Dataset Information

Dyadic Dynamics in a Randomized Weight Loss Intervention.

ABSTRACT: Despite health and economic burdens associated with overweight and obesity, long-term weight loss intervention efforts have been largely unsuccessful. Observations that weight status tends to cluster in social groups, and findings showing "ripple" effects of weight change within social clusters, raise questions about the impact of social relationships on weight loss.Through a reanalysis of data from a randomized weight loss intervention, this study compared dyadic dynamics in intervention participants and in-home partners.Over the course of 18 months, data was collected from 201 pairs enrolled in either behavioral weight loss treatment (BWL) or treatment including partners and providing items to facilitate healthy choices at home (BWL?+?H). Using a dyadic growth curve model, covariance between baseline BMI, BMI change trajectories, and starting BMI and BMI trajectory for both the self and the other were examined.There were strong indicators of dependence in the data. Baseline BMI was positively correlated for both treatment groups. In the BWL?+?H condition, BMI change trajectories were positively correlated. In the BWL condition, this reversed: Change trajectories were negatively correlated. Additionally, partner BMI and primary participant BMI change were positively correlated, indicating that a heavier partner at baseline related to less weight loss.Social relationships exert a significant influence on weight loss outcomes. Depending on the intervention group, these influences may help (BWL?+?H) or hinder (BWL). It may be that home intervention changed social support and interaction in important ways and that these effects could be effectively harnessed to implement more effective interventions (NCT00200330).

SUBMITTER: Cornelius T

PROVIDER: S-EPMC4935664 | biostudies-other | 2016 Aug

REPOSITORIES: biostudies-other

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Dyadic Dynamics in a Randomized Weight Loss Intervention.

Cornelius Talea T Gettens Katelyn K Gorin Amy A AA

Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 20160801 4

<h4>Background</h4>Despite health and economic burdens associated with overweight and obesity, long-term weight loss intervention efforts have been largely unsuccessful. Observations that weight status tends to cluster in social groups, and findings showing "ripple" effects of weight change within social clusters, raise questions about the impact of social relationships on weight loss.<h4>Purpose</h4>Through a reanalysis of data from a randomized weight loss intervention, this study compared dya ...[more]

PMID: 26865258

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Project description:BackgroundBehavioral weight loss programs typically enroll 12-40 people into groups that then suffer from declining engagement over time. Web-based patient communities, on the other hand, typically offer no limits on capacity and membership is fluid. This model may be useful for boosting engagement in behavioral weight loss interventions, which could lead to better outcomes.ObjectiveIn this study, we aimed to examine the feasibility and acceptability of continuously enrolling participants into a Facebook-delivered weight loss intervention for the first 8 of 16 weeks relative to the same intervention where no new participants were enrolled after randomization.MethodsWe conducted a randomized pilot trial to compare a Facebook weight loss group that used open enrollment with a group that used closed enrollment on feasibility and acceptability in adults with BMI 27-45 kg/m2. The feasibility outcomes included retention, engagement, and diet tracking adherence. We described the percentage loss of ≥5% weight in both groups as an exploratory outcome. We also explored the relationship between total volume of activity in the group and weight loss. The participants provided feedback via web-based surveys and focus groups.ResultsRandomized participants (68/80, 85% women) were on average, aged 40.2 (SD 11.2) years with a mean BMI of 34.4 (SD 4.98) kg/m2. We enrolled an additional 54 participants (50/54, 93% female) in the open enrollment condition between weeks 1 and 8, resulting in a total group size of 94. Retention was 88% and 98% under the open and closed conditions, respectively. Randomized participants across conditions did not differ in engagement (P=.72), or diet tracking adherence (P=.42). Participant feedback in both conditions revealed that sense of community was what they liked most about the program and not enough individualized feedback was what they liked the least. Weight loss of ≥5% was achieved by 30% (12/40) of the participants randomized to the open enrollment condition and 18% (7/40) of the participants in the closed enrollment condition. Exploratory analyses revealed that the open condition (median 385, IQR 228-536.5) had a greater volume of engagement than the closed condition (median 215, IQR 145.5-292; P=.007). Furthermore, an increase of 100 in the total volume of engagement in the Facebook group each week was associated with an additional 0.1% weekly weight loss among the randomized participants (P=.02), which was independent of time, individual participant engagement, and sociodemographic characteristics.ConclusionsOpen enrollment was as feasible and acceptable as closed enrollment. A greater volume of engagement in the Facebook group was associated with weight loss, suggesting that larger groups that produce more engagement overall may be beneficial. Future research should examine the efficacy of the open enrollment approach for weight loss in a fully powered randomized trial.Trial registrationClinicalTrials.gov NCT02656680; https://clinicaltrials.gov/ct2/show/NCT02656680.

Project description:ObjectiveThis randomized clinical trial tested the effectiveness of an addiction-based digital weight-loss intervention, focusing on withdrawal/abstinence from self-identified problem foods, snacking and excessive amounts at meals, and discomfort displacement, with and without coaching, compared to an in-person, multi-disciplinary, care model among adolescents with obesity. We hypothesized that the digital intervention with coaching would yield greater weight loss and lower delivery burden than the standard clinical arm, and greater participant engagement than the digital arm without coaching.MethodsAdolescents were randomized to app intervention, with or without coaching, or in-person multidisciplinary obesity intervention for 6 months. The primary outcome was change in %BMIp95 at weeks 12 and 24. A mixed-effects linear regression model was used to assess the association between change in %BMIp95 and intervention arm. We were also interested in assessing delivery burden, participant engagement and evaluating the relationships between weight change and demographic characteristics, mood, executive function and eating behaviours.ResultsAll adolescents (n = 161; BMI ≥95th%, age 16 ± 2.5 year; 47% Hispanic, 65% female, 59% publicly insured) lost weight over 24-weeks (-1.29%, [-1.82, -0.76], p < 0.0001), with no significant weight loss difference between groups (p = 0.3). Girls lost more weight than boys, whereas binge eating behaviour at baseline was associated with increase in %BMIp95 when controlling for other covariates. There was no association between ethnicity, mood, timing of intervention in relation to the pandemic, or executive function and change in %BMIp95 .ConclusionsContrary with our hypothesis, our results showed no difference in the change in BMI status between treatment arms. Since efficacy of this digital intervention was not inferior to in-person, multi-disciplinary care, this could offer a reasonable weight management option for clinicians, based on youth and family specific characteristics, such as accessibility, resources, and communication styles.Clinical trial registrationClinicalTrials.gov identifier: NCT035008353.

Dataset Information

Dyadic Dynamics in a Randomized Weight Loss Intervention.

Publications

Dyadic Dynamics in a Randomized Weight Loss Intervention.

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