scholarly journals A Clinical Trial to Increase Self-Monitoring of Physical Activity and Eating Behaviors Among Adolescents: Protocol for the ImPACT Feasibility Study

10.2196/18098 ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. e18098
Author(s):  
Justin B Moore ◽  
Joshua R Dilley ◽  
Camelia R Singletary ◽  
Joseph A Skelton ◽  
David P Miller Jr ◽  
...  
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Weight Loss ◽  
Weight Management ◽  
Management Program ◽  
Evidence Based ◽  
Weight Management Program ◽  
Management Protocol ◽  
Pediatric Weight Management ◽  
The Impact

Background Severe obesity among youths (BMI for age≥120th percentile) has been steadily increasing. The home environment and parental behavioral modeling are two of the strongest predictors of child weight loss during weight loss interventions, which highlights that a family-based treatment approach is warranted. This strategy has been successful in our existing evidence-based pediatric weight management program, Brenner Families in Training (Brenner FIT). However, this program relies on face-to-face encounters, which are limited by the time constraints of the families enrolled in treatment. Objective This study aims to refine and test a tailored suite of mobile health (mHealth) components to augment an existing evidence-based pediatric weight management program. Methods Study outcomes will include acceptability from a patient and clinical staff perspective, feasibility, and economic costs relative to the established weight management protocol alone (ie, Brenner FIT vs Brenner FIT + mHealth [Brenner mFIT]). The Brenner mFIT intervention will consist of 6 mHealth components designed to increase patient and caregiver exposure to Brenner FIT programmatic content including the following: (1) a mobile-enabled website, (2) dietary and physical activity tracking, (3) caregiver podcasts (n=12), (4) animated videos (n=6) for adolescent patients, (5) interactive messaging, and (6) in-person tailored clinical feedback provided based on a web-based dashboard. For the study, 80 youths with obesity (aged 13-18 years) and caregiver dyads will be randomized to Brenner FIT or Brenner mFIT. All participants will complete baseline measures before randomization and at 3- and 6-month follow-up points. Results This study was approved by the Institutional Review Board in July 2019, funded in August 2019, and will commence enrollment in April 2020. The results of the study are expected to be published in the fall/winter of 2021. Conclusions The results of this study will be used to inform a large-scale implementation-effectiveness clinical trial. International Registered Report Identifier (IRRID) PRR1-10.2196/18098

scholarly journals A Clinical Trial to Increase Self-Monitoring of Physical Activity and Eating Behaviors Among Adolescents: Protocol for the ImPACT Feasibility Study (Preprint)

2020 ◽  
Author(s):  
Justin B Moore ◽  
Joshua R Dilley ◽  
Camelia R Singletary ◽  
Joseph A Skelton ◽  
David P Miller Jr ◽  
...  
Keyword(s):  
Physical Activity ◽  
Clinical Trial ◽  
Weight Loss ◽  
Weight Management ◽  
Management Program ◽  
Evidence Based ◽  
Weight Management Program ◽  
Management Protocol ◽  
Pediatric Weight Management ◽  
The Impact

BACKGROUND Severe obesity among youths (BMI for age≥120th percentile) has been steadily increasing. The home environment and parental behavioral modeling are two of the strongest predictors of child weight loss during weight loss interventions, which highlights that a family-based treatment approach is warranted. This strategy has been successful in our existing evidence-based pediatric weight management program, Brenner Families in Training (Brenner FIT). However, this program relies on face-to-face encounters, which are limited by the time constraints of the families enrolled in treatment. OBJECTIVE This study aims to refine and test a tailored suite of mobile health (mHealth) components to augment an existing evidence-based pediatric weight management program. METHODS Study outcomes will include acceptability from a patient and clinical staff perspective, feasibility, and economic costs relative to the established weight management protocol alone (ie, Brenner FIT vs Brenner FIT + mHealth [Brenner <i>m</i>FIT]). The Brenner <i>m</i>FIT intervention will consist of 6 mHealth components designed to increase patient and caregiver exposure to Brenner FIT programmatic content including the following: (1) a mobile-enabled website, (2) dietary and physical activity tracking, (3) caregiver podcasts (n=12), (4) animated videos (n=6) for adolescent patients, (5) interactive messaging, and (6) in-person tailored clinical feedback provided based on a web-based dashboard. For the study, 80 youths with obesity (aged 13-18 years) and caregiver dyads will be randomized to Brenner FIT or Brenner <i>m</i>FIT. All participants will complete baseline measures before randomization and at 3- and 6-month follow-up points. RESULTS This study was approved by the Institutional Review Board in July 2019, funded in August 2019, and will commence enrollment in April 2020. The results of the study are expected to be published in the fall/winter of 2021. CONCLUSIONS The results of this study will be used to inform a large-scale implementation-effectiveness clinical trial. INTERNATIONAL REGISTERED REPORT PRR1-10.2196/18098

scholarly journals Mechanisms of Action in a Behavioral Weight-Management Program: Latent Growth Curve Analysis

2021 ◽  
Author(s):  
Sarah Bates ◽  
Paul Norman ◽  
Penny Breeze ◽  
Alan Brennan ◽  
Amy L Ahern
Keyword(s):  
Weight Loss ◽  
Weight Management ◽  
Dietary Restraint ◽  
Self Regulation ◽  
Mechanisms Of Action ◽  
Management Program ◽  
Habit Strength ◽  
Growth Curve Analysis ◽  
Weight Management Program ◽  
The Impact

Abstract Background A greater understanding of the mechanisms of action of weight-management interventions is needed to inform the design of effective interventions. Purpose To investigate whether dietary restraint, habit strength, or diet self-regulation mediated the impact of a behavioral weight-management intervention on weight loss and weight loss maintenance. Methods Latent growth curve analysis (LGCA) was conducted on trial data in which adults (N = 1,267) with a body mass index (BMI) ≥28 kg/m2 were randomized to either a brief intervention (booklet on losing weight), a 12 week weight-management program or the same program for 52 weeks. LGCA estimated the trajectory of the variables over four time points (baseline and 3, 12 and 24 months) to assess whether potential mechanisms of action mediated the impact of the weight-management program on BMI. Results Participants randomized to the 12 and 52 week programs had a significantly greater decrease in BMI than the brief intervention. This direct effect became nonsignificant when dietary restraint, habit strength, and autonomous diet self-regulation were controlled for. The total indirect effect was significant for both the 12 (estimate = −1.33, standard error [SE] = 0.41, p = .001) and 52 week (estimate = −2.13, SE = 0.52, p &lt; .001) program. Only the individual indirect effect for dietary restraint was significant for the 12 week intervention, whereas all three indirect effects were significant for the 52 week intervention. Conclusions Behavior change techniques that target dietary restraint, habit strength, and autonomous diet self-regulation should be considered when designing weight loss and weight loss maintenance interventions. Longer interventions may need to target both deliberative and automatic control processes to support successful weight management.

scholarly journals The Effect of Incorporating an Exergame Application in a Multidisciplinary Weight Management Program on Physical Activity and Fitness Indices in Children with Overweight and Obesity

Children ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 18
Author(s):  
Rotem Kahana ◽  
Shai Kremer ◽  
Merav Dekel Dahari ◽  
Einat Kodesh
Keyword(s):  
Physical Activity ◽  
Weight Management ◽  
Intervention Group ◽  
Management Program ◽  
Overweight And Obesity ◽  
Weight Management Program ◽  
Fitness Components ◽  
Behavioral Counseling ◽  
Before And After ◽  
The Impact

Children with overweight/obese (OW/OB) have low physical activity (PA) levels and excessive daily screen times. Although access to personal smartphones may complicate restricting sedentary screen time, these devices may be used to promote PA and improve fitness. Therefore, we aim to examine the impact of incorporating an exergame application (APP) into an existing weight management program on BMI, physical activity, fitness levels, and attitude toward PA among OW/OB children. Seventy-nine children (51% girls), median age 10 years, completed an established 5-month weight management program. The intervention included structured PA sessions (2/week), nutritional, and behavioral counseling. An exergame app was installed on the smartphones of the intervention group (APP, n = 32). BMI, physical fitness, PA level, and attitudes toward PA were assessed before and after the intervention. BMI decreased (p < 0.0001) in both groups by 0.67 kg/m2 (Q1, Q3: −1.36–0.12). There were improvements in more fitness components in the APP group than controls, with significantly greater improvements in aerobic fitness (p = 0.038), speed and agility (p = 0.01), and leg strength endurance (p = 0.05) compared to controls. PA levels increased similarly in both groups during the intervention period. The incorporation of an exergame application leads to more significant improvements in fitness components. These findings support the use of exergame apps to improve fitness in OW/OB children.

scholarly journals Sustainability of weight loss from a family-centered pediatric weight management program integrated in primary care

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Veronica Else ◽  
Qiaoling Chen ◽  
Alan B. Cortez ◽  
Corinna Koebnick
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Weight Management ◽  
Management Program ◽  
Lifestyle Changes ◽  
Relative Distance ◽  
Current Evidence ◽  
Weight Management Program ◽  
Significant Difference ◽  
Pediatric Weight Management

Abstract Background A 6-month pediatric weight loss program showed modest success, but the sustainability of this success after 12 months was unclear. The present study aims tomeasure the medium-term effectiveness of family-based weight management in pediatric primary care to reduce body weight in children living with obesity. Methods In a retrospective cohort study, children ages 3 to 17 years with obesity in Kaiser Permanente Orange County, California, who enrolled in a weight management program between April 2014 and December 2018 (FB-WMG, n = 341) were compared to children referred but not enrolled (Ref-CG, n = 317) and controls matched by sex, age, zip code and BMI (Area-CG, n = 801). The relative distance from the median BMI-for-age at months 0, 6, and 12 were expressed as difference-in-differences (DID) using multivariable linear regressions with robust standard error. Results The baseline BMI-for-age was 98.6 (SD 1.08) percentile in FB-WMG, 98.2 (SD 1.22) percentile in Ref-CG, and 98.6 (1.13 in Area-CG). FB-WMG had a median of 3 visits (P25 1 visit, P75 5 visits) in the first 6 months. Despite a more considerable decrease in the relative distance to the median BMI-for-age in FB-WMG children with 3+ visits after 6 months, the success obtained was not sustained at 12 months (DID FB-WMG vs Area-CG -0.34, 95% CI − 3.00 to 2.33%, FB-WMG vs Ref-CG -0.39, 95% CI − 3.14 to 2.35%). At 12 months, there was no statistical significant difference between the three groups (FB-WWG, Ref-CG, Area-CG). Conclusions The initial success in weight management was not sustained in the absence of continued support for healthy lifestyle changes. Based on current evidence, continued support is necessary to maintain and promote success beyond a brief 6 month intervention. Long-term pediatric weight management programs are needed to promote continuing progress.

scholarly journals The Effect of Cost Sharing on an Employee Weight Loss Program: A Randomized Trial

2016 ◽  
Vol 32 (1) ◽  
pp. 170-176 ◽  
Author(s):  
Leslie K. John ◽  
Andrea B. Troxel ◽  
William S. Yancy ◽  
Joelle Friedman ◽  
Jingsan Zhu ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Trial ◽  
Weight Management ◽  
Program Effectiveness ◽  
Pragmatic Trial ◽  
Management Program ◽  
Future Research ◽  
Weight Management Program ◽  
Alternative Designs ◽  
The Impact

Purpose: To test the effects of employer subsidies on employee enrollment, attendance, and weight loss in a nationally available weight management program. Design: A randomized trial tested the impact of employer subsidy: 100%; 80%, 50%, and a hybrid 50% subsidy that could become a 100% subsidy by attaining attendance targets. Trial registration: NCT01756066. Setting and Participants: Twenty three thousand twenty-three employees of 2 US companies. Measures: The primary outcome was the percentage of employees who enrolled in the weight management program. We also tested whether the subsidies were associated with differential attendance and weight loss over 12 months, as might be predicted by the expectation that they attract employees with differing degrees of motivation. Analysis and Results: Enrollment differed significantly by subsidy level ( P < .0001). The 100% subsidy produced the highest enrollment (7.7%), significantly higher than each of the lower subsidies (vs 80% subsidy: 6.2%, P = .002; vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Enrollment in the 80% subsidy group was significantly higher than both lower subsidy groups (vs 50% subsidy: 3.9%, P < .0001; vs hybrid: 3.7%, P < .0001). Among enrollees, there were no differences among the 4 groups in attendance or weight loss. Conclusion: This pragmatic trial, conducted in a real-world workplace setting, suggests that higher rates of employer subsidization help individuals to enroll in weight loss programs, without a decrement in program effectiveness. Future research could explore the cost-effectiveness of such subsidies or alternative designs.

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