Cardiovascular Risk Factors Over 6 Years in Young Adults in a Randomized Trial of Weight Gain Prevention.

Obesity (Silver Spring) 2020 12;28(12):2323-2330

Department of Psychiatry and Human Behavior, Weight Control and Diabetes Research Center, Alpert Medical School, Brown University-Miriam Hospital, Providence, Rhode Island, USA.

Objective: This study aimed to determine the impact of weight gain prevention interventions on changes in cardiovascular risk factors over 6 years.

Methods: The Study of Novel Approaches to Weight Gain Prevention (SNAP) randomized 599 participants (ages 18-35; 46% with BMI 21-25; 54% with BMI 25-30) to Large Changes (produce buffer by losing 5-10 pounds initially), Small Changes (daily small changes in intake and activity) or Control and followed 355 participants with ongoing intervention and assessments through 6 years.

Results: There were no significant differences among interventions for changes in weight or cardiovascular disease (CVD) risk factors from baseline to 6 years. However, 44% of participants gained ≥5%, and only 14% lost ≥5% over 6 years. Weight changes, from baseline to year 6, were significantly associated with changes in risk factors, especially insulin and high-density lipoprotein cholesterol. Earlier weight changes (e.g., weight cycling) had no beneficial or adverse effect on changes in CVD risk factors at 6 years, independent of 6-year weight changes.

Conclusions: Despite participation in a weight gain prevention trial, almost half of these young adults gained ≥5% or more over 6 years, with significant worsening in CVD risk factors. Greater attention to long-term weight gain prevention in young adults is needed.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.23003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7687606PMC
December 2020

Examination of a partial dietary self-monitoring approach for behavioral weight management.

Obes Sci Pract 2020 Aug 26;6(4):353-364. Epub 2020 Apr 26.

WW New York NY USA.

Introduction: Dietary self-monitoring in behavioral weight loss programmes traditionally involves keeping track of all foods and beverages to achieve a calorie deficit. While effective, adherence declines over time. WW™ (formerly Weight Watchers), a widely available commercial weight management programme, sought to pilot an approach that permitted participants to consume over 200 foods without monitoring them.

Methods: The current study used a pre-post evaluation design with anthropometric, psychosocial and physical health assessments at baseline, 3 and 6 months.

Results: Participants ( = 152) were, on average, 48.4 (±12.3) years old, with body mass index (BMI) of 32.8 (±4.8) m/kg and 94% female. Mean weight loss was 6.97 + 5.55 kg or 7.9 ± 6.1% of initial body weight (s < .0001) at 6 months. One third (32.6%) of the sample lost 10% or more of initial body weight. Significant improvements in hunger, cravings, happiness, sleep, quality of life, aerobic stamina, flexibility and blood pressure were observed. Attendance at group meetings, as well as decreases in hunger, and fast food cravings from baseline to 3 months were associated with achieving 10% weight loss at 6 months ( < .01).

Conclusions: Using an approach that does not require self-monitoring of all foods and beverages produced significant weight losses and other physical and psychosocial improvements.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/osp4.416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7448156PMC
August 2020

Optimizing Behavioral Interventions for Obesity Using an Engineering-Inspired Approach.

Obesity (Silver Spring) 2020 09 7;28(9):1574. Epub 2020 Aug 7.

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22957DOI Listing
September 2020

Examining barriers, physical activity, and weight change among parents and nonparents in a weight loss intervention.

Obes Sci Pract 2020 Jun 30;6(3):264-271. Epub 2020 Jan 30.

Departments of Health Behavior and Nutrition University of North Carolina at Chapel Hill North Carolina.

Introduction: Little is known about the influence of children in the home on physical activity and weight among adults in weight loss interventions. This study evaluated the association between number of children in the home, weight loss, and weight regain in a behavioural weight loss intervention, and whether those relationships were mediated in sequence by physical activity barriers and physical activity changes.

Methods: The sample included 267 participants from a randomized trial who had complete data on study variables. Variables at baseline, 6, and 18 months included physical activity barriers, objectively measured minutes of moderate-to-vigorous physical activity (MVPA), and objectively measured weight used to calculate percent weight loss (PWL) from baseline to 6 months and percent weight regained (PWG) from 6 to 18 months.

Results: A greater number of children in the home was associated with less PWL at 6 months. This relationship was mediated by greater baseline physical activity barriers and a smaller increase in MVPA at 6 months. The mediated effect was no longer significant when controlling for changes in dietary intake. There was no relationship between number of children and PWG from 6 to 18 months.

Conclusions: Parents may need unique intervention supports to overcome barriers to initiation of physical activity to help them reach optimal weight loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/osp4.401DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7278899PMC
June 2020

Experiences of African American Breast Cancer Survivors Using Digital Scales and Activity Trackers in a Weight Gain Prevention Intervention: Qualitative Study.

JMIR Mhealth Uhealth 2020 06 8;8(6):e16059. Epub 2020 Jun 8.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Background: The use of digital tools to promote daily self-weighing and daily activity tracking may be a promising strategy for weight control among African American breast cancer survivors (AABCS). There have been no studies exploring the acceptability and feasibility of using digital tools for weight control or qualitative studies characterizing perceptions of daily self-weighing and daily activity tracking among AABCS.

Objective: This study aimed to explore the subjective experiences of daily self-weighing and daily activity tracking using digital tools, including wireless scales and activity trackers, in a sample of AABCS participating in two technology-based weight gain prevention interventions over 6 months.

Methods: Semistructured interviews (N=21) were conducted in person or over the phone, were audio recorded, and then transcribed verbatim. Each transcript was read to identify key themes and develop a codebook. Each transcript was coded using Atlas.ti software, and code outputs were used to identify overarching themes and patterns in the data.

Results: On average, participants were 52.6 (SD 8.3) years of age, with obesity at baseline (BMI 33.1 kg/m, SD 5.9), and weighed on 123.4 (SD 48.0) days out of the 168 days (73.5%) in the study period. Women tended to attribute their weight gain to cancer treatment and framed program benefits in terms of improved quality of life and perceptions of prolonging their survival following treatment. Using the smart scale for daily self-weighing was viewed as the tool by which participants could control their weight and improve their health and well-being posttreatment. The activity tracker increased awareness of physical activity and motivated participants to be more active.

Conclusions: Participants reported positive experiences and benefits from daily self-weighing and daily activity tracking. Findings suggest that daily self-weighing and daily activity tracking using digital tools are well-received, acceptable, and feasible intervention strategies for AABCS in the context of posttreatment weight management.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/16059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308909PMC
June 2020

Understanding the Role of Fathers in Children's Physical Activity: A Qualitative Study.

J Phys Act Health 2020 05 1;17(5):540-547. Epub 2020 May 1.

Background: Parents are influential in supporting children's physical activity, but relatively little is known about the role of fathers in children's physical activity.

Methods: Semi-structured interviews (n = 24) were conducted with low-active and active fathers of children 3-11 years old. Deductive thematic analysis was used to identify fathers' physical activity practices and understand how fathers interact with their children around physical activity.

Results: All fathers demonstrated coparticipation in physical activity with their children. Other physical activity practices commonly used by fathers included as follows: facilitation of active opportunities, modeling, involvement through coaching or teaching, and encouragement. In addition, fathers viewed physical activity as an opportunity to spend time with their children to bond and develop shared interests. Finally, fathers perceived their role in children's physical activity to be different compared with mothers. Regarding father activity level, active fathers discussed modeling more frequently and tended to engage in a variety of different activities compared with low-active fathers.

Conclusions: Fathers play an important role in their children's physical activity, suggesting that physical activity may be one context in which to prompt paternal involvement, foster father-child relationships, and strengthen paternal parenting.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2019-0386DOI Listing
May 2020

Examining Heterogeneity of Outcomes in a Weight Gain Prevention Program for Young Adults.

Obesity (Silver Spring) 2020 03 6;28(3):521-528. Epub 2020 Feb 6.

Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island, USA.

Objective: This study aimed to characterize young adults who experienced significant weight gains (> 10%) over 3 years in a weight gain prevention program.

Methods: Secondary data analysis from the Study of Novel Approaches to Weight Gain Prevention (SNAP), a randomized trial comparing two self-regulation interventions and a control arm in young adults (18-35 years; BMI 21-30.9 kg/m ), was used. Large Gainers (≥ 10% of their body weight; n = 48), Small Gainers (2.6%-9.9%; n = 149), and Weight Stable participants (± 2.5%; n = 143) were compared on dimensions affecting weight gain.

Results: Differences in weight gain among the three groups were significant by year 1 and subsequently increased. Those who became Large Gainers were heavier at baseline and further below their highest weight, and they reported more weight cycling than Weight Stable, with Small Gainers intermediate. Neither study arm nor pregnancy explained weight change differences among the three groups. Large Gainers reported more depressive symptoms than Weight Stable at years 1 and 2. Large Gainers were less likely to weigh themselves at least weekly at 4 months, before differences in weight gain emerged, and at years 1 and 2.

Conclusions: Large Gainers (representing almost 10% of participants) could be identified early by greater weight issues at baseline and lower use of weight gain prevention strategies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22720DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7042032PMC
March 2020

Weight Gain of Service Members After Basic Military Training.

Am J Prev Med 2020 01;58(1):117-121

Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina.

Introduction: Despite weight and fitness requirements, the prevalence of overweight and obesity in the U.S. military approaches that in the general population. The purpose of this study is to assess trends in anthropometric measurements shortly after military enlistment.

Methods: This longitudinal study evaluated the change in objectively measured body weight and waist circumference in the population of U.S. Air Force members who enlisted in 2012-2013 and graduated from Basic Military Training (n=49,466). Individuals were followed for 4 years or until they left the military, for a mean follow-up of 1,218 (SD=261) days. Data were collected in 2018 and analyzed in 2019.

Results: Among Basic Military Training graduates with available and plausible baseline data (n=46,706), weight increased incrementally by a mean of 1.5-1.8 kg per year and waist circumference by 0.3-1.1 cm per year. Over the 4-year period, total mean weight gain was 6.6 (SD=7.7) kg and waist circumference increase was 3.1 (SD=6.4) cm. Male graduates gained 7.0 (SD=7.7) kg and female graduates gained 4.7 (SD=7.5) kg. Of those who stayed in the military for 4 years, 37.3% transitioned to a higher BMI category (i.e., from normal to overweight/obese or from overweight to obese), whereas 3.9% transitioned to a lower category.

Conclusions: Future research is needed to understand determinants of unhealthy weight gain and the association between weight gain and physical fitness among young adults embarking on a military career.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.amepre.2019.08.022DOI Listing
January 2020

Weight Gain Over 6 Years in Young Adults: The Study of Novel Approaches to Weight Gain Prevention Randomized Trial.

Obesity (Silver Spring) 2020 01;28(1):80-88

Alpert Medical School of Brown University, Miriam Hospital, Providence, Rhode Island, USA.

Objective: The study objective was to determine whether two self-regulation interventions that reduced 3-year weight gain in young adults remain effective at 6 years.

Methods: A randomized trial was conducted in two academic settings in 599 young adults, aged 18 to 35 years, with normal weight or overweight; 504 (84%) reconsented for a 6-year extension (Study of Novel Approaches to Weight Gain Prevention-Extended [SNAP-E]) with ongoing intervention and assessments. Weight gain over 6 years was compared for all assigned to Control, Large Changes (LC; lose 5-10 pounds initially), and Small Changes (SC; make small daily changes in intake and activity).

Results: Weight change from baseline to 6 years did not differ significantly among the three groups (Control = 3.9 kg, SC = 4.1 kg, and LC = 2.8 kg). However, there was a significant age-by-treatment interaction (P = 0.002). Among those < 25 years old, weight gain from baseline to 6 years averaged 7.3 kg in the Control group and was reduced by almost 50% in LC and SC. LC also significantly reduced mean weight gain (area under the curve) over 6 years compared with Control or SC.

Conclusions: Although the interventions did not reduce weight gain at 6 years for the full cohort, they were effective in those < 25 years old. Future efforts should focus on young adults aged 18 to 24.9 and test more intensive interventions with more diverse participants.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927481PMC
January 2020

Comparative effectiveness of a standard behavioral and physical activity enhanced behavioral weight loss intervention in Black women.

Women Health 2020 07 8;60(6):676-691. Epub 2019 Dec 8.

Department of Health Behavior, Department of Nutrition, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina, USA.

Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m. Standard and enhanced groups' weight change (-2.83 kg and -2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/03630242.2019.1700585DOI Listing
July 2020

New research directions on disparities in obesity and type 2 diabetes.

Ann N Y Acad Sci 2020 02 3;1461(1):5-24. Epub 2019 Dec 3.

David Geffen School of Medicine at the University of California, and UCLA Fielding School of Public Health, Los Angeles, Los Angeles, California.

Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and low-income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scaling-up successful interventions and reaching at-risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/nyas.14270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7159314PMC
February 2020

Engagement and Weight Loss in a Web and Mobile Program for Low-Income Postpartum Women: Fit Moms/.

Health Educ Behav 2019 12;46(2_suppl):114-123

University of North Carolina at Chapel Hill, NC, USA.

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/ 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/ 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1090198119873915DOI Listing
December 2019

Deconstructing Weight Management Interventions for Young Adults: Looking Inside the Black Box of the EARLY Consortium Trials.

Obesity (Silver Spring) 2019 07 28;27(7):1085-1098. Epub 2019 May 28.

Epidemiology & Biostatistics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Objective: The goal of the present study was to deconstruct the 17 treatment arms used in the Early Adult Reduction of weight through LifestYle (EARLY) weight management trials.

Methods: Intervention materials were coded to reflect behavioral domains and behavior change techniques (BCTs) within those domains planned for each treatment arm. The analytical hierarchy process was employed to determine an emphasis profile of domains in each intervention.

Results: The intervention arms used BCTs from all of the 16 domains, with an average of 29.3 BCTs per intervention arm. All 12 of the interventions included BCTs from the six domains of Goals and Planning, Feedback and Monitoring, Social Support, Shaping Knowledge, Natural Consequences, and Comparison of Outcomes; 11 of the 12 interventions shared 15 BCTs in common across those six domains.

Conclusions: Weight management interventions are complex. The shared set of BCTs used in the EARLY trials may represent a core intervention that could be studied to determine the required emphases of BCTs and whether additional BCTs add to or detract from efficacy. Deconstructing interventions will aid in reproducibility and understanding of active ingredients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22506DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6749832PMC
July 2019

Dietary outcomes within the study of novel approaches to weight gain prevention (SNAP) randomized controlled trial.

Int J Behav Nutr Phys Act 2019 01 31;16(1):14. Epub 2019 Jan 31.

Weight Control and Diabetes Research Center at The Miriam Hospital, Providence, RI, USA.

Background: Young adults (YA) are at high-risk for unhealthy dietary behaviors and weight gain. The Study of Novel Approaches to Weight Gain Prevention (SNAP) Trial demonstrated that two self-regulation approaches were effective in reducing weight gain over 2 years compared with control. The goal of this analysis was to examine effects of intervention on dietary outcomes and the association of diet changes with weight change.

Methods: Participants were 599 YA, age 18-35 years, BMI 21.0-30.0 kg/m (27.4 ± 4.4 years; 25.4 ± 2.6 kg/m; 22% men; 73% non-Hispanic White), who were recruited in Providence, RI and Chapel Hill, NC and randomized to self-regulation with Small Changes (SC), self-regulation with Large Changes (LC) or Control (C). SC and LC emphasized frequent self-weighing to cue behavior changes (small daily changes vs. periodic large changes) and targeted high-risk dietary behaviors. Diet and weight were assessed at baseline, 4 months and 2 years.

Results: LC and SC had greater decreases in energy intake than C at 4 months but not 2 years. LC had the greatest changes in percent calories from fat at 4 months, but differences were attenuated at 2 years. No differences in diet quality were observed. Across conditions, increased total energy consumption, fast food, meals away from home, and binge drinking, and decreased dietary quality and breakfast consumption were all associated with weight gain at 2 years.

Conclusions: This study suggests the need to strengthen interventions to produce longer term changes in dietary intake and helps to identify specific behaviors associated with weight gain over time in young adults.

Trial Registration: Clinicaltrials.gov # NCT01183689 , registered August 18, 2010.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12966-019-0771-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357348PMC
January 2019

Eating pathology and psychological outcomes in young adults in self-regulation interventions using daily self-weighing.

Health Psychol 2019 Feb 13;38(2):143-150. Epub 2018 Dec 13.

Warren Alpert Medical School.

Objective: Self-regulation interventions encouraging daily weighing prevent weight gain in young adults; however, concerns have been raised that such interventions may have undesirable effects on eating pathology, depression, and health-related quality of life (HRQL). The present study examined whether self-regulation interventions and self-weighing frequency were associated with these indices in normal weight individuals and those with overweight or obesity.

Methods: Young adults ( = 599), 18-35 years with a body mass index (BMI) 21.0-30.9 kg/m² were randomized to control, self-regulation with small changes (SC) or self-regulation with large changes (LC). Interventions taught frequent self-weighing to guide behavioral changes. SC prescribed daily small decreases in intake and increases in physical activity. LC prescribed a 5- to 10-lb weight loss to buffer against anticipated gains. Psychological indices were assessed at baseline and periodically over 2 years of follow-up.

Results: There was no evidence that the interventions increased depressive symptoms or compensatory behaviors or decreased HRQL relative to control. LC increased flexible and rigid control and SC decreased disinhibition. Results did not differ by weight status with the exception of rigid control; here, differences between LC and the other conditions were smaller among those with BMI ≥ 25. Greater self-weighing frequency over time was associated with increases in flexible and rigid control, dietary restraint, and improvements in HRQL.

Conclusions: The self-regulation interventions and increases in self-weighing had no untoward effects. Encouraging weight gain prevention in young adults through frequent weighing and self-regulation appears to be safe for normal weight young adults and those with overweight. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1037/hea0000689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447368PMC
February 2019

Weight and Shape Concern Impacts Weight Gain Prevention in the SNAP Trial: Implications for Tailoring Intervention Delivery.

Obesity (Silver Spring) 2018 08 28;26(8):1270-1276. Epub 2018 Jun 28.

The Miriam Hospital, Alpert Medical School, Brown University, Providence, Rhode Island, USA.

Objective: The Study of Novel Approaches to Weight Gain Prevention (SNAP) trial demonstrated that two self-regulatory interventions prevented weight gain in young adults. Weight and shape concern (WSC) at baseline was evaluated as a moderator of weight outcomes at 24 months.

Methods: Young adults (n = 599) were randomized to self-regulation with small changes (to create 200 kcal/day deficit), self-regulation with large changes (to facilitate preemptive weight loss of 5-10 lb), or self-guided control. WSC was assessed by using one item from the Eating Disorders Assessment. ANOVA was used to examine whether the association between baseline level of WSC and percent weight change over 24 months differed across treatment conditions.

Results: Approximately 22% of participants reported high WSC (37% moderate; 41% low). WSC and treatment condition interacted to influence weight change at 24 months (P = 0.03). Individuals with high WSC gained weight in the large changes group (WSC least squares means ± SE, high: + 0.73% ± 1.19%; moderate: -2.74% ± 0.84%; low: -2.41% ± 0.79%). The small changes condition was particularly effective for those with high WSC (high WSC: -2.49% ± 1.16%; moderate: -0.60% ± 0.88%; low: -0.71% ± 0.80%). WSC did not impact weight change among control participants.

Conclusions: Individuals with high WSC may benefit from a small-changes approach to weight gain prevention. These findings indicate WSC may be used to match individuals to weight gain prevention treatment conditions.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6437682PMC
August 2018

Nonadherence to daily self-weighing and activity tracking is associated with weight fluctuations among African American breast cancer survivors.

PLoS One 2018 26;13(6):e0199751. Epub 2018 Jun 26.

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America.

Introduction: Daily self-weighing (DSW) and daily activity tracking (DAT) are useful strategies for preventing weight gain among African American breast cancer survivors. However, self-monitoring behaviors vary over time, increasing risk of weight gain. This study explored the association of nonadherence to DSW and DAT with corresponding weight fluctuations among African American breast cancer survivors.

Methods: Using data from a 6-month randomized controlled trial, we conducted a secondary data analysis among women randomized into a DSW group (n = 13) and a DSW+DAT group (n = 11). DSW and DAT were captured from wireless scale and activity tracker data. Nonadherence to DSW was defined as one or more days without a weight measurement, and nonadherence to DAT was defined as one or more days without activity tracking. Generalized estimating equations were used to examine weight fluctuations in relation to nonadherence to DSW and DAT. Data analysis occurred from September 2016-April 2017.

Results: Over the 6-month study period, women provided 119.2 ± 46.0 weight measurements and 121.9 ± 53.2 days of physical activity tracking. Nonadherence to DSW was associated with weight fluctuations. For every 1-day increase in nonadherence to DSW, weight increased by 0.031 kg (95% CI: 0.012, 0.050; p<0.01). Additionally, during periods of DSW and DAT weight decreased by 0.028 kg (95% CI: -0.042, -0.014; p<0.001) and 0.017 kg (95% CI: -0.030; -0.004) respectively.

Conclusions: Our findings suggest that nonadherence to DSW was associated with weight gain among breast cancer survivors. Weight loss was enhanced during periods of DSW and DAT.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0199751PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6019092PMC
December 2018

Pattern of Daily Steps is Associated with Weight Loss: Secondary Analysis from the Step-Up Randomized Trial.

Obesity (Silver Spring) 2018 06 6;26(6):977-984. Epub 2018 Apr 6.

Physical Activity and Weight Management Research Center, Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Objective: The aim of this study was to examine the association between the amount, intensity, and pattern of steps·day with weight loss.

Methods: Participants (N = 260; age = 42.8 ± 8.9 y; BMI = 32.8 ± 3.5 kg/m ) completed an 18-month weight-loss intervention that included a calorie-restricted diet and prescribed physical activity. Participants were categorized by 18-month weight loss as weight gain (GAIN), weight loss of 0% to < 5% (WL < 5%), 5% to < 10% (WL < 10%), or ≥ 10% (WL ≥ 10%). Steps·day were measured at 0, 6, 12, and 18 months and defined as total steps·day , total steps·day of moderate-to-vigorous physical activity (MVPA) (≥3 metabolic equivalents) in bouts of ≥ 10 minutes (BOUT-MVPA), MVPA in bouts of < 10 minutes (NON-BOUT-MVPA), or non-MVPA steps·day (NON-MVPA).

Results: There was a weight-loss category by time interaction (P < 0.0001) for total and BOUT-MVPA steps·day . The total steps·day at 18 months were WL ≥ 10% = 9,822 (95% CI: 9,073-10,571), WL < 10% = 8,612 (7,613-9,610), WL < 5% = 7,802 (6,782-8,822), and GAIN = 7,801 (6,549-9,053). BOUT-MVPA steps·day at 18 months were WL ≥ 10% = 3,482 (2,982-3,981), WL < 10% = 1,949 (1,269-2,629), WL < 5% = 1,735 (1,045-2,426), and GAIN = 1,075 (210-1,941). Participants were also categorized based on achieving ≥ 10% weight loss at either 6 or 18 months, and a similar pattern was observed.

Conclusions: These findings show that 10,000 steps·day , with approximately 3,500 steps·day performed as BOUT-MVPA, are associated with enhanced weight loss in a behavioral intervention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.22171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5970037PMC
June 2018

Optimizing Tailored Communications for Health Risk Assessment: A Randomized Factorial Experiment of the Effects of Expectancy Priming, Autonomy Support, and Exemplification.

J Med Internet Res 2018 03 1;20(3):e63. Epub 2018 Mar 1.

Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.

Background: Health risk assessments with tailored feedback plus health education have been shown to be effective for promoting health behavior change. However, there is limited evidence to guide the development and delivery of online automated tailored feedback.

Objective: The goal of this study was to optimize tailored feedback messages for an online health risk assessment to promote enhanced user engagement, self-efficacy, and behavioral intentions for engaging in healthy behaviors. We examined the effects of three theory-based message factors used in developing tailored feedback messages on levels of engagement, self-efficacy, and behavioral intentions.

Methods: We conducted a randomized factorial experiment to test three different components of tailored feedback messages: tailored expectancy priming, autonomy support, and use of an exemplar. Individuals (N=1945) were recruited via Amazon Mechanical Turk and randomly assigned to one of eight different experimental conditions within one of four behavioral assessment and feedback modules (tobacco use, physical activity [PA], eating habits, and weight). Participants reported self-efficacy and behavioral intentions pre- and postcompletion of an online health behavior assessment with tailored feedback. Engagement and message perceptions were assessed at follow-up.

Results: For the tobacco module, there was a significant main effect of the exemplar factor (P=.04); participants who received exemplar messages (mean 3.31, SE 0.060) rated their self-efficacy to quit tobacco higher than those who did not receive exemplar messages (mean 3.14, SE 0.057). There was a three-way interaction between the effect of message conditions on self-efficacy to quit tobacco (P=.02), such that messages with tailored priming and an exemplar had the greatest impact on self-efficacy to quit tobacco. Across PA, eating habits, and weight modules, there was a three-way interaction among conditions on self-efficacy (P=.048). The highest self-efficacy scores were reported among those who were in the standard priming condition and received both autonomy supportive and exemplar messages. In the PA module, autonomy supportive messages had a stronger effect on self-efficacy for PA in the standard priming condition. For PA, eating habits, and weight-related behaviors, the main effect of exemplar messages on behavioral intentions was in the hypothesized direction but did not reach statistical significance (P=.08). When comparing the main effects of different message conditions, there were no differences in engagement and message perceptions.

Conclusions: Findings suggest that tailored feedback messages that use exemplars helped improve self-efficacy related to tobacco cessation, PA, eating habits, and weight control. Combining standard priming and autonomy supportive message components shows potential for optimizing tailored feedback for tobacco cessation and PA behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2196/jmir.7613DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856933PMC
March 2018

Racial Differences in Weight Loss Mediated by Engagement and Behavior Change.

Ethn Dis 2018 1;28(1):43-48. Epub 2018 Feb 1.

Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Objective: We set out to determine if a primarily Internet-delivered behavioral weight loss intervention produced differential weight loss in African American and non-Hispanic White women, and to identify possible mediators.

Design: Data for this analysis were from a randomized controlled trial, collected at baseline and 4-months.

Setting: The intervention included monthly face-to-face group sessions and an Internet component that participants were recommended to use at least once weekly.

Participants: We included overweight or obese African American and non-Hispanic White women (n=170), with at least weekly Internet access, who were able to attend group sessions.

Intervention: Monthly face-to-face group sessions were delivered in large or small groups. The Internet component included automated tailored feedback, self-monitoring tools, written lessons, video resources, problem solving, exercise action planning tools, and social support through message boards.

Main Outcome Measure: Multiple linear regression was used to evaluate race group differences in weight change.

Results: Non-Hispanic White women lost more weight than African American women (-5.03% vs.-2.39%, P=.0002). Greater website log-ins and higher change in Eating Behavior Inventory score in non-Hispanic White women partially mediated the race-weight loss relationship.

Conclusions: The weight loss disparity may be addressed through improved website engagement and adoption of weight control behaviors.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.18865/ed.28.1.43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5794447PMC
October 2019

Objectively-assessed physical activity and weight change in young adults: a randomized controlled trial.

Int J Behav Nutr Phys Act 2017 12 4;14(1):165. Epub 2017 Dec 4.

University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA.

Background: Reductions in physical activity (PA) are common throughout young adulthood and low PA is associated with weight gain. The SNAP Trial previously reported that two self-regulation approaches to weight gain prevention reduced weight gain over a 2-year period in 18-35 year olds. Presented here are secondary analyses examining changes in PA and the relationship between PA and weight change over 2 years.

Methods: 599 young adults (age: 27.4 ± 4.4 yrs.; BMI: 25.4 ± 2.6 kg/m) were randomly assigned to 1 of 3 treatment arms: Small Changes (reduce calorie intake by 100 kcals/day & add 2000 steps/day), Large Changes (lose 2.3-4.5 kg initially & increase PA to ≥250 min/wk), or Self-guided (control condition). Small and Large Changes received 10, face-to-face group sessions (months 1-4), and two 4-week refresher courses each subsequent year. Body weight and PA were objectively-measured at baseline, 4 months, 1 and 2 years. Daily steps and bout-related moderate-to-vigorous intensity PA (MVPA: ≥3 METs, ≥10-min bouts) was calculated.

Results: Changes in bout-related MVPA and daily steps did not differ among treatment groups over the 2-year period (p's > 0.16). Collapsed across groups, participants gaining >1 lb. (n = 187; 39.6%) had smaller changes in bout-related MVPA at 4 months, 1 and 2 years relative to those maintaining or losing weight (≤1 lb. weight gain; n = 282, 60.4%, p's < 0.05). Averaged across time points, this difference equated to 47.8 min/week. Those gaining and not gaining >1 lb. did not differ on daily steps (p's > 0.10). Among participants engaging in ≥250 min/wk. of MVPA at 2 years (n = 181), 30% gained >1 lb. from baseline to 2 years, which was not different from those engaging in 150-250 min/wk. (n = 87; 36%; p = 0.40), but this percentage was significantly lower when compared to those engaging in <150 min/wk. (n = 176; 49%; p < 0.001).

Conclusions: On average, PA differences were not observed between young adults assigned to small or large changes self-regulation interventions to prevent weight gain. Regardless of group assignment, higher levels of MVPA were associated with better weight gain prevention over 2 years. Our data suggest that achieving >150 min/week of MVPA is needed for weight gain prevention and that increasing MVPA, rather than steps, should be targeted.

Trial Registration: www.clinicaltrials.gov (NCT01183689). Registered Aug 13, 2010.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12966-017-0620-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5715643PMC
December 2017

Randomized trial comparing group size of periodic in-person sessions in a remotely delivered weight loss intervention.

Int J Behav Nutr Phys Act 2017 10 23;14(1):144. Epub 2017 Oct 23.

Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599-7294, USA.

Background: Few randomized studies have examined differential effects of group size in behavioral weight control, especially in hybrid programs that include Internet treatment approaches.

Methods: Randomized controlled trial (n = 195) comparing a 4 month hybrid internet weight loss program coupled with monthly face to face groups of 100 persons (Large Group, LG; 1 group) or to the same approach with monthly groups of 20 persons (Small Group, SG; 4 groups). Repeated-measures mixed-model analysis with age and race as covariates were used to estimate primary (weight) and secondary outcomes, and to test group differences in change over time.

Results: The sample was 46.3 years old ±10.4, 90.3% female, and 51.9% non-white, with BMI 37.9 ± 8.4 kg/m. Participants in the LG were more likely to return for the 4-month assessment visit than those in the SG (p = 0.04). Participants randomized to both the LG and SG conditions experienced significant WL over time (no between group difference: -4.1 kg and -3.7 kg, respectively) and weight loss was positively associated with attendance at monthly meetings and logins to the website. Satisfaction with the program was high and similar in both groups (94.4% reported that they were "satisfied" or "very satisfied").

Conclusions: Using a hybrid approach of in-person and online weight loss interventions may be an effective way to reach larger and more diverse populations. Delivering the face to face component of the intervention in groups larger than those traditionally delivered (20-25 people) could increase the cost-effectiveness of group-based behavioral weight loss interventions.

Clinical Trials Registration Number: NCT01615471 . Registered June 6, 2012. Registered retrospectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12966-017-0599-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654056PMC
October 2017

Weight Loss Strategies Utilized in a Men's Weight Loss Intervention.

Health Educ Behav 2018 06 28;45(3):401-409. Epub 2017 Sep 28.

1 University of North Carolina at Chapel Hill, NC, USA.

Men are underrepresented in weight loss programs and little is currently known about the weight loss strategies men prefer. This study describes the weight loss strategies used by men during a men-only weight loss program. At baseline, 3 months, and 6 months, participants reported how frequently they used 45 weight loss strategies including strategies frequently recommended by the program (i.e., mentioned during every intervention contact; e.g., daily self-weighing), strategies occasionally recommended by the program (i.e., mentioned at least once during the program; e.g., reduce calories from beverages), and strategies not included in the program (e.g., increase daily steps). At baseline participants ( N = 107, 44.2 years, body mass index = 31.4 kg/m, 76.6% White) reported regularly using 7.3 ± 6.6 ( M ± SD) strategies. The intervention group increased the number of strategies used to 19.1 ± 8.3 at 3 months and 17.1 ± 8.4 at 6 months with no changes in the waitlist group. The intervention group reported increased use of most of the strategies frequently recommended by the program (4 of 5), nearly half of the strategies occasionally recommended by the program (10 of 24), and one strategy not included in the program (of 16) at 6 months. The intervention effect at 6 months was significantly mediated by the number of strategies used at 3 months. This study adds to what is known about men's use of weight loss strategies prior to and during a formal weight loss program and will help future program developers create programs that are tailored to men.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1090198117733025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5832568PMC
June 2018

Physical Activity Opportunities Within the Schedule of Early Care and Education Centers.

J Phys Act Health 2018 02 27;15(2):73-81. Epub 2017 Nov 27.

Background: Physical activity has many benefits for young children's health and overall development, but few studies have investigated how early care and education centers allot time for physical activity, along with measured individual physical activity levels for indoor/outdoor activities during a typical day.

Methods: Fifty early care and education centers in central North Carolina participated in 4 full-day observations, and 559 children aged 3-5 years within centers wore accelerometers assessing physical activity during observation days. Observation and physical activity data were linked and analyzed for associations between child activity and type of classroom activity.

Results: Children averaged 51 (13) minutes per day of moderate to vigorous physical activity and 99 (18) minutes per day of light physical activity while in child care. Children averaged 6 (10) and 10 (13) minutes per day of observed outdoor and indoor daily teacher-led physical activity, respectively. Outdoor time averaged 67 (49) minutes per day, and physical activity levels were higher during outdoor time than during common indoor activities (center time, circle time, and TV time).

Conclusions: Physical activity levels varied between indoor and outdoor class activities. Policy and program-related efforts to increase physical activity in preschoolers should consider these patterns to leverage opportunities to optimize physical activity within early care and education centers.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1123/jpah.2017-0071DOI Listing
February 2018

Acculturation Influences Postpartum Eating, Activity, and Weight Retention in Low-Income Hispanic Women.

J Womens Health (Larchmt) 2017 12 17;26(12):1333-1339. Epub 2017 Aug 17.

4 Kinesiology Department, California Polytechnic State University , San Luis Obispo, California.

Background: Low-income Hispanic women experience elevated rates of high postpartum weight retention (PPWR), which is an independent risk factor for lifetime obesity. Sociocultural factors might play an important role among Hispanic women; however, very few studies have examined this association.

Objective: The purpose of our study was to examine the associations between acculturation and maternal diet, physical activity, and PPWR.

Design: This is a cross-sectional study of baseline data from 282 Hispanic women participating in the FitMoms/Mamás Activas study, a randomized controlled trial examining the impact of primarily an internet-based weight control program, in reducing PPWR among low-income women. We performed multivariable linear regression to examine the association of acculturation with diet quality, physical activity, and PPWR at study entry.

Results: A total of 213 (76%) women had acculturation scores reflecting Mexican orientation or bicultural orientation, whereas 69 (24%) had scores that represented assimilation to Anglo culture. Women who were more acculturated had lower intakes of fruits and vegetables, lower HEI scores, and lower physical activity levels than women who were less acculturated (p < 0.05). We found an association between acculturation and PPWR in that for every 1-unit increase in acculturation score, PPWR increased, on average, by 0.80 kg.

Conclusion: Higher acculturation was associated with poorer diet and physical activity behaviors and greater PPWR.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1089/jwh.2016.6154DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733667PMC
December 2017

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

J Health Psychol 2019 06 29;24(7):870-887. Epub 2017 Jan 29.

3 The Miriam Hospital, USA.

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/m, 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.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/1359105316688951DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623115PMC
June 2019

Improvements in Cardiovascular Risk Factors in Young Adults in a Randomized Trial of Approaches to Weight Gain Prevention.

Obesity (Silver Spring) 2017 10 7;25(10):1660-1666. Epub 2017 Aug 7.

Department of Biostatistical Sciences, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, North Carolina, USA.

Objective: Weight gain occurs commonly in young adults and increases the risk of cardiovascular disease (CVD). Following on a previous report that two self-regulation interventions reduced weight gain relative to control, this study examines whether these interventions also benefit CVD risk factors.

Methods: The Study of Novel Approaches to Weight Gain Prevention was a randomized trial in two academic settings (N = 599; 18-35 years; BMI 21-30 kg/m ) comparing two interventions (Self-Regulation with Small Changes; Self-Regulation with Large Changes) and a control group. Small Changes taught participants to make daily small changes in calorie intake (approximately 100 calories) and activity. Large Changes taught participants to initially lose 5 to 10 pounds to buffer anticipated weight gains. CVD risk factors were assessed at baseline and at 2 years in 471 participants.

Results: Although Large Changes was associated with more beneficial changes in glucose, insulin, and homeostatic model assessment of insulin resistance than Control, these differences were not significant after adjusting for multiple comparisons or 2-year weight change. Comparison of participants grouped by percent weight change from baseline to 2 years showed significant differences for several CVD risk factors, with no interaction with treatment condition.

Conclusions: Magnitude of weight change, rather than specific weight gain prevention interventions, was related to changes in CVD risk factors in young adults.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/oby.21917DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5656399PMC
October 2017