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Directive and nondirective e-coach support for weight loss in overweight adults.

ABSTRACT: Although e-coach support increases the effectiveness of Internet weight loss interventions, no studies have assessed influence of type of e-coach support.The effects of nondirective (collaborative, flexible) and directive (prescriptive, protocol driven) e-coach support on weight loss, dietary behavior, physical activity, and engagement were assessed in a 12-week weight loss e-coaching program.Overweight adults (N?=?104) were randomly assigned to nondirective, directive, or minimal support. All received weekly lessons and feedback graphs via e-mail. Participants in the nondirective and directive support conditions received individualized nondirective or directive weight loss support.For females, weight loss (?(2)?=?0.10) and changes in waist circumference (?(2)?=?0.07) were greater in the directive than in the nondirective and minimal support conditions.Differences in type of e-coach support are salient to participants. Directive support is beneficial to females in a 12-week e-coach weight loss program.

SUBMITTER: Gabriele JM

PROVIDER: S-EPMC3891570 | biostudies-literature | 2011 Apr

REPOSITORIES: biostudies-literature

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Directive and nondirective e-coach support for weight loss in overweight adults.

Gabriele Jeanne Marisa JM Carpenter Brian D BD Tate Deborah F DF Fisher Edwin B EB

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 20110401 2

<h4>Background</h4>Although e-coach support increases the effectiveness of Internet weight loss interventions, no studies have assessed influence of type of e-coach support.<h4>Purpose</h4>The effects of nondirective (collaborative, flexible) and directive (prescriptive, protocol driven) e-coach support on weight loss, dietary behavior, physical activity, and engagement were assessed in a 12-week weight loss e-coaching program.<h4>Procedures</h4>Overweight adults (N = 104) were randomly assigned ...[more]

PMID: 21108032

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Project description:OBJECTIVE: To examine the associations between eating behavior traits and weight loss according to sleep quality and duration in adults enrolled in common weight-loss interventions. METHODS: Participants included overweight and obese men and women (n=150) (mean±s.d. age, 38.8±8.6 years; mean±s.d. body mass index (BMI), 33.3±3.5 kg m(-2)) who were subjected to a dietary intervention over a period of 12-16 weeks. Anthropometric measurements, eating behavior traits (Three-Factor Eating Questionnaire), sleep quality (total Pittsburgh Sleep Quality Index (PSQI) score) and sleep duration (hours per night, self-reported from the PSQI) were assessed at both baseline and post intervention. Linear regression analysis was used to quantify the relationships between eating behavior traits and changes in anthropometric markers for all subjects and by sleep categories (short sleep: <7 h per night vs recommended sleep: ⩾7 h per night; poor sleep quality: ⩾5 PSQI score vs good sleep quality: <5 PSQI score). We adjusted for age, sex and baseline BMI in analyses. RESULTS: Baseline eating behavior traits were modest predictors of weight-loss success, but they were all significantly associated with their changes over the weight-loss intervention (P<0.01). The diet intervention induced significant changes in eating behavior traits and even more for those having a non-favorable eating behavior profile at baseline. We observed that changes in flexible control and strategic dieting behavior were constantly negatively associated with changes in body weight and fat mass (P<0.05) for recommended duration sleepers. The change in situational susceptibility to disinhibition was positively associated with the change in fat mass and body weight for those having healthy sleeping habits (P<0.05). For poor quality sleepers, the change in avoidance of fattening foods was negatively associated with changes in adiposity (P<0.05). CONCLUSION: Eating behavior traits and sleep may act together to influence the outcome of weight-loss programs.

Project description:BackgroundTelephone quitlines can help employees quit smoking. Quitlines typically use directive coaching, but nondirective, flexible coaching is an alternative. Call-2-Quit used a worksite-sponsored quitline to compare directive and nondirective coaching modes, and evaluated employee race and income as potential moderators.MethodsAn unblinded randomized controlled trial compared directive and nondirective telephone coaching by trained laypersons. Participants were smoking employees and spouses recruited through workplace smoking cessation campaigns in a hospital system and affiliated medical school. Coaches were four non-medical women trained to use both coaching modes. Participants were randomized by family to coaching mode. Participants received up to 7 calls from coaches who used computer assisted telephone interview software to track topics and time. Outcomes were reported smoking abstinence for 7 days at last contact, 6 or 12 months after coaching began. Both worksites implemented new tobacco control policies during the study.ResultsMost participants responded to an insurance incentive introduced at the hospital. Call-2-Quit coached 518 participants: 22 % were African-American; 45 % had incomes below $30,000. Income, race, and intervention did not affect coaching completion rates. Cessation rates were comparable with directive and nondirective coaching (26 % versus 30 % quit, NS). A full factorial logistic regression model identified above median income (odds ratio = 1.8, p = 0.02), especially among African Americans (p = 0.04), and recent quit attempts (OR = 1.6, p = 0.03) as predictors of cessation. Nondirective coaching was associated with high cessation rates among subgroups of smokers reporting income above the median, recent quit attempts, or use of alternative therapies. Waiting up to 4 weeks to start coaching did not affect cessation. Of 41 highly addicted or depressed smokers who had never quit more than 30 days, none quit.ConclusionNondirective coaching improved cessation rates for selected smoking employees, but less expensive directive coaching helped most smokers equally well, regardless of enrollment incentives and delays in receiving coaching. Some subgroups had very low cessation rates with either mode of quitline support.Trial registrationClinicalTrials.gov NCT02730260 , Registered March 31, 2016.

Dataset Information

Directive and nondirective e-coach support for weight loss in overweight adults.

Publications

Directive and nondirective e-coach support for weight loss in overweight adults.

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