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LaRose JG, Gorin AA, Fava JL, Bean MK, Lanoye A, Robinson E, Carey K. Using motivational interviewing to enhance emerging adults' engagement in weight loss: The Live Well RVA pilot randomized clinical trial. Obes Sci Pract 2020; 6:460-472. [PMID: 33082988 PMCID: PMC7556426 DOI: 10.1002/osp4.435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 05/07/2020] [Accepted: 05/10/2020] [Indexed: 11/15/2022] Open
Abstract
Background Emerging adults (ages 18–25) are at high risk for overweight/obesity, yet traditional adult behavioural weight loss (BWL) interventions do not meet the needs of individuals at this developmental stage. Motivational interviewing (MI) is an evidence‐based approach to promote behaviour change but has not been tested for weight loss in this population. The study aimed to test the feasibility and preliminary efficacy of an MI‐enhanced weight loss programme to promote engagement, retention and weight loss in emerging adults. Methods Emerging adults with overweight/obesity (N = 47, 81% female, 47% racial/ethnic minority, body mass index [BMI] = 33.2 ± 4.6 kg/m2) were randomized to either standard BWL or MI‐enhanced BWL (MIBWL). Weight was assessed objectively at baseline and posttreatment (3 months). Engagement (in‐person session attendance [weeks 1 and 2], online self‐monitoring [weeks 3–12] and online content viewing [weeks 3–12]) was tracked throughout the program. Results Though results did not reach the level of statistical significance, participants in MIBWL demonstrated greater programme engagement (77% vs. 61.0%, p = .11; Cohen d = .48), retention (71% vs. 48.0%, p = .10; Cohen h = .47) and intent‐to‐treat weight loss (−3.3% vs. −2.2%, p = .37; Cohen d = .26) compared with those in BWL. Conclusions Effect sizes suggest that MI might be a viable approach to enhance engagement and retention in weight loss programmes targeting emerging adults. This finding is meaningful, given the documented challenges with engagement and retention in this vulnerable population and the relationship between engagement and better weight loss outcomes. The results of this small pilot study support efforts to replicate these findings within the context of a fully powered trial.
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Affiliation(s)
- Jessica Gokee LaRose
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA
| | - Amy A Gorin
- Department of Psychological Sciences University of Connecticut Mansfield Connecticut USA.,Institute for Collaboration on Health, Intervention, and Policy University of Connecticut Mansfield Connecticut USA
| | - Joseph L Fava
- Weight Control and Diabetes Research Center The Miriam Hospital Providence Rhode Island USA
| | - Melanie K Bean
- Department of Pediatrics Children's Hospital of Richmond at Virginia Commonwealth University Richmond Virginia USA
| | - Autumn Lanoye
- Department of Health Behavior and Policy Virginia Commonwealth University School of Medicine Richmond Virginia USA
| | - Elizabeth Robinson
- Department of Pediatrics Children's Hospital of Richmond at Virginia Commonwealth University Richmond Virginia USA.,Summit Emotional Health Richmond Virginia USA
| | - Kate Carey
- Department of Behavioral and Social Sciences Brown University School of Public Health Providence Rhode Island USA
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LaRose JG, Leahey TM, Lanoye A, Reading J, Wing RR. A Secondary Data Analysis Examining Young Adults' Performance in an Internet Weight Loss Program with Financial Incentives. Obesity (Silver Spring) 2020; 28:1062-1067. [PMID: 32374527 PMCID: PMC7380503 DOI: 10.1002/oby.22797] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 02/20/2020] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In traditional behavioral weight loss (BWL) programs, young adults fare worse than older adults with respect to engagement, retention, and weight loss, but money and use of technology have been cited as program factors that might improve outcomes for this population. This study evaluated young adult performance in internet-based BWL (IBWL) offering financial incentives for self-monitoring and weight loss. METHODS Participants (N = 180; BMI = 33.2 ± 6.0 kg/m2 ) were randomly assigned to a 12-week IBWL or IBWL + incentives (IBWL + $) group. This secondary data analysis compared young adults (ages 18-35) in IBWL (n = 16) with young adults in IBWL + $ (n = 12) on percent weight loss, engagement, and retention. Young adults (n = 28) were also compared with older adults (ages 36-70; n = 152) on these outcomes. RESULTS Young adult weight loss was -2.8% ± 5.2% in IBWL and -5.4% ± 5.7% in IBWL + $ (P = 0.23, partial η2 = 0.06). A greater proportion of young adults in IBWL + $ achieved a 10% weight loss compared with IBWL (42% vs. 6%, P = 0.02). Compared with older adults, young adults were less engaged, but there were no differences for retention or weight loss (P values > 0.05). CONCLUSIONS Findings suggest that technology-based BWL has the potential to eliminate weight loss disparities observed between young adults and older adults in in-person BWL trials. Moreover, adding financial incentives holds promise for promoting clinically meaningful weight loss for young adults.
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Affiliation(s)
- Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Tricia M Leahey
- Department of Allied Health Services, University of Connecticut, Storrs, Connecticut, USA
| | - Autumn Lanoye
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jean Reading
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Rena R Wing
- Weight Control and Diabetes Research Center, Miriam Hospital, Providence, Rhode Island, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island, USA
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Bihuniak JD, Bryant T, Kleiman J, Rotondo M, Decoteau J, Haisley S, Monserrate D, Cunningham M, MacKenzie A, Dauz S, Ippolito R, Fernandes N, LaRose JG, Leahey TM. Behavioural weight loss treatment preferences of college students with overweight and obesity. Clin Obes 2020; 10:e12343. [PMID: 31613059 DOI: 10.1111/cob.12343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 09/04/2019] [Accepted: 09/11/2019] [Indexed: 01/08/2023]
Abstract
The college environment increases risk of weight gain in young adults with overweight/obesity. Behavioural weight loss interventions are proven effective, however, young adults' adherence to such programs is poor. The purpose of the study was to determine weight loss treatment preferences of 2- and 4-year college students for the development of population-specific interventions. Students with a BMI ≥25, between 18 and 24 years of age, and enrolled in one of four institutions were recruited. A questionnaire was developed to assess students' preferences and was administered via Qualtrics. BMI was calculated from objectively assessed height and weight measurements. Descriptive analyses, chi-square, Fisher's Exact Test, Mann-Whitney U test and Cramer's V were performed. Participants (n = 133, age = 20.2 ± 1.8) predominately identified as female (70%), non-Hispanic (68%) and Black/African American (32%) or White (32%). Fifty-five percent met criteria for obesity. Most students preferred session length of ≤1 hour (78%), for meetings to be held on a weekday (70%) and for both a peer and a professional to co-facilitate meetings (61%). Preferences for health outcomes and physical activity monitoring, type of physical activity, frequency of dietary monitoring, physical activity tracking method and interest in financial incentives to promote core treatment components differed between institutions. Heterogeneity in program preferences by college environment should be considered when designing weight loss interventions.
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Affiliation(s)
- Jessica D Bihuniak
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Tiffany Bryant
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Jennifer Kleiman
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
| | - Megan Rotondo
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Jessica Decoteau
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
| | - Samantha Haisley
- Department of Nutrition and Food Studies, Steinhardt School of Culture, Education, and Human Development, New York University, New York, New York
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - David Monserrate
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Michael Cunningham
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Allison MacKenzie
- Health and Exercise Science Program, Manchester Community College, Manchester, Connecticut
| | - Steve Dauz
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Rosann Ippolito
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Nicolle Fernandes
- Health Sciences Department, LaGuardia Community College, Long Island City, New York
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Tricia M Leahey
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut
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Robinson R, Roberson KB, Onsomu EO, Dearman C, Nicholson YM, Price AA, Duren-Winfield V. Perceived Risk of Cardiovascular Disease and Health Behaviors in Black College Students. JOURNAL OF BEST PRACTICES IN HEALTH PROFESSIONS DIVERSITY : RESEARCH, EDUCATION AND POLICY 2019; 12:24-45. [PMID: 32905472 PMCID: PMC7470036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
For college students, the transition from adolescence to young adulthood can be a time of increased stress and negative health behaviors, such as poor diet and physical inactivity, that may lead to cardiovascular disease (CVD), the primary cause of death in the United States. Blacks are disproportionately prone to CVD. Perception of disease risk is a critical predictor of engagement in healthy lifestyle activities intended to reduce CVD development. This project examined the relationship between perceived risk of CVD and health behaviors in Black HBCU students aged 18-25 years. All participants (n = 14) perceived that they were not at risk for heart disease within the next 10 years. Almost half (n = 6, 42.86%) had moderately high CVD risk scores, and three (21.43%) were at high risk for developing CVD. Scores on the subscales for dread risk, risk, and unknown risk were 28.29, 37.67, and 43.86, respectively. Total scores for perceived risk of heart disease ranged from 20 to 80. The Spearman's correlation between these Black college students' perceived dread risk and health responsibility was positive and moderately correlated (rs = 0.62, p = 0.019). A negative and moderate correlation was demonstrated between unknown perceived risk and health responsibility (rs = -0.54, p = 0.046). Thus, higher risk perception is correlated with greater health responsibility, while low risk perception is correlated with less health responsibility. Barriers to healthy lifestyle behaviors identified by the sample included lack of time and sleep, physical inactivity, cost, convenience of unhealthy foods, and low perception of developing CVD. A major implication is the benefit of implementing interventions to modify risk perception and college-specific barriers that increase CVD risk.
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Affiliation(s)
- Rhonda Robinson
- Division of Nursing, Winston-Salem State University, Winston-Salem, North Carolina
| | - Kristina B. Roberson
- Division of Nursing, Winston-Salem State University, Winston-Salem, North Carolina
| | - Elijah O. Onsomu
- Division of Nursing, Winston-Salem State University, Winston-Salem, North Carolina
| | | | - Yolanda M. Nicholson
- Student Health Center, North Carolina A&T State University, Greensboro, North Carolina
| | - Amanda Alise Price
- Department of Exercise Physiology, Winston-Salem State University, Winston-Salem, North Carolina
| | - Vanessa Duren-Winfield
- Department of Healthcare Management, Winston-Salem State University, Winston-Salem, North Carolina
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Abstract
PURPOSE OF REVIEW Emerging adulthood (age 18-25) represents a critical period for weight control: rate of weight gain is greatest during these years and the prevalence of overweight and obesity is estimated to be at least 40% among emerging adults. Unique behavioral, psychosocial, and cognitive risk factors among this population must be specifically addressed within weight management programs. We review extant treatment approaches, including lessons learned from the nascent literature specifically targeting this population. Lastly, we provide suggestions to inform future work in this area. RECENT FINDINGS The EARLY consortium comprises seven clinical trials targeting weight control in young adults age 18-35. Though these studies encompass a broader age range, two of the trials enrolled large numbers of 18-25-year-olds. Results from these trials and other recent pilot trials provide a foundation for next steps with respect to developing weight management interventions for emerging adults. The design of targeted weight control approaches for emerging and young adults has contributed to improved outcomes for this high-risk population. However, suboptimal engagement and variability in response pose challenges. Identifying and intervening on individual-level behavioral and psychological variables may enhance the effects of these adapted treatments.
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Affiliation(s)
- Autumn Lanoye
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street Box 842018, Richmond, VA, 23284, USA
| | - Kristal L Brown
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA
| | - Jessica G LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, Richmond, VA, 23219, USA.
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Assessing parents’ receptiveness to a vegetable-focussed in-school nutrition intervention. Appetite 2017; 117:359-364. [DOI: 10.1016/j.appet.2017.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 07/14/2017] [Accepted: 07/15/2017] [Indexed: 11/22/2022]
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Stevens J, Pratt C, Boyington J, Nelson C, Truesdale KP, Ward DS, Lytle L, Sherwood NE, Robinson TN, Moore S, Barkin S, Cheung YK, Murray DM. Multilevel Interventions Targeting Obesity: Research Recommendations for Vulnerable Populations. Am J Prev Med 2017; 52:115-124. [PMID: 28340973 PMCID: PMC5571824 DOI: 10.1016/j.amepre.2016.09.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 08/18/2016] [Accepted: 09/06/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The origins of obesity are complex and multifaceted. To be successful, an intervention aiming to prevent or treat obesity may need to address multiple layers of biological, social, and environmental influences. METHODS NIH recognizes the importance of identifying effective strategies to combat obesity, particularly in high-risk and disadvantaged populations with heightened susceptibility to obesity and subsequent metabolic sequelae. To move this work forward, the National Heart, Lung, and Blood Institute, in collaboration with the NIH Office of Behavioral and Social Science Research and NIH Office of Disease Prevention convened a working group to inform research on multilevel obesity interventions in vulnerable populations. The working group reviewed relevant aspects of intervention planning, recruitment, retention, implementation, evaluation, and analysis, and then made recommendations. RESULTS Recruitment and retention techniques used in multilevel research must be culturally appropriate and suited to both individuals and organizations. Adequate time and resources for preliminary work are essential. Collaborative projects can benefit from complementary areas of expertise and shared investigations rigorously pretesting specific aspects of approaches. Study designs need to accommodate the social and environmental levels under study, and include appropriate attention given to statistical power. Projects should monitor implementation in the multiple venues and include a priori estimation of the magnitude of change expected within and across levels. CONCLUSIONS The complexity and challenges of delivering interventions at several levels of the social-ecologic model require careful planning and implementation, but hold promise for successful reduction of obesity in vulnerable populations.
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Affiliation(s)
- June Stevens
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Charlotte Pratt
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Josephine Boyington
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Cheryl Nelson
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland
| | - Kimberly P Truesdale
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Dianne S Ward
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Leslie Lytle
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nancy E Sherwood
- HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - Thomas N Robinson
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California; Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Shirley Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
| | - Shari Barkin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ying Kuen Cheung
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York
| | - David M Murray
- Division of Program Coordination, Planning, and Strategic Initiatives, NIH, Bethesda, Maryland
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LaRose JG, Guthrie KM, Lanoye A, Tate DF, Robichaud E, Caccavale LJ, Wing RR. A mixed methods approach to improving recruitment and engagement of emerging adults in behavioural weight loss programs. Obes Sci Pract 2016; 2:341-354. [PMID: 28090339 PMCID: PMC5192532 DOI: 10.1002/osp4.71] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/25/2016] [Accepted: 08/26/2016] [Indexed: 11/23/2022] Open
Abstract
Objective Emerging adults ages 18–25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults. Purpose To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high‐risk population in BWL programs. Methods We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 (N = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 (N = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1. Results Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self‐improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in‐person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default. Conclusions An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.
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Affiliation(s)
- J G LaRose
- Virginia Commonwealth University School of Medicine Richmond VA USA; Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA; Alpert Medical School of Brown University Providence RI USA
| | - K M Guthrie
- Alpert Medical School of Brown University Providence RI USA; Centers for Behavioral and Preventive Medicine The Miriam Hospital Providence RI USA
| | - A Lanoye
- Virginia Commonwealth University School of Medicine Richmond VA USA
| | - D F Tate
- Gillings Global School of Public Health 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
| | - E Robichaud
- Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA
| | - L J Caccavale
- Virginia Commonwealth University School of Medicine Richmond VA USA
| | - R R Wing
- Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA; Alpert Medical School of Brown University Providence RI USA
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Laska MN, Lytle LA, Nanney MS, Moe SG, Linde JA, Hannan PJ. Results of a 2-year randomized, controlled obesity prevention trial: Effects on diet, activity and sleep behaviors in an at-risk young adult population. Prev Med 2016; 89:230-236. [PMID: 27283096 PMCID: PMC5038135 DOI: 10.1016/j.ypmed.2016.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 05/31/2016] [Accepted: 06/04/2016] [Indexed: 12/14/2022]
Abstract
Excess weight gain tends to occur in young adulthood. However, research examining effective weight-related interventions for this age group has been limited. As one of seven trials in the EARLY Trials consortium (Early Adult Reduction of weight through LifestYle intervention), the CHOICES Study (Choosing Healthy Options in College Environments and Settings) tested effects of a technology-integrated, young adult weight gain prevention intervention. It was a randomized controlled trial with assessments at baseline (2011) and 4-, 12- and 24-months post-intervention initiation and included 441 participants (ages 18-35) who were students at three Minnesota community colleges. The 24-month intervention included a 1-credit academic course and social networking and support online intervention. This analysis examined effects on 12 secondary behavioral outcomes across three domains: diet (fast food, sugary beverages, breakfast, at-home meal preparation), physical activity/screen time (minutes and energy expenditure in leisure time physical activity, television viewing, leisure time computer use) and sleep (hours of sleep, time required to fall asleep, days not getting enough rest, difficulty staying awake). The intervention resulted in significant reductions in fast food (p=0.007) but increases in difficulty staying awake (p=0.015). There was limited evidence of other behavior changes at 4months (0.05<p<0.1) in the expected direction but differences by treatment condition dissipated over time. Analyses examining summary treatment effects (i.e., modeling effects on all behavioral outcomes simultaneously) indicated significant overall effects (p=0.014), largely driven by 4-month results (p=0.005). Additional research is needed to understand effective obesity prevention among young adults, particularly when addressing multiple weight-related outcomes.
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Affiliation(s)
- Melissa N Laska
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA.
| | - Leslie A Lytle
- University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Marilyn S Nanney
- University of Minnesota, Medical School, Department of Family Medicine and Community Health, Minneapolis, MN, USA
| | - Stacey G Moe
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Jennifer A Linde
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
| | - Peter J Hannan
- University of Minnesota, School of Public Health, Division of Epidemiology and Community Health, Minneapolis, MN, USA
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Lanoye A, Gorin AA, LaRose JG. Young Adults' Attitudes and Perceptions of Obesity and Weight Management: Implications for Treatment Development. Curr Obes Rep 2016; 5:14-22. [PMID: 26923688 PMCID: PMC5621592 DOI: 10.1007/s13679-016-0188-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Young adults are underrepresented in standard behavioral weight loss trials, and evidence suggests that they differ from older adults on many weight-related constructs. The aim of this review is to explore young adults' attitudes toward obesity and weight management, with particular attention to those factors that may play a role in the development of future treatment efforts. Both intrapersonal and interpersonal considerations unique to young adulthood are assessed; in addition, we examine young adults' perceptions of specific weight-related behaviors such as dieting, physical activity, and self-weighing. Conclusions are consistent with other findings suggesting that weight management interventions should be adapted and designed specifically for this age group.
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Affiliation(s)
- Autumn Lanoye
- Department of Psychology, Virginia Commonwealth University, 806 West Franklin Street, PO Box 842018, Richmond, VA, 23284, USA
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, 4th Floor, Richmond, VA, 23219, USA
| | - Amy A Gorin
- Department of Psychology, Center for Health, Intervention, and Prevention, University of Connecticut, 2006 Hillside Road, Unit 1248, Storrs, CT, 06269, USA
| | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, 830 East Main Street, 4th Floor, Richmond, VA, 23219, USA.
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11
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Lam E, Partridge SR, Allman-Farinelli M. Strategies for successful recruitment of young adults to healthy lifestyle programmes for the prevention of weight gain: a systematic review. Obes Rev 2016; 17:178-200. [PMID: 26663091 DOI: 10.1111/obr.12350] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/28/2015] [Accepted: 09/30/2015] [Indexed: 12/12/2022]
Abstract
Recruiting healthy young adults, aged 18-35, to lifestyle programmes for prevention of weight gain is challenging but important given their increasing rates of obesity. This review aimed to examine the success of different recruitment strategies. A systematic literature search identified 26 separate studies using 10 electronic databases. Participant characteristics and efficacy of interventions were well reported in all studies, but reporting of recruitment procedures, costs, times and effectiveness was minimal. Of those reporting recruitment, both active (e.g. face-to-face) and passive (e.g. print-media and mass-mailings) approaches were identified with the latter most frequently employed. Novel strategies such as social media and marketing approaches were identified. Television and radio have potentially high reach but low efficiency with high cost compared with mass-mailings which yield high numbers of participants. Marketing campaigns appeared to be a promising approach. Incentives demonstrated enhanced recruitment. The use of formative research to guide recruitment strategies for interventions is recommended. Reporting of success, cost and timelines for recruitment should be included in reporting of future trials. This first synthesis of recruitment information can be used to inform recruitment frameworks for lifestyle programmes seeking to attract young adults.
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Affiliation(s)
- E Lam
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
| | - S R Partridge
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
| | - M Allman-Farinelli
- School of Molecular Bioscience, Charles Perkins Centre, University of Sydney, Sydney, 2006, Australia
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12
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Moe SG, Lytle LA, Nanney MS, Linde JA, Laska MN. Recruiting and retaining young adults in a weight gain prevention trial: Lessons learned from the CHOICES study. Clin Trials 2015; 13:205-13. [PMID: 26378096 DOI: 10.1177/1740774515605084] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND/AIMS Young adults are at risk of weight gain, but little is known about designing effective weight control trials for young adults or how to recruit and retain participants in these programs. The Choosing Healthy Options in College Environments and Settings (CHOICES) study evaluated the effectiveness of a weight gain prevention intervention for 2-year college students. We describe the methods used to recruit and retain the colleges and their students, describe the sample and discuss recommendations for future studies. METHODS Students were recruited into a 24-month trial of a weight control intervention with assessment periods at baseline, 4-, 12- and 24-month follow-up. RESULTS We successfully recruited 441 students through partnerships with three 2-year colleges through a variety of campus-based methods. Ultimately, 83.4% of the randomized cohort participated in the 24-month assessment period. Those retained more often were White (p = 0.03) compared to those who dropped out or were lost to follow-up; no other socio-demographic factor (e.g. gender, ethnicity and education), body mass index, body fat, waist circumference or weight status was observed to differ between randomly assigned groups. CONCLUSION Two-year colleges and their students are interested in participating in weight-related trials and partnering with universities for research. Researchers must work closely with administrators to identify benefits to their institutions and to resolve student-level barriers to recruitment and retention. Our experiences from the Choosing Healthy Options in College Environments and Settings study should be useful in identifying effective recruitment and retention methods for weight gain prevention trials among young adults.
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Affiliation(s)
- Stacey G Moe
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Leslie A Lytle
- Department of Health Behavior, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Marilyn S Nanney
- Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jennifer A Linde
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Melissa N Laska
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA
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Laska MN, Sevcik SM, Moe SG, Petrich CA, Nanney MS, Linde JA, Lytle LA. A 2-year young adult obesity prevention trial in the US: Process evaluation results. Health Promot Int 2015; 31:793-800. [PMID: 26135586 DOI: 10.1093/heapro/dav066] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Our objective was to conduct a process evaluation of the CHOICES (Choosing Healthy Options in College Environments and Settings) study, a large, randomized, controlled trial designed to prevent unhealthy weight gain in young adults (aged 18-35) attending 2-year community colleges in the USA. The 24-month intervention consisted of participation in an academic course and a social networking and support website. Among intervention participants, completion rates for most course activities were >80%, reflecting a high level of dose received. Course retention and participant satisfaction were also high. Engagement results, however, were mixed with less than half of participants in the online and hybrid sections of the course reporting that they interacted with course materials ≥3 h/week, but 50-75% reporting that they completed required lessons 'all/very thoroughly'. Engagement in the website activities was also mixed with more than half of intervention participants logging onto the website during the first month, but then declining to 25-40% during the following 23 months of the intervention. Intervention engagement is a challenge of online interventions and a challenge of working with the young adult age group in general. Additional research is needed to explore strategies to support engagement among this population, particularly for relatively long intervention durations.
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Affiliation(s)
- Melissa N Laska
- School of Public Health, Division of Epidemiology and Community Health and
| | - Sarah M Sevcik
- School of Public Health, Division of Epidemiology and Community Health and
| | - Stacey G Moe
- School of Public Health, Division of Epidemiology and Community Health and
| | | | - Marilyn S Nanney
- Medical School, Family Medicine and Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Jennifer A Linde
- School of Public Health, Division of Epidemiology and Community Health and
| | - Leslie A Lytle
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, Chapel Hill, NC, USA
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Partridge SR, Juan SJH, McGeechan K, Bauman A, Allman-Farinelli M. Poor quality of external validity reporting limits generalizability of overweight and/or obesity lifestyle prevention interventions in young adults: a systematic review. Obes Rev 2015; 16:13-31. [PMID: 25407633 DOI: 10.1111/obr.12233] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 09/09/2014] [Accepted: 09/29/2014] [Indexed: 12/22/2022]
Abstract
Young adulthood is a high-risk life stage for weight gain. Evidence is needed to translate behavioural approaches into community practice to prevent weight gain in young adults. This systematic review assessed the effectiveness and reporting of external validity components in prevention interventions. The search was limited to randomized controlled trial (RCT) lifestyle interventions for the prevention of weight gain in young adults (18-35 years). Mean body weight and/or body mass index (BMI) change were the primary outcomes. External validity, quality assessment and risk of bias tools were applied to all studies. Twenty-one RCTs were identified through 14 major electronic databases. Over half of the studies were effective in the short term for significantly reducing body weight and/or BMI; however, few showed long-term maintenance. All studies lacked full reporting on external validity components. Description of the intervention components and participant attrition rates were reported by most studies. However, few studies reported the representativeness of participants, effectiveness of recruitment methods, process evaluation detail or costs. It is unclear from the information reported how to implement the interventions into community practice. Integrated reporting of intervention effectiveness and enhanced reporting of external validity components are needed for the translation and potential upscale of prevention strategies.
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Affiliation(s)
- S R Partridge
- Discipline of Nutrition and Metabolism, School of Molecular Bioscience, University of Sydney, Sydney, New South Wales, Australia
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