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Behr H, Earl S, Ho AS, Lee J, Mitchell ES, McCallum M, May CN, Michaelides A. Changes in Health-Promoting Behaviors and Their Association with Weight Loss, Retention, and Engagement on a Digital Program: Prospective Study. Nutrients 2022; 14:nu14224812. [PMID: 36432498 PMCID: PMC9699210 DOI: 10.3390/nu14224812] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 10/10/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Health-promoting lifestyle behaviors (e.g., as measured by the HPLP-II) are associated with reductions in lifestyle disease mortality, as well as improved well-being, mental health, and quality of life. However, it is unclear how a weight-management program relates to a broad range of these behaviors (i.e., health responsibility, physical activity, nutrition, spiritual growth, interpersonal relations, and stress management), especially a fully digital program on which individuals have to self-manage their own behaviors in their daily lives (with assistance from a virtual human coach). In the context of a digital setting, this study examined the changes in health-promoting behaviors over 12 months, as well as the associations between health-promoting behaviors and weight loss, retention, and engagement, among participants who self-enrolled in a mobile CBT-based nutritionally focused behavior change weight management program (n = 242). Participants lost a statistically significant amount of weight (M = 6.7 kg; SD = 12.7 kg; t(80) = 9.26, p < 0.001) and reported significantly improved overall health-promoting lifestyle behaviors (i.e., HPLP-II summary scores), as well as, specifically, health responsibility, physical activity, nutrition, spiritual growth, stress management, and interpersonal relations behaviors from baseline to 6 months and from 6 months to 12 months (all ps < 0.008). Health-promoting behaviors at 6 months (i.e., learned health-promoting behaviors) compared to baseline were better predictors of retention and program engagement. A fully digital, mobile weight management intervention can improve HPLP-II scores, which, in turn, has implications for improved retention, program engagement, and better understanding the comprehensive effects of weight management programs, particularly in a digital setting.
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Affiliation(s)
- Heather Behr
- Department of Integrative Health, Saybrook University, 55 W Eureka St., Pasadena, CA 91103, USA
| | - Sydney Earl
- Department of Psychology, North Carolina State University, Poe Hall, 2310 Stinson Dr., Raleigh, NC 27695, USA
| | - Annabell Suh Ho
- Academic Research, Noom, 450 W 33rd St., New York, NY 10001, USA
| | - Jihye Lee
- Moody College of Communication, The University of Texas at Austin, 300 W Dean Keeton St., Austin, TX 78712, USA
| | | | - Meaghan McCallum
- Academic Research, Noom, 450 W 33rd St., New York, NY 10001, USA
| | - Christine N. May
- Academic Research, Noom, 450 W 33rd St., New York, NY 10001, USA
- Correspondence:
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