1
|
Nicol GE, Ricchio AR, Metts CL, Yingling MD, Ramsey AT, Schweiger JA, Miller JP, Lenze EJ. A Smartphone-Based Technique to Detect Dynamic User Preferences for Tailoring Behavioral Interventions: Observational Utility Study of Ecological Daily Needs Assessment. JMIR Mhealth Uhealth 2020; 8:e18609. [PMID: 33055063 PMCID: PMC7695533 DOI: 10.2196/18609] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/14/2020] [Accepted: 10/15/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Mobile health apps are promising vehicles for delivering scalable health behavior change interventions to populations that are otherwise difficult to reach and engage, such as young adults with psychiatric conditions. To improve uptake and sustain consumer engagement, mobile health interventions need to be responsive to individuals' needs and preferences, which may change over time. We previously created an ecological daily needs assessment to capture microprocesses influencing user needs and preferences for mobile health treatment adaptation. OBJECTIVE The objective of our study was to test the utility of a needs assessment anchored within a mobile app to capture individualized, contextually relevant user needs and preferences within the framework of a weight management mobile health app. METHODS Participants with an iOS device could download the study app via the study website or links from social media. In this fully remote study, we screened, obtained informed consent from, and enrolled participants through the mobile app. The mobile health framework included daily health goal setting and self-monitoring, with up to 6 daily prompts to determine in-the-moment needs and preferences for mobile health-assisted health behavior change. RESULTS A total of 24 participants downloaded the app and provided e-consent (22 female; 2 male), with 23 participants responding to at least one prompt over 2 weeks. The mean length of engagement was 5.6 (SD 4.7) days, with a mean of 2.8 (1.1) responses per day. We observed individually dynamic needs and preferences, illustrating daily variability within and between individuals. Qualitative feedback indicated preferences for self-adapting features, simplified self-monitoring, and the ability to personalize app-generated message timing and content. CONCLUSIONS The technique provided an individually dynamic and contextually relevant alternative and complement to traditional needs assessment for assessing individually dynamic user needs and preferences during treatment development or adaptation. The results of this utility study suggest the importance of personalization and learning algorithms for sustaining app engagement in young adults with psychiatric conditions. Further study in broader user populations is needed.
Collapse
Affiliation(s)
- Ginger E Nicol
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Amanda R Ricchio
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Christopher L Metts
- Department of Pathology and Laboratory Medicine, College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Michael D Yingling
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Alex T Ramsey
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Julia A Schweiger
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - J Philip Miller
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, United States
| | - Eric J Lenze
- Healthy Mind Lab, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| |
Collapse
|
2
|
Xu S, Zhang J, Dong Y, Chen R, Xu W, Tan Z, Gao L, Shang L. The PROMOTE study (High-protein and resistance-training combination in overweight and obesity) for short-term weight loss and long-term weight maintenance for Chinese people: a protocol for a pilot randomized controlled trial. Trials 2020; 21:47. [PMID: 31915038 PMCID: PMC6950796 DOI: 10.1186/s13063-019-3954-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 12/03/2019] [Indexed: 11/23/2022] Open
Abstract
Background It is very important for clinicians and dieticians to explore reasonable weight management strategies for obese people that address both short-term weight loss and subsequent weight maintenance. We hypothesized that resistance training combined with a high-protein diet would result in similar short-term weight loss but better long-term weight maintenance than either a conventional low-fat diet control or a high-protein diet alone. Methods/design This is an 8-week randomized parallel controlled trial followed by a 24-week observational follow-up study. A 48-week supplementary follow-up study will be carried out if necessary. The study will be conducted between June 2019 and October 2020. The 90 overweight or obese participants will be randomly assigned to the conventional low-fat diet group, the high-protein diet group and the high-protein diet and resistance training combination group. Primary outcomes are body weight change at week 8 and week 24 compared with the baseline level. Discussion High-quality research on the effect of a high-protein diet combined resistance training on weight loss and weight maintenance is limited in the Chinese population. Our study will provide a basis for obesity management in China and will promote the development of exercise- and diet-related studies. Trial registration Chinese Clinical Trial Registry, ChiCTR1900023841. Registered on 14 June 2019.
Collapse
Affiliation(s)
- Shaoyong Xu
- Department of Health Statistics, Shaanxi Key Laboratory of Free Radical Biology and Medicine and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University of PLA, Changle West Road No. 169, Xi'an, 710032, Shaanxi, China.,Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangyang, 441021, Hubei, China
| | - Juan Zhang
- Department of Endocrinology, 3201 Hospital of Xi'an Jiao tong University Health Science Center, 783 Tianhan Road, Hanzhong, 723000, Shaanxi, China
| | - Yuxiang Dong
- Department of Clinical Nutrition, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangyang City, 441021, Hubei, China
| | - Ruikun Chen
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangyang, 441021, Hubei, China
| | - Wenlei Xu
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangyang, 441021, Hubei, China
| | - Zhijun Tan
- Department of Health Statistics, Shaanxi Key Laboratory of Free Radical Biology and Medicine and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University of PLA, Changle West Road No. 169, Xi'an, 710032, Shaanxi, China
| | - Ling Gao
- Department of Endocrinology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136, Jingzhou Street, Xiangyang, 441021, Hubei, China.
| | - Lei Shang
- Department of Health Statistics, Shaanxi Key Laboratory of Free Radical Biology and Medicine and the Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University of PLA, Changle West Road No. 169, Xi'an, 710032, Shaanxi, China.
| |
Collapse
|
3
|
Design of the Rural LEAP randomized trial: An evaluation of extended-care programs for weight management delivered via group or individual telephone counseling. Contemp Clin Trials 2018; 76:55-63. [PMID: 30408606 DOI: 10.1016/j.cct.2018.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/01/2018] [Accepted: 11/04/2018] [Indexed: 11/24/2022]
Abstract
Obesity is a major contributor to the greater prevalence of chronic disease morbidity and mortality observed in rural versus nonrural areas of the U.S. Nonetheless, little research attention has been given to modifying this important driver of rural/urban disparities in health outcomes. Although lifestyle treatments produce weight reductions of sufficient magnitude to improve health, the existing research is limited with respect to the long-term maintenance of treatment effects and the dissemination of services to underserved populations. Recent studies have demonstrated the feasibility of delivering lifestyle programs through the infrastructure of the U.S. Cooperative Extension Service (CES), which has >2900 offices nationwide and whose mission includes nutrition education and health promotion. In addition, several randomized trials have shown that supplementing lifestyle treatment with extended-care programs consisting of either face-to-face sessions or individual telephone counseling can improve the maintenance of weight loss. However, both options entail relatively high costs that inhibit adoption in rural communities. The delivery of extended care via group-based telephone intervention may represent a promising, cost-effective alternative that is well suited to rural residents who tend to be isolated, have heightened concerns about privacy, and report lower quality of life. The Rural Lifestyle Eating and Activity Program (Rural LEAP) is a randomized trial, conducted via CES offices in rural communities, targeted to adults with obesity (n = 528), and designed to evaluate the effectiveness and cost-effectiveness of extended-care programs delivered via group or individual telephone counseling compared to an education control condition on long-term changes in body weight.
Collapse
|
4
|
Impact of the LIFESTEPS Weight Management Program on Measures of Adiposity, Self-Efficacy, and Lifestyle Behaviors. TOP CLIN NUTR 2018. [DOI: 10.1097/tin.0000000000000144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
5
|
Burgess E, Hassmén P, Welvaert M, Pumpa KL. Behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity: a systematic review and meta-analysis. Clin Obes 2017; 7:105-114. [PMID: 28199047 DOI: 10.1111/cob.12180] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 12/10/2016] [Accepted: 12/21/2016] [Indexed: 11/30/2022]
Abstract
Poor adherence to lifestyle intervention remains a key factor hindering treatment effectiveness and health outcomes for adults with obesity. The aim of this systematic review and meta-analysis is to determine if behavioural treatment strategies (e.g. goal setting, motivational interviewing, relapse prevention, cognitive restructuring etc.) improve adherence to lifestyle intervention programmes in adults with obesity. Randomized controlled trials that investigated the use of behavioural treatment strategies in obesity management were identified by systematically reviewing the literature within Medline, PsycINFO, CINAHL, SPORTDiscus and Web of Science from their inception to August 2016. This meta-analysis shows that behavioural treatment interventions have a significant positive effect on session attendance (percentage) and physical activity (total min/week) in adults with obesity (M = 17.63 (95% confidence interval (CI) = 10.77, 24.50), z =5.0337, P < 0.0001 and M = 105.98 (95% CI = 58.64, 153.32), z =4.3878, P < 0.0001, respectively). This meta-analysis of randomized controlled trials provides evidence that behavioural treatment strategies improve adherence to lifestyle intervention programmes in adults with obesity. These strategies should be routinely incorporated into lifestyle intervention, obesity management and weight loss programmes with the aim of improving engagement and adherence. If adherence were improved, treatment effectiveness, health outcomes and the ultimate burden of chronic disease could also be improved.
Collapse
Affiliation(s)
- E Burgess
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - P Hassmén
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- School of Health and Human Sciences, Southern Cross University, Lismore, Australia
| | - M Welvaert
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- Innovation, Research and Development, Australian Institute of Sport, Canberra, Australia
| | - K L Pumpa
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
- Discipline of Sport and Exercise Science, University of Canberra, Canberra, Australia
| |
Collapse
|
6
|
Nam SS, Sunoo S, Park HY, Moon HW. The effects of long-term whole-body vibration and aerobic exercise on body composition and bone mineral density in obese middle-aged women. J Exerc Nutrition Biochem 2016; 20:19-27. [PMID: 27508150 PMCID: PMC4977903 DOI: 10.20463/jenb.2016.06.20.2.3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/03/2016] [Accepted: 05/12/2016] [Indexed: 11/22/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the effectiveness of whole-body passive vibration exercise and its differences from aerobic exercise on body composition, bone mineral density (BMD) and bone mineral content (BMC). METHODS Obese middle-aged women (n=33 out of 45) with 34±3% body fat completed the training protocol. They were randomly assigned into diet (n=9; control group), diet plus whole-body vibration exercise (n=13; vibration group), and diet plus aerobic exercise (n=11; aerobic group) groups and we compared their body composition, BMD, and BMC before and after 9 months of training. There were no significant differences in nutrient intake among groups during the training period. RESULTS Relative body fat (%) decreased significantly (p < .05) in all three groups and the exercise groups showed a greater reduction in fat mass than the diet only group. BMD in the whole body, lumbar spine, hip and forearm were not significantly different among the three groups. Total body BMC increased significantly in the vibration group throughout the first 6 months of training. CONCLUSION Results suggest that long- term vibration training when used in conjunction with a diet program is as effective as aerobic exercise with a diet program in improving body composition of obese middle-aged women without compromising BMC or BMD. Thus, it can be considered a novel and effective method for reducing body fat.
Collapse
Affiliation(s)
- Sang-Seok Nam
- Department of Sports Medicine, Kyung Hee University, Yongin-si Republic of Korea
| | - Sub Sunoo
- Department of Sports Medicine, Kyung Hee University, Yongin-si Republic of Korea
| | - Hun-Young Park
- Department of Sports Medicine, Kyung Hee University, Yongin-siRepublic of Korea; Performance Activity and Performance Institute, Konkuk University, SeoulRepublic of Korea
| | - Hwang-Woon Moon
- Department of Sports and Outdoors, Eulji University, Yangji-dong, Seongnam-si Republic of Korea
| |
Collapse
|
7
|
Long-term weight status in regainers after weight loss by lifestyle intervention: status and challenges. Proc Nutr Soc 2014; 73:509-18. [PMID: 25192545 DOI: 10.1017/s0029665114000718] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
After having participated in a weight loss trial, most participants do not stabilise the obtained weight loss but return to their initial weight. The aim of this review is to describe the main determinants of continued low weight status after weight loss, and the effectiveness of physical activity (PA), energy restriction and macronutrient composition of the diet for low long-term weight regain. Studies with intervention periods of at least 3 months duration of weight reduction measures and a follow-up at least 2 years after the intervention period were considered as eligible for the review. Owing to limited data, the studies describing the role of PA in weight management were eligible with a follow-up of 1 year only. It appears that a diet with self-regulation of dietary intake seems to be given a prominent role in the strategy of successful long-term weight loss among the obese. This measure could be combined with behaviour therapy and PA and tailored to the individual situation. However, considering available evidence it is difficult to conclude regarding unambiguous measures and to recommend a specific dietary intervention. Nevertheless, interventions should be effective in promoting intrinsic motivation and self-efficacy. The harmonisation and standardisation of data collection in the follow-up period of long-term weight loss studies is a major challenge.
Collapse
|
8
|
Morton D, Rankin P, Kent L, Dysinger W. The Complete Health Improvement Program (CHIP): History, Evaluation, and Outcomes. Am J Lifestyle Med 2014; 10:64-73. [PMID: 30202259 DOI: 10.1177/1559827614531391] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 01/31/2014] [Indexed: 12/25/2022] Open
Abstract
The Complete Health Improvement Program (CHIP) is a premier lifestyle intervention targeting chronic disease that has been offered for more than 25 years. The intervention has been used in clinical, corporate, and community settings, and the short-term and long-term clinical benefits of the intervention, as well as its cost-effectiveness, have been documented in more than 25 peer-reviewed publications. Being an easily administered intervention, CHIP has been presented not only by health professionals but also by non-health-trained volunteers. The benefits of the program have been extensively studied under these 2 delivery channels, consistently demonstrating positive outcomes. This article provides a brief history of CHIP and describes the content and structure of the intervention. The published evaluations and outcomes of the intervention are presented and discussed and future directions are highlighted.
Collapse
Affiliation(s)
- Darren Morton
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia (DM, PR, LK).,Department of Preventive Medicine, Loma Linda University, Loma Linda, California (WD)
| | - Paul Rankin
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia (DM, PR, LK).,Department of Preventive Medicine, Loma Linda University, Loma Linda, California (WD)
| | - Lillian Kent
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia (DM, PR, LK).,Department of Preventive Medicine, Loma Linda University, Loma Linda, California (WD)
| | - Wayne Dysinger
- Lifestyle Research Centre, Avondale College of Higher Education, Cooranbong, New South Wales, Australia (DM, PR, LK).,Department of Preventive Medicine, Loma Linda University, Loma Linda, California (WD)
| |
Collapse
|
9
|
Brunyé TT, Hayes JF, Mahoney CR, Gardony AL, Taylor HA, Kanarek RB. Get in my belly: food preferences trigger approach and avoidant postural asymmetries. PLoS One 2013; 8:e72432. [PMID: 24023618 PMCID: PMC3758305 DOI: 10.1371/journal.pone.0072432] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 07/09/2013] [Indexed: 11/18/2022] Open
Abstract
Appetitive motivational states are fundamental neural and behavioral mechanisms underlying healthy and abnormal eating behavior, though their dynamic influence on food-related behavior is unknown. The present study examined whether personal food-related preferences would activate approach and avoidance systems, modulating spontaneous postural sway toward and away from food items. Participants stood on a balance board that collected real-time data regarding postural sway along two axes (x, y) while they viewed a series of images depicting food items varying in nutritional value and individual preferences. Overall, participants showed reliable postural sway toward highly preferred and away from highly non-preferred items. This effect became more pronounced over time; sway along the mediolateral axis showed no reliable variation by preference. Results carry implications for two-factor (homeostatic versus hedonic) neurobehavioral theories of hunger and appetitive motivation, and carry applied clinical implications for the measurement and management of abnormal eating behavior.
Collapse
Affiliation(s)
- Tad T. Brunyé
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
- Cognitive Science, United States Army Natick Soldier Research, Development & Engineering Center, Natick, Massachusetts, United States of America
- * E-mail:
| | - Jackie F. Hayes
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
- Cognitive Science, United States Army Natick Soldier Research, Development & Engineering Center, Natick, Massachusetts, United States of America
| | - Caroline R. Mahoney
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
- Cognitive Science, United States Army Natick Soldier Research, Development & Engineering Center, Natick, Massachusetts, United States of America
| | - Aaron L. Gardony
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
- Cognitive Science, United States Army Natick Soldier Research, Development & Engineering Center, Natick, Massachusetts, United States of America
| | - Holly A. Taylor
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
| | - Robin B. Kanarek
- Department of Psychology, Tufts University, Medford, Massachusetts, United States of America
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts, United States of America
| |
Collapse
|
10
|
Eto M, Ohkawara K, Sasai H, Tsujimoto T, So R, Matsuo T, Ohkubo H, Tanaka K. Efficiency of a free-living physical activity promotion program following diet modification for fat loss in Japanese obese men. J Nutr Sci Vitaminol (Tokyo) 2013; 58:384-92. [PMID: 23419396 DOI: 10.3177/jnsv.58.384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of the current study was to examine the efficiency of a free-living physical activity promotion (PAP) program following a diet modification program for fat loss. Fifty obese men, aged 51.4±7.0 y, received a 6-mo regimen consisting of 2 phases. Weekly 90-min free-living PAP sessions were provided for 3 mo immediately after a 3-mo diet modification phase. Fat mass (FM) was measured at baseline and at months 3 and 6 using dual energy X-ray absorptiometry. The time spent in moderate-vigorous physical activity (MVPA) was monitored by a validated single-axis accelerometer. The total energy intake of all participants was assessed at baseline and during weeks 9 and 10 of both the diet modification and PAP programs. The change (Δ) in FM was -1.4±1.9 kg (p<0.05) during the PAP program after the diet modification program (-4.3±2.9 kg, p<0.01). Although there was no significant relationship between ΔFM and ΔMVPA during the PAP phase (p=0.11), MVPA was significantly increased during the PAP phase (+76.0±146.5 min/wk, p<0.01). However, a significant correlation was observed between energy intake/weight and MVPA during the PAP program (r=0.39). Our results suggest that the magnitude of expected FM loss induced by an increase in PA may be suppressed as a result of increased energy intake, even during a PAP program after a diet modification program.
Collapse
Affiliation(s)
- Miki Eto
- Doctoral Program in Sports Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Martin J, Chater A, Lorencatto F. Effective behaviour change techniques in the prevention and management of childhood obesity. Int J Obes (Lond) 2013; 37:1287-94. [PMID: 23756676 DOI: 10.1038/ijo.2013.107] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 05/29/2013] [Accepted: 06/02/2013] [Indexed: 11/09/2022]
Abstract
Rates of childhood obesity are increasing, and it is essential to identify the active components of interventions aiming to prevent and manage obesity in children. A systematic review of behaviour change interventions was conducted to find evidence of behaviour change techniques (BCTs) that are most effective in changing physical activity and/or eating behaviour for the prevention or management of childhood obesity. An electronic search was conducted for randomised controlled trials published between January 1990 and December 2009. Of 4309 titles and abstracts screened, full texts of 135 articles were assessed, of which 17 published articles were included in this review. Intervention descriptions were coded according to the behaviour-specific CALO-RE taxonomy of BCTs. BCTs were identified and compared across obesity management (n=9) vs prevention (n=8) trials. To assess the effectiveness of individual BCTs, trials were further divided into those that were effective (defined as either a group reduction of at least 0.13 body mass index (BMI) units or a significant difference in BMI between intervention and control groups at follow-up) vs non-effective (reported no significant differences between groups). We reliably identified BCTs utilised in effective and non-effective prevention and management trials. To illustrate the relative effectiveness of each BCT, effectiveness ratios were calculated as the ratio of the number of times each BCT was a component of an intervention in an effective trial divided by the number of times they were a component of all trials. Results indicated six BCTs that may be effective components of future management interventions (provide information on the consequences of behaviour to the individual, environmental restructuring, prompt practice, prompt identification as role model/position advocate, stress management/emotional control training and general communication skills training), and one that may be effective in prevention interventions (prompting generalisation of a target behaviour). We identified that for management trials, providing information on the consequences of behaviour in general was a feature of non-effective interventions and for prevention trials, providing information on the consequences of behaviour in general, providing rewards contingent on successful behaviour and facilitating social comparison were non-effective. To design effective behaviour change programmes for the prevention and management of childhood obesity, we would recommend utilising the BCTs identified as effective in this review. The impact on intervention effectiveness of combining BCTs should be the topic of further research.
Collapse
Affiliation(s)
- J Martin
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | | |
Collapse
|
12
|
Jacobson D, Melnyk BM. A primary care healthy choices intervention program for overweight and obese school-age children and their parents. J Pediatr Health Care 2012; 26:126-38. [PMID: 22360932 DOI: 10.1016/j.pedhc.2010.07.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 06/28/2010] [Accepted: 07/10/2010] [Indexed: 11/29/2022]
Abstract
INTRODUCTION The escalating crisis of childhood overweight and obesity creates an urgent demand for evidence-based interventions that can be used by primary care providers. Therefore, the purpose of this study was to test the feasibility, acceptability, and preliminary efficacy of a theory-based Healthy Choices Intervention (HCI) Program with fifteen 9-12 year old overweight and obese children and their parents in a primary care setting. METHODS A 1-group, 7-week pre-/posttest study design was used. Outcome measures included: body mass index (BMI) percentile, physical activity and nutrition knowledge, beliefs, choices and behaviors, anxiety, depression, self-concept, and social competence. RESULTS Children and parents found the HCI to be useful and informative. Positive effects of the HCI for the children included decreased BMI percentile, increased knowledge, beliefs, choices and behaviors, and self-control. Positive effects of the intervention for the parents included increased knowledge, beliefs, behaviors, and decreased anxiety. DISCUSSION This study provides evidence to support the feasibility, acceptability, and preliminary effects of the HCI with overweight and obese school-age children and their parents within a primary care setting.
Collapse
Affiliation(s)
- Diana Jacobson
- Arizona State University College of Nursing and Health Innovation, Phoenix, AZ 85004, USA.
| | | |
Collapse
|
13
|
Dalton WT, Kitzmann KM. A Preliminary Investigation of Stimulus Control, Self-Monitoring, and Reinforcement in Lifestyle Interventions for Pediatric Overweight. Am J Lifestyle Med 2011. [DOI: 10.1177/1559827611402582] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective. The current study examined the use of stimulus control, self-monitoring, and reinforcement by youth, parents, and interventionists as related to weight management in lifestyle intervention programs. Design. Secondary analysis of an existing data set was used to integrate the results of 14 published, randomized treatment–control intervention trials for overweight youth aged 2 to 18 years. Main outcome measure. Between-group differences in weight-related outcomes, including weight, body mass index (BMI), and percentage overweight, measured at the end of treatment, were used to calculate effect sizes for each treatment–control comparison. Additionally, average effect sizes were calculated among sets of comparisons sharing similar approaches to implementing behavioral techniques. Results. Treatment programs that taught youth to use stimulus control, taught youth to self-monitor, and taught parents to use reinforcement, produced significantly larger effect sizes than programs that did not include these components. The beneficial effects of these specific behavioral techniques appeared to be amplified when used with multiple key individuals. Conclusion. This initial study quantitatively demonstrated significant benefits associated with teaching youth stimulus control and self-monitoring, and teaching parents reinforcement to shape health behaviors in lifestyle interventions for pediatric overweight. Furthermore, teaching youth and parents the same techniques may contribute to better weight-related outcomes. These findings and descriptive information on how techniques were described, taught, and delivered may guide future research efforts aimed at identifying and examining the most effective behavioral components to include in brief interventions.
Collapse
Affiliation(s)
- William T. Dalton
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee (WTD)
- Department of Psychology, University of Memphis, Memphis, Tennessee (KMK)
| | - Katherine M. Kitzmann
- Department of Psychology, East Tennessee State University, Johnson City, Tennessee (WTD)
- Department of Psychology, University of Memphis, Memphis, Tennessee (KMK)
| |
Collapse
|
14
|
Svensson M, Lagerros YT. Motivational technologies to promote weight loss--from internet to gadgets. PATIENT EDUCATION AND COUNSELING 2010; 79:356-360. [PMID: 20378298 DOI: 10.1016/j.pec.2010.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Revised: 03/04/2010] [Accepted: 03/06/2010] [Indexed: 05/29/2023]
Affiliation(s)
- Madeleine Svensson
- Karolinska Institutet, Unit of Clinical Epidemiology, Stockholm, Sweden.
| | | |
Collapse
|
15
|
Cullen KW, Lara Smalling A, Thompson D, Watson KB, Reed D, Konzelmann K. Creating healthful home food environments: results of a study with participants in the expanded food and nutrition education program. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2009; 41:380-388. [PMID: 19879493 DOI: 10.1016/j.jneb.2008.12.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 12/16/2008] [Accepted: 12/24/2008] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate a modified curriculum for the 6-session Texas Expanded Food and Nutrition Education Program (EFNEP) promoting healthful home food environments and parenting skills related to obesity prevention. DESIGN Two-group randomized control trial; intervention versus usual EFNEP curriculum. SETTING Texas EFNEP classes. PARTICIPANTS 1,104 EFNEP clients in 100 classes. INTERVENTION Six short videos, with goal setting, problem solving, guided discussion, and handouts, incorporated into existing EFNEP classes. MAIN OUTCOME MEASURES Body mass index (BMI), diet, psychosocial variables with baseline measurements, immediately post, and 4 months later. ANALYSIS Mixed-model repeated measures analysis of variance. RESULTS 100 classes were randomized (54 intervention/46 comparison), with 1,006 participants at baseline (582 intervention, 424 comparison, 97% women, 89% Hispanic). Significant improvements over time were found for both groups' consumption of most food items and nutrients, and nearly all psychosocial variables, regardless of study group. Only the intervention group had a significant BMI decrease at post. Fidelity to the intervention class session structure was high, and comments from intervention staff and clients were positive. CONCLUSION AND IMPLICATIONS Existing EFNEP programs in local communities could have a significant impact on family dietary behaviors for populations at risk of obesity. Replication with similar populations is warranted.
Collapse
Affiliation(s)
- Karen Weber Cullen
- USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030-2600, USA.
| | | | | | | | | | | |
Collapse
|
16
|
Corbalán MD, Morales EM, Canteras M, Espallardo A, Hernández T, Garaulet M. Effectiveness of cognitive-behavioral therapy based on the Mediterranean diet for the treatment of obesity. Nutrition 2009; 25:861-9. [PMID: 19539176 DOI: 10.1016/j.nut.2009.02.013] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Revised: 01/08/2009] [Accepted: 02/05/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The Mediterranean dietary pattern improves cardiovascular disease factors. More research is needed on the usefulness of a Mediterranean dietary pattern in terms of weight loss. The objective of this study was to assess the effectiveness of behavioral therapy based on the Mediterranean diet for the treatment of obesity and to determine the main obstacles to weight loss. METHODS A total of 1406 obese subjects (body mass index, 31+/-5kg/m(2)), aged 20-65 y, from a Mediterranean area in southeast Spain were subjected to a weight-reduction program. To evaluate effectiveness, weight loss, body fat distribution, biochemical variables, blood pressure changes, mean duration of treatment, percentage of attrition, and the ability to fulfill a Mediterranean diet pattern were assessed. To determine the main barriers to losing weight, a "Barriers to Weight Loss" checklist was completed. RESULTS The behavioral therapy program was effective for the treatment of obesity. The average weight loss was 7.7kg. The duration of treatment was 34 wk. Eighty-nine percent of subjects fulfilled the Mediterranean principles during the program, and all the variables studied were significantly improved. Attrition was 4-9%, with the main reason being stress (37%). Main obstacles to weight loss were "losing motivation," being "prone to stress-related eating," and being liable to eat when bored. Recording food intake and assisting group therapy were also important tools for losing weight (P< or =0.05). CONCLUSIONS Dietary/behavioral treatment based on Mediterranean dietary principles is effective in clinical practice. Nutrition professionals should encourage their patients to record food intake and to attend group therapy.
Collapse
|
17
|
Abstract
INTRODUCTION Overweight and obesity are causes for numerous non-communicable chronic diseases. In recent years their incidence have become a major epidemiological problem both in Poland and many other countries. PURPOSE Evaluation of the current situation of the overweight and obesity prevalence among adults in Poland and changes in this regard in the years 1983-2005. MATERIAL AND METHODS Review of the countrywide research and research in selected towns and regions on overweight and obesity occurrence conducted in Poland over the last 20 years. RESULTS On the basis of national data for Poland, the incidence of overweight is estimated to be 39-40% among men and 28-29% among women, while the percentage of obese men and women is 16-21% and 19-22% respectively. The incidence of overweight and obesity differs with respect to gender, age, environment, the region of the country and social status. Excessive body weight is often observed in patients treated in hospitals. Abdominal obesity is very common and according to the ATP III guidelines, affects 16-28% of men and 35-40% of women, whereas under more strict IDF criteria it involves almost 40% of adult males and almost a half of adult females. CONCLUSIONS Results from numerous surveys conducted in the last few years indicate growth of the incidence of overweight and obesity, especially among men. The prevalence of overweight and obesity in Poland is comparable with most European countries.
Collapse
|