Dataset Information

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

ABSTRACT:

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.

SUBMITTER: Olson KL

PROVIDER: S-EPMC6437682 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Publications

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

Olson KayLoni L KL Neiberg Rebecca H RH Tate Deborah F DF Garcia Katelyn R KR Gorin Amy A AA Lewis Cora E CE Unick Jessica J Wing Rena R RR

Obesity (Silver Spring, Md.) 20180628 8

<h4>Objective</h4>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.<h4>Methods</h4>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 se ...[more]

PMID: 29956495

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Project description:BackgroundWeight gain during young adulthood is common and is associated with increased cardiovascular risk. Preventing this weight gain from occurring may be critical to improving long-term health. Few studies have focused on weight gain prevention, and these studies have had limited success. SNAP (Study of Novel Approaches to Weight Gain Prevention) is an NIH-funded randomized clinical trial examining the efficacy of two novel self-regulation approaches to weight gain prevention in young adults compared to a minimal treatment control. The interventions focus on either small, consistent changes in eating and exercise behaviors, or larger, periodic changes to buffer against expected weight gains.Methods/designSNAP targets recruitment of six hundred young adults (18-35 years) with a body mass index between 21.0-30.0 kg/m2, who will be randomly assigned with equal probability to: (1) minimal intervention control; (2) self-regulation with Small Changes; or (3) self-regulation with Large Changes. Both interventions receive 8 weekly face-to-face group sessions, followed by 2 monthly sessions, with two 4-week refresher courses in each of subsequent years. Participants are instructed to report weight via web at least monthly thereafter, and receive monthly email feedback. Participants in Small Changes are taught to make small daily changes (~100 calorie changes) in how much or what they eat and to accumulate 2000 additional steps per day. Participants in Large Changes are taught to create a weight loss buffer of 5-10 pounds once per year to protect against anticipated weight gains. Both groups are encouraged to self-weigh daily and taught a self-regulation color zone system that specifies action depending on weight gain prevention success. Individualized treatment contact is offered to participants who report weight gains. Participants are assessed at baseline, 4 months, and then annually. The primary outcome is weight gain over an average of 3 years of follow-up; secondary outcomes include diet and physical activity behaviors, psychosocial measures, and cardiovascular disease risk factors.DiscussionSNAP is unique in its focus on weight gain prevention in young adulthood. The trial will provide important information about whether either or both of these novel interventions are effective in preventing weight gain.Trial registrationClinicalTrials.gov, NCT01183689.

Project description:Rates of physical inactivity are high among Black women living in the United States with overweight or obesity, especially those living in the rural South. This study was conducted to determine if an efficacious weight gain prevention intervention increased moderate-vigorous physical activity (MVPA).The Shape Program, a weight gain prevention intervention implemented in community health centers in rural North Carolina, was designed for socioeconomically disadvantaged Black women with overweight or obesity. MVPA was measured using accelerometers, and summarized into 1- and 10-min bouts. We employed analyses of covariance (ANCOVA) to assess the relationship between changes in MVPA over 12 months, calculated as a change score, and intervention assignment (intervention versus usual care).Participants completing both baseline and 12-month accelerometer assessments (n = 121) had a mean age of 36.1 (SD = 5.43) years and a mean body mass index of 30.24 kg/m2 (SD = 2.60). At baseline, 38% met the physical activity recommendation (150 min of MVPA/week) when assessed using 10-min bouts, and 76% met the recommendation when assessed using 1-min bouts. There were no significant differences in change in MVPA participation among participants randomized to the intervention from baseline to 12-months using 1-min bouts (adjusted intervention mean [95% CI]: 20.50 [-109.09 to 150.10] vs. adjusted usual care mean [95% CI]: -80.04 [-209.21 to 49.13], P = .29), or 10-min bouts (adjusted intervention mean [95% CI]: 7.39 [-83.57 to 98.35] vs. adjusted usual care mean [95% CI]: -17.26 [-107.93 to 73.40], P = .70).Although prior research determined that the Shape intervention promoted weight gain prevention, MVPA did not increase significantly among intervention participants from baseline to 12 months. The classification of bouts had a marked effect on the prevalence estimates of those meeting physical activity recommendations. More research is needed to understand how to promote increased MVPA in weight gain prevention interventions.This study is registered at www.clinicaltrials.gov database (No. NCT00938535. Retrospectively Registered 7/10/2009).

Project description:IMPORTANCE:Weight gain occurs commonly in young adults and has adverse effects on health. OBJECTIVE:To compare 2 self-regulation interventions vs control in reducing weight gain in young adults over a mean follow-up of 3 years. DESIGN, SETTING, AND PARTICIPANTS:Randomized clinical trial in 2 academic settings of 599 participants aged 18 to 35 years with body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) of 21.0 to 30.0, recruited via mailings and emails from August 2010 to February 2012. Data were analyzed from January 2015 to January 2016. INTERVENTIONS:Participants were randomized to control, self-regulation plus small changes, or self-regulation plus large changes. Both interventions focused on frequent self-weighing to cue behavior changes. "Small changes" taught participants to reduce intake and increase activity, both by approximately 100 calories per day. "Large changes" focused on losing 2.3 to 4.5 kg initially to buffer against expected weight gain. MAIN OUTCOMES AND MEASURES:Changes in weight from baseline over mean follow-up of 3 years. Secondary outcomes included proportion gaining at least 0.45 kg from baseline, proportion developing obesity (BMI, ?30.0), and weight change baseline to 2 years. RESULTS:Among the 599 participants (22% men; 27% minority; mean [SD] age, 27.7 [4.4] years; mean [SD] BMI, 25.4 [2.6]), mean (SE) weight changes over a mean follow-up of 3 years were 0.26 (0.22), -0.56 (0.22), and -2.37 (0.22) kg in the control, small-changes, and large-changes groups, respectively (P?<?.001). Differences among all 3 groups were significant (large changes vs control, P?<?.001; small changes vs control, P?=?.02; large changes vs small changes, P?<?.001). On secondary outcomes, both interventions significantly reduced incidence of obesity relative to control (mean [SE], 8.6% [2.0%], 7.9% [2.0%], and 16.9% [2.7%] in the large-changes, small-changes, and control groups, respectively; P?=?.02 for large changes vs control and P?=?.002 for small changes vs control); a smaller percentage of participants in the large-changes group gained 0.45 kg or more (mean [SE], 23.6% [2.8%], 32.5% [3.8%], and 40.8% [4.4%], respectively; P?<?.001 vs control and P?=?.02 vs small changes) and weight change from baseline to 2 years was greater in control than in small or large changes (mean [SE], 0.54 [0.33], -0.77 [0.33], and -1.50 [0.34] kg, respectively; P?=?.02 vs small changes and P?<?.001 vs large changes). CONCLUSIONS AND RELEVANCE:Self-regulation with large or small changes both reduced weight gain in young adults over 3 years relative to control, but the large-changes intervention was more effective. TRIAL REGISTRATION:clinicaltrials.gov Identifier: NCT01183689.

Project description:PurposeTo determine characteristics of weight gain prevention programs that facilitate engagement.DesignRandomized factorial experiment (5 × 2).SettingRecruited nationally online.ParticipantsAdults aged 18 to 75 with body mass index ≥25 who decline a behavioral weight loss intervention (n = 498).MeasuresParticipants were randomly presented with one of 10 possible descriptions of hypothetical, free weight gain prevention programs that were all low dose and technology-based but differed in regard to 5 behavior change targets (self-weighing only; diet only; physical activity only; combined diet, physical activity, and self-weighing; or choice between diet, physical activity, and self-weighing targets) crossed with 2 financial incentive conditions (presence or absence of incentives for self-monitoring). Participants reported willingness to join the programs, perceived program effectiveness, and reasons for declining enrollment.AnalysisLogistic regression and linear regression to test effects of program characteristics offered on willingness to initiate programs and programs' perceived effectiveness, respectively. Content analyses for open-ended text responses.ResultsParticipants offered the self-weighing-only programs were more willing to initiate than those offered the programs targeting all 3 behaviors combined (50% vs 36%; odds ratio [OR] = 1.79; 95% confidence interval [CI], 1.01-3.13). Participants offered the programs with financial incentives were more willing to initiate (50% vs 33%; OR = 2.08; 95% CI, 1.44-2.99) and anticipated greater intervention effectiveness (β = .34, P = .02) than those offered no financial incentives. Reasons for declining to initiate included specific program features, behavior targets, social aspects, and benefits.ConclusionTargeting self-weighing and providing financial incentives for self-monitoring may result in greater uptake of weight gain prevention programs.Study preregistrationhttps://osf.io/b9zfh, June 19, 2018.

Project description:BackgroundNearly 60% of black women are obese. Despite their increased risk of obesity and associated chronic diseases, black women have been underrepresented in clinical trials of weight loss interventions, particularly those conducted in the primary care setting. Further, existing obesity treatments are less effective for this population. The promotion of weight maintenance can be achieved at lower treatment intensity than can weight loss and holds promise in reducing obesity-associated chronic disease risk. Weight gain prevention may also be more consistent with the obesity-related sociocultural perspectives of black women than are traditional weight loss approaches.Methods/designWe conducted an 18-month randomized controlled trial (the Shape Program) of a weight gain prevention intervention for overweight black female patients in the primary care setting. Participants include 194 premenopausal black women aged 25 to 44 years with a BMI of 25-34.9 kg/m2. Participants were randomized either to usual care or to a 12-month intervention that consisted of: tailored obesogenic behavior change goals, self-monitoring via interactive voice response phone calls, tailored skills training materials, 12 counseling calls with a registered dietitian and a 12-month YMCA membership.Participants are followed over 18 months, with study visits at baseline, 6-, 12- and 18-months. Anthropometric data, blood pressure, fasting lipids, fasting glucose, and self-administered surveys are collected at each visit. Accelerometer data is collected at baseline and 12-months.At baseline, participants were an average of 35.4 years old with a mean body mass index of 30.2 kg/m2. Participants were mostly employed and low-income. Almost half of the sample reported a diagnosis of hypertension or prehypertension and 12% reported a diagnosis of diabetes or prediabetes. Almost one-third of participants smoked and over 20% scored above the clinical threshold for depression.DiscussionThe Shape Program utilizes an innovative intervention approach to lower the risk of obesity and obesity-associated chronic disease among black women in the primary care setting. The intervention was informed by behavior change theory and aims to prevent weight gain using inexpensive mobile technologies and existing health center resources. Baseline characteristics reflect a socioeconomically disadvantaged, high-risk population sample in need of evidence-based treatment strategies.Trial registrationThe trial is registered with clinicaltrials.gov NCT00938535.

Project description:Background:Transparent reporting of the intervention content study participants receive is particularly important for dissemination and implementation of evidence-based interventions to address obesity. This study explores intervention delivery and perceptions of content when an intervention is embedded within an organization's usual practice and associations with weight outcomes. Methods:This is a secondary analysis from the Healthy Eating and Active Living Taught at Home (HEALTH) randomized trial. HEALTH is a weight gain prevention intervention embedded within a national home visiting programme (Parents as Teachers, PAT). To be consistent with PAT practice, HEALTH has a suggested but also flexible home visit structure. Therefore, the number and frequency of home visits are determined by the family's needs and preferences based on the parent educator's professional judgement. The proportion of participants who received each curriculum core lesson was explored among the 105 families randomized to the HEALTH intervention group, as were mean parent educator perception ratings of the visits (5-point Likert-type scale). A chi-square test was used to examine the association between utilization (ie, low: 1-6, middle: 7-12, or high: 13-18 visits) category and weight maintenance. Results:Mothers received on average 13.3 (standard deviation 6.2) core visits. Mean parent educator perception of the mothers' response (out of 5) ranged from 3.99 to 4.27; educators' perception of their own experience with the lesson ranged from 4.13 to 4.34. Among mothers who maintained their weight, 13% were low, 22% were middle, and 65% were high utilizers, while among mothers who gained weight, 3%, 31%, and 67% were low, middle, and high utilizers, respectively; this difference was not statistically significant. Conclusions:This study identified wide variation in the visits families received from the curriculum but minimal variation in visit perceptions. Future studies could explore whether there are optimal patterns for visit content, associated with successful outcomes.

Dataset Information

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

Objective

Methods

Results

Conclusions

Publications

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

Similar Datasets

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