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Scotti KB, Rajoria M, Carrera Seoane M, Ross KM, Muenyi S, McVay MA. Exploring potential reach and representativeness of a self-weighing weight gain prevention intervention in adults with overweight and obesity. Clin Obes 2024; 14:e12641. [PMID: 38302264 PMCID: PMC11090748 DOI: 10.1111/cob.12641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 12/18/2023] [Accepted: 12/21/2023] [Indexed: 02/03/2024]
Abstract
Most adults with obesity do not enrol in comprehensive weight loss interventions when offered. For these individuals, lower burden self-weighing interventions may offer an acceptable alternative, though data is lacking on the potential for reach and representativeness of such interventions. Health system patients with BMI ≥30 kg/m2 (or 25-30 kg/m2 with an obesity comorbidity) completed a general health survey. During the survey, patients were given information about comprehensive weight loss interventions. If they denied interest or did not enrol in a comprehensive intervention, they were offered enrolment in a low-burden weight gain prevention intervention focused on daily self-weighing using a cellular network-connected in-home scale without any dietary or physical activity prescriptions. Enrolment in this program was documented. Among patients offered the self-weighing intervention (n = 85; 55.3% men; 58.8% White; BMI = 34.2 kg/m2), 44.2% enrolled. Compared to those who did not enrol, enrollers had higher educational attainment (57.1% vs. 42.9% with bachelor's degree p = .02), social anxiety (5.8 vs. 2.8, p < .001), and perceptions of the effectiveness of the self-weighing intervention (25.8 vs. 20.9 on 35, p = .007). The most highly endorsed reason for not enrolling in the self-weighing intervention was that it would make individuals overly focused on weight. A low-intensity weight gain prevention intervention may serve as a viable alternative to comprehensive weight loss interventions for the substantial portion of patients who are at risk for continued weight gain but would otherwise not enrol in a comprehensive intervention. Differential enrolment by education, however, suggests potential for inequitable uptake.
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Affiliation(s)
- Kellie B Scotti
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | | | - Montserrat Carrera Seoane
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
| | - Kathryn M Ross
- Department of Clinical & Health Psychology, College of Public Health & Health Professions, University of Florida, Gainesville, Florida, USA
| | - Sofia Muenyi
- Department of Community Health and Family Medicine, College of Medicine-Jacksonville, University of Florida Health, Jacksonville, Florida, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, Florida, USA
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McVay MA, Carrera Seoane M, Rajoria M, Dye M, Marshall N, Muenyi S, Alkanderi A, Scotti KB, Ruiz J, Voils CI, Ross KM. A low-burden, self-weighing intervention to prevent weight gain in adults with obesity who do not enroll in comprehensive treatment. Obes Sci Pract 2024; 10:e745. [PMID: 38510333 PMCID: PMC10951869 DOI: 10.1002/osp4.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 02/13/2024] [Accepted: 03/03/2024] [Indexed: 03/22/2024] Open
Abstract
Background For individuals who are eligible but unlikely to join comprehensive weight loss programs, a low burden self-weighing intervention may be a more acceptable approach to weight management. Methods This was a single-arm feasibility trial of a 12-month self-weighing intervention. Participants were healthcare patients with a BMI ≥25 kg/m2 with a weight-related comorbidity or a BMI >30 kg/m2 who reported lack of interest in joining a comprehensive weight loss program, or did not enroll in a comprehensive program after being provided program information. In the self-weighing intervention, participants were asked to weigh themselves daily on a cellular connected scale and were sent text messages every other week with tailored weight change feedback, including messages encouraging use of comprehensive programs if weight gain occurred. Results Of 86 eligible patients, 39 enrolled (45.3%) in the self-weighing intervention. Self-weighing occurred on average 4.6 days/week (SD = 1.4). At 12 months, 12 participants (30.8%) lost ≥3% baseline weight, 11 (28.2%) experienced weight stability (±3% baseline), 6 (15.4%) gained ≥3% of baseline weight, and 10 (25.6%) did not have available weight data to evaluate. Three participants reported joining a weight loss program during the intervention (7.7%). Participants reported high intervention satisfaction in quantitative ratings (4.1 of 5), and qualitative interviews identified areas of satisfaction (e.g., timing and content of text messages) and areas for improvement (e.g., increasing personalization of text messages). Conclusion A low-burden self-weighing intervention can reach adults with overweight/obesity who would be unlikely to engage in comprehensive weight loss programs; the efficacy of this intervention for preventing weight gain should be further evaluated in a randomized trial.
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Affiliation(s)
- Megan A. McVay
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
- Center for Integrative Cardiovascular and Metabolic DiseaseUniversity of FloridaGainesvilleFloridaUSA
| | - Montserrat Carrera Seoane
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | | | - Marissa Dye
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Natalie Marshall
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Sofia Muenyi
- Department of Community Health and Family MedicineCollege of Medicine‐JacksonvilleUniversity of FloridaJacksonvilleFloridaUSA
| | - Anas Alkanderi
- Department of Epidemiology & Community HealthUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Kellie B. Scotti
- Department of Health Education and BehaviorCollege of Health and Human PerformanceUniversity of FloridaGainesvilleFloridaUSA
| | - Jaime Ruiz
- Department of Computer & Information Science & EngineeringCollege of EngineeringUniversity of FloridaGainesvilleFloridaUSA
| | - Corrine I. Voils
- William S. Middleton Memorial Veterans HospitalMadisonWisconsinUSA
- Department of SurgerySchool of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - Kathryn M. Ross
- Center for Integrative Cardiovascular and Metabolic DiseaseUniversity of FloridaGainesvilleFloridaUSA
- Department of Clinical & Health PsychologyCollege of Public Health & Health ProfessionsUniversity of FloridaGainesvilleFloridaUSA
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Cooper KB, Lapierre S, Carrera Seoane M, Lindstrom K, Pritschmann R, Donahue M, Christou DD, McVay MA, Jake-Schoffman DE. Behavior change techniques in digital physical activity interventions for breast cancer survivors: a systematic review. Transl Behav Med 2023; 13:268-280. [PMID: 36694356 DOI: 10.1093/tbm/ibac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Given the broad benefits of physical activity (PA) but low PA levels among breast cancer survivors (i.e., women who have received a breast cancer diagnosis), innovative and evidence-based techniques are needed to motivate and support exercise. This study systematically reviews the use of behavior change techniques (BCTs) in digital PA interventions for breast cancer survivors. Studies were retrieved from five electronic databases and were included if they (i) sampled exclusively female breast cancer survivors aged >18 years, (ii) involved a digital intervention with the primary purpose of increasing PA, (iii) included a BCT component, (iv) used a randomized or quasi-randomized design, and (v) were published from January 2000 to May 2022. Two coders independently extracted data. Twenty primary studies met the inclusion criteria and were included in this review. All interventions used at least one BCT (mean 4 ± 1, range 2-13); self-monitoring (85%) and goal setting (79%) were the most common BCTs. Twelve of 20 (60%) studies reported improvements in PA behavior in the intervention vs. control group, and self-monitoring and goal setting were the most commonly used BCTs in these studies. Of the 93 total BCTs, 66 were not used in any interventions in the review, including critical constructs for PA behavior change (e.g., biofeedback). BCTs, important facilitators of PA behavior change, are being underutilized in digital PA interventions for breast cancer survivors. Future research should incorporate more diverse BCTs to explore if they can add to the effectiveness of digital interventions for this population.
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Affiliation(s)
- Kellie B Cooper
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Stephanie Lapierre
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | | | - Katie Lindstrom
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Ricarda Pritschmann
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
| | - Marissa Donahue
- Department of Psychology, Utah State University, Logan, UT 84322, USA
| | - Demetra D Christou
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA
| | - Megan A McVay
- Department of Health Education and Behavior, University of Florida, Gainesville, FL 32611, USA
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Jake-Schoffman DE, Carrera Seoane M, Cooper K, Rajoria M, McVay MA. Engaging adults with obesity in organic online communities to support weight loss: a mixed methods pilot study. Psychol Health 2022:1-20. [PMID: 35726546 DOI: 10.1080/08870446.2022.2087073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/20/2022] [Accepted: 06/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Organic online communities have shown potential for aiding weight loss, but few adults use them. We sought to test strategies to encourage adults to select and engage in online communities for weight loss. DESIGN 4-week single-arm, mixed-methods pilot. MAIN OUTCOME MEASURES Quantitative and qualitative data on selection of online community, engagement with community, and engagement and satisfaction with tasks. RESULTS On average, participants (n = 25) were female (80.0%) and white (68.0%), 45.2 ± 18.1 years old, with a BMI of 36.2 ± 6.5 kg/m2. Selection of online community varied across participants (13 MyFitnessPal, 5 Facebook, 5 Reddit). In qualitative analyses, reasons for selection included experience with community, privacy considerations, and seeking people similar to them. Most tasks were fully or partially completed by a majority of participants (>80.0%). For most tasks, ∼50% of participants felt the task helped them with weight loss support. Variability in response was observed, especially between tasks that requested reading compared to posting/commenting in the community. Frequent reading of community content throughout the study was reported by >70.0% of participants, though posting/commenting was less frequent. Barriers to further engagement included concerns about privacy, judgement, and misinformation. CONCLUSIONS This study provides insights about strategies for engaging individuals in online health communities.
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Affiliation(s)
- Danielle E Jake-Schoffman
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Montserrat Carrera Seoane
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Kellie Cooper
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Melinda Rajoria
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
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McVay MA, Cooper KB, Donahue ML, Carrera Seoane M, Shah NR, Webb F, Perri M, Jake‐Schoffman DE. Engaging primary care patients with existing online tools for weight loss: A pilot trial. Obes Sci Pract 2022; 8:569-584. [PMID: 36238223 PMCID: PMC9535672 DOI: 10.1002/osp4.592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/29/2021] [Accepted: 01/18/2022] [Indexed: 11/11/2022] Open
Abstract
Objective Free online tools show potential for promoting weight loss at a low cost, but there is limited evidence about how to effectively engage patients with them. To address this, a low‐dose, flexible intervention was developed that aims to enhance weight‐related discussions with primary care providers (PCPs) and engage patients with an organic (i.e., not researcher‐created) weight loss‐focused social media community and online self‐monitoring tool. Feasibility and acceptability of the intervention was evaluated in a single‐arm, 12‐week pilot. Methods PCPs were recruited at two clinics, then PCP's patients with upcoming appointments were identified and recruited. Patients received an interactive online kickoff before their scheduled primary care appointment, then 8 follow‐up messages over 12 weeks via email or their electronic health record patient portal. Patients completed assessments at baseline, post‐appointment, and week 12. Primary care providers and patients completed semi‐structured interviews. Results All PCPs approached enrolled (n = 6); patient recruitment was on track to meet the study goal prior to COVID‐19 restrictions, and n = 27 patients enrolled. Patient satisfaction with the pre‐appointment kickoff was high. Twenty‐four patients reported discussing weight‐related topics at their primary care appointment and all were satisfied with the discussion. Twenty‐two patients completed 12‐week assessments. Of these, 15 reported engaging with the self‐monitoring tool and 9 with the social media community. Patient interviews revealed reasons for low social media community engagement, including perceived lack of fit. On average, patients with available data (n = 21) lost 2.4 ± 4.1% of baseline weight, and 28.6% of these patients lost ≥3% of baseline weight. Primary care providers reported high intervention satisfaction. Conclusions The intervention and trial design show potential, although additional strategies are needed to promote tool engagement.
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Affiliation(s)
- Megan A. McVay
- Department of Health Education & Behavior University of Florida Gainesville FL
| | - Kellie B Cooper
- Department of Health Education & Behavior University of Florida Gainesville FL
| | | | | | - Nipa R. Shah
- Department of Community Health and Family Medicine University of Florida College of Medicine Jacksonville FL
| | - Fern Webb
- Department of Surgery University of Florida Jacksonville FL
| | - Michael Perri
- College of Public Health and Health Professions University of Florida Gainesville
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McVay MA, Cooper KB, Seoane MC, Donahue ML, Scherer LD. Transparent reporting of hypotheses and analyses in behavioral medicine research: An audit of publications in 2018 and 2008. Health Psychol Behav Med 2021; 9:285-297. [PMID: 34046250 PMCID: PMC8145985 DOI: 10.1080/21642850.2021.1907186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objective We aimed to document the use of transparent reporting of hypotheses and analyses in behavioral medicine journals in 2018 and 2008. Design: We examined a randomly selected portion of articles published in 2018 and 2008 by behavioral medicine journals with the highest impact factor, excluding manuscripts that were reviews or purely descriptive. Main Outcome Measures: We coded whether articles explicitly stated if the hypotheses/outcomes/analyses were primary or secondary; if study was registered/pre-registered; if ‘exploratory’ or a related term was used to describe analyses/aims; and if power analyses were reported. Results: We coded 162 manuscripts published in 2018 (87% observational and 12% experimental). Sixteen percent were explicit in describing hypotheses/outcomes/analyses as primary or secondary, 51% appeared to report secondary hypotheses/outcomes/analyses but did not use term ‘secondary,’ and 33% were unclear. Registration occurred in 14% of studies, but 91% did not report which analyses were registered. ‘Exploratory’ or related term was used in 31% of studies. Power analyses were reported in 8% of studies. Compared to 2008 (n = 120), studies published in 2018 were more likely to be registered and less likely to be unclear if outcomes were primary or secondary. Conclusions: Behavioral medicine stakeholders should consider strategies to increase clarity of reporting, and particularly details that will inform readers if analyses were pre-planned or post-hoc. Study registration https://osf.io/39ztn
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Affiliation(s)
- Megan A McVay
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Kellie B Cooper
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Montserrat Carrera Seoane
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA
| | - Marissa L Donahue
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, FL, USA and Department of Psychology, Utah State University, Logan, UT, USA
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