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Palacz-Poborczyk I, Naughton F, Luszczynska A, Januszewicz A, Quested E, Hagger MS, Pagoto S, Verboon P, Robinson S, Kwasnicka D. Choosing Health: acceptability and feasibility of a theory-based, online-delivered, tailored weight loss, and weight loss maintenance intervention. Transl Behav Med 2024:ibae023. [PMID: 38768381 DOI: 10.1093/tbm/ibae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/22/2024] Open
Abstract
Few weight loss and weight loss maintenance interventions are tailored to include factors demonstrated to predict the user's behavior. Establishing the feasibility and acceptability of such interventions is crucial. The aim of this study was to assess the acceptability and feasibility of a theory-based, tailored, online-delivered weight loss and weight loss maintenance intervention (Choosing Health). We conducted a mixed methods process evaluation of the Choosing Health tailored intervention, nested in a randomized controlled trial (N = 288) with an embedded N-of-1 study, investigating participants' and implementers' experiences related to intervention context, implementation, and mechanisms of impact. Measures included: (i) surveys, (ii) data-prompted interviews (DPIs) with study participants, (iii) semi-structured interviews with implementers, and (iv) intervention access and engagement data. Five themes described the acceptability of the intervention to participants: (i) monitoring behavior change and personal progress to better understand the weight management process, (ii) working collaboratively with the intervention implementers to achieve participants' goals, (iii) perceived benefits of non-judgmental and problem-solving tone of the intervention, (iv) changes in personal perception of the weight management process due to intervention tailoring, and (v) insufficient intervention content tailoring. The intervention delivery was feasible, however, emails and text messages differed in terms of accessibility and resources required to deliver the content. The use of Ecological Momentary Assessment as a technique to gather personal data for further tailoring was acceptable, and facilitated behavior change monitoring. Personalization of the intervention content above and beyond domain-specific issues, for example, by addressing participants' social roles may better match their needs. Support from the implementers and feedback on body composition changes may increase participants' engagement.
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Affiliation(s)
- Iga Palacz-Poborczyk
- Faculty of Psychology, SWPS University, Aleksandra Ostrowskiego 30b, 53-238 Wroclaw, Poland
| | - Felix Naughton
- Behavioural and Implementation Science Group, School of Health Sciences, University of East Anglia, Norwich NR4 7UL, UK
| | - Aleksandra Luszczynska
- Faculty of Psychology, SWPS University, Aleksandra Ostrowskiego 30b, 53-238 Wroclaw, Poland
| | - Anna Januszewicz
- Faculty of Psychology, SWPS University, Aleksandra Ostrowskiego 30b, 53-238 Wroclaw, Poland
| | - Eleanor Quested
- Physical Activity and Well-being Research Group, enAble Institute, Curtin University, Perth, Australia
- Curtin School of Population Health, Curtin University, Kent Street, 6102 Perth, Australia
| | - Martin S Hagger
- Department of Psychological Sciences, University of California, Merced, 5200 N. Lake Rd., Merced, CA 95343, USA
- Health Sciences Research Institute, University of California, Merced, 5200 N. Lake Rd., Merced, CA 95343, USA
- Faculty of Sport and Health Sciences, University of Jyväskylä, Seminaarinkatu 15, 40014 Jyväskylä, Finland
- School of Applied Psychology, Griffith University, Mt. Gravatt Campus,176 Messines Ridge Rd, Mount Gravatt QLD 4122, Australia
| | - Sherry Pagoto
- Department of Allied Health Sciences, The UConn Center for mHealth and Social Media, University of Connecticut, Connecticut, USA
| | - Peter Verboon
- Department of Psychology, Open Universiteit Nederland, Heerlen, The Netherlands
| | - Suzanne Robinson
- Curtin School of Population Health, Curtin University, Kent Street, 6102 Perth, Australia
- Deakin Health Economics, Institute for Health Transformation, Deakin University, Victoria, Australia
| | - Dominika Kwasnicka
- Faculty of Psychology, SWPS University, Aleksandra Ostrowskiego 30b, 53-238 Wroclaw, Poland
- Melbourne School of Population and Global Health, University of Melbourne, 333 Exhibition Street, 3000 Melbourne, Australia
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Fabrig A, Schmidt R, Mansfeld T, Sander J, Seyfried F, Kaiser S, Stroh C, Dietrich A, Hilbert A. Depressive Symptoms among Bariatric Surgery Candidates: Associations with Stigmatization and Weight and Shape Concern. Nutrients 2024; 16:510. [PMID: 38398834 PMCID: PMC10891665 DOI: 10.3390/nu16040510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/03/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Bariatric surgery candidates (BSC) are a highly vulnerable group for mental health impairments. According to the theoretical model of weight stigma, weight-related experienced stigmatization (ES) negatively influences mental health through weight bias internalization (WBI). This study tested this model among BSC and investigated whether this association depends on a negative body image in terms of weight and shape concern as a potential moderator. As part of a German multicenter study, ES, WBI, weight and shape concern, and depressive symptoms were assessed via self-report questionnaires among n = 854 BSC. Simple and moderated mediation analyses were applied to analyze whether WBI influences the relationship between ES and depressive symptoms, and whether this influence depends on weight and shape concern. WBI significantly mediated the relationship between ES and depressive symptoms by partially reducing the association of ES with depressive symptoms. Weight and shape concern emerged as significant moderators in the overall model and specifically for associations between WBI and depressive symptoms. The results suggest that the association between ES and depressive symptoms among BSC is stronger in those with high WBI. This association is strengthened by weight and shape concern, especially at low and mean levels. Studies evaluating longitudinal associations between weight-related stigmatization and mental health are indicated, as well as intervention studies targeting WBI in order to reduce adverse effects of ES on mental health in BSC.
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Affiliation(s)
- Alexandra Fabrig
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
| | - Ricarda Schmidt
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
| | - Thomas Mansfeld
- Department of General Surgery, Asklepios Clinic, 22559 Hamburg, Germany
| | - Johannes Sander
- Schön Klinik Hamburg Eilbek, Obesity Clinic, 22081 Hamburg, Germany
| | - Florian Seyfried
- Department of General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, 97080 Würzburg, Germany
| | - Stefan Kaiser
- Department of Visceral, Pediatric and Vascular Surgery, Hospital Konstanz, 78464 Konstanz, Germany
| | - Christine Stroh
- Department of Surgery, SRH Wald-Klinikum, Adipositas Zentrum, 07548 Gera, Germany
| | - Arne Dietrich
- Department of Surgery, Clinic for Visceral, Transplantation, Thoracic and Vascular Surgery, University Hospital Leipzig, 04103 Leipzig, Germany
| | - Anja Hilbert
- Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, Integrated Research and Treatment Center AdiposityDiseases, University of Leipzig Medical Center, Stephanstrasse 9a, 04103 Leipzig, Germany; (A.F.)
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Adherence of Obese Patients from Poland and Germany and Its Impact on the Effectiveness of Morbid Obesity Treatment. Nutrients 2022; 14:nu14183880. [PMID: 36145256 PMCID: PMC9505872 DOI: 10.3390/nu14183880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed to investigate and compare the adherence of patients treated for morbid obesity living in Poland and Germany. Methods: A cross-sectional international multicenter survey design was adopted. The study involved 564 adult subjects treated for morbid obesity at selected healthcare facilities in Germany (210 participants) and Poland (354 participants). A validated, custom-made questionnaire based on the literature related to this issue was used. Results: The degree of adherence was higher, but not statistically significant, among Polish patients (83.82% vs. 78.33%, p = 0.26140). Patient adherence was associated with gender, age, level of education, duration of obesity, number of health professionals involved in obesity treatment, and type of obesity treatment (p < 0.05). A positive correlation was observed in the case of age, level of education, and a growing number of health professionals involved in obesity treatment, whereas a negative correlation was observed in the case of the duration of obesity. Patients who underwent bariatric surgery significantly more often followed medical recommendations regarding lifestyle changes, compared to obese participants treated only conservatively. Adherence in the field of obesity treatment significantly increases the percentage of total weight loss and excess weight loss due to applied obesity treatment among both Polish and German groups (p < 0.001). Both the percentage of total weight loss and that of excess weight loss were significantly higher in the group of adherent patients compared to the nonadherent patients (p < 0.00001). The levels of perceived anxiety, stress, and depression were significantly higher in nonadherent patients in both countries. Conclusions: These findings confirm the role of adherence in the effective and satisfactory treatment of morbid obesity. There is a great need to improve patient adherence to overcome the consequences of the obesity pandemic.
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