scholarly journals The Interplay of Support, Comparison, and Surveillance in Social Media Weight Management Interventions: A Qualitative Study (Preprint)

2020 ◽  
Author(s):  
Leanne Chang ◽  
Kaushik Chattopadhyay ◽  
Jialin Li ◽  
Miao Xu ◽  
Li Li

BACKGROUND There has been a significant increase in trend in using social media as a platform to deliver weight management interventions. This illustrates a need to develop a holistic understanding of doctor-patient communication and peer-to-peer communication in social media interventions and their influences on weight management of people with overweight or obesity. Studies like this will highlight how social media can be more effectively integrated into weight management programs to enhance individuals’ short-term and long-term weight management behaviors. OBJECTIVE This study aimed to examine patients’ experiences with doctor-patient communication and peer interactions in a social media-based (WeChat) weight management program, and describe the interplay of three social influence factors—social support, social comparison, and surveillance—in their weight control practices. The program, designed and implemented by the research team located in a tertiary referral hospital in a southeastern province in China, included both diet and physical activity components that targeted people with overweight or obesity. METHODS We conducted in-depth interviews with 32 program participants of different ages (M = 35.6, SD = 7.7), gender (18 females), duration of program membership (M = 1.4 years), and weight loss outcomes (54% weight loss to 9% weight gain). All interview data were audio-recorded, transcribed, and translated using the translation-back-translation technique. Nvivo software was used to facilitate the coding process. RESULTS Results of a thematic analysis indicated the distinct functions of professionally led support and peer support. Professional support was presented in the form of knowledge infusion, efficacy enhancement, and provision of timely feedback. Peer support fostered empathy and sense of belonging and had a mutually reinforcing relationship with peer comparison and peer-based surveillance. Peer comparison enhanced motivation and positive competition. However, it also reinforced negative group norms and resulted in downturns in reference standards and collective inactivity. Social media surveillance prompted participants’ reactions to the gaze from medical professionals and peers that could be encouraging or inhibiting. Surveillance enhanced vigilance with weight control norms. However, its influence weakened when participants chose to fake weight data and turn off notifications. Findings from this study illustrated the interrelated and fluctuant influences of support, comparison, and surveillance. CONCLUSIONS The interactive traits of social media eased the practices of social support and social comparison and created new forms of surveillance. This study contributed to an in-depth understanding of social media influences on individuals’ weight control behaviors. Practical implications of the study concerned improved strategies for maintaining the positive dynamics of social media interactions and preventing negative resistance to surveillance technology. CLINICALTRIAL Clinical Trial ChiCTR1900025861.

Author(s):  
Marlene Adams

Obesity is a serious, prevalent, and refractory disorder that increases with age particularly in women who enroll in formal weight loss treatments. This study examined the processes used by obese postmenopausal women as they participated in a formal weight loss program. Using grounded theory, interviews were conducted with 14 women engaged in a formal weight loss study examining success with specific, targeted weight loss treatments based on one’s weight control self-efficacy typology. “Taking Charge of One’s Life” emerged as a model for weight management success, comprised of three phases: engaging, internalizing, and keeping one’s commitment. This study supports the unique, complex, and individualized nature of making a decision to lose weight and then maintaining one’s commitment to weight loss.


2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Zoe Rock ◽  
Juliana Chen ◽  
Joanna Jaques ◽  
Bernard L Champion ◽  
Reginald V Lord ◽  
...  

Abstract Over 2.5 billion people worldwide are overweight or obese. Multidisciplinary weight management interventions have evolved to address the complexity of weight loss for those with one or more chronic diseases, and the trend of weight regain. The aim of these interventions is to encourage sustainable lifestyle changes, resulting in weight loss and weight maintenance and improvements in comorbidities. While some prospective clinical trials have demonstrated efficacy, results are often not reported by real life practices. The aim of this study was to evaluate the effectiveness of a Sydney based multidisciplinary weight management clinic with endocrinology, dietetics, exercise physiology, psychology, and bariatric surgical domains. All patients who attended the clinic for weight loss purposes between March 2017 and April 2019 were included (n=220). A retrospective chart review was conducted. Patient data on weight, BMI, waist circumference, body composition measurements, and selected blood test results and co-morbidities were analysed. All patient therapy included endocrinological input for co-morbidity identification and management, lifestyle intervention (dietetic and exercise physiology input) with optional adjunct pharmacotherapy or psychological counselling. Of the 220 cohort, 20 of the patients had sleeve gastrectomy. Patient retention in the clinic after the first consultation was 85% (n=186), a high rate within the weight management community. 59% of patients achieved a minimum of 5% total body weight loss, including 18% who achieved greater than 10% total body weight loss. Additionally, 31% of patients lost enough weight to decrease their BMI class by up to 2 or more classes. Of the gastric sleeve cohort average excess body weight loss was 32kg (21-56kg) enhanced by multidisciplinary care in the lead up to surgery. Across the cohort some patients completely reversed co-morbidities; including dyslipidaemia (n=1), hypertension (n=3), NAFLD (n=1), pre-diabetes (n=8) and type 2 diabetes (n=3), OSA (n=1). These results demonstrate that obesity is a chronic condition that can be successfully managed. We have demonstrated significant durable weight loss and improvement in metabolic co-morbidities with holistic coordinated care. Future directions include translating this model of care into standard practice in Australia and other countries where obesity to date not received the same coordinated approach as other chronic conditions.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Shufang Yang ◽  
Lin Huang ◽  
Yanli Zhang ◽  
Pengzhu Zhang ◽  
Yuxiang Chris Zhao

PurposeThe literature reports inconsistent findings about the effects of social media usage (SMU). Researchers distinguish between active and passive social media usage (ASMU and PSMU), which can generate different effects on users by social support and social comparison mechanisms, respectively. Drawing on social presence theory (SPT), this study integrates an implicit social presence mechanism with the above two mechanisms to explicate the links between SMU and seniors' loneliness.Design/methodology/approachData were collected from a field study by interviewing seniors living in eight aging care communities in China. Loneliness, social media activities and experiences with social media in terms of online social support (OSS), upward social comparison (USC) and social presence (SP) were assessed. Factor-based structural equation modeling was used to analyze the data.FindingsOSS can mediate the relationship between ASMU and seniors' loneliness. Moreover, SP mediates between ASMU, PSMU, and seniors' loneliness, and between OSS, USC and seniors' loneliness. OSS mediates the relationship between ASMU and SP, and USC mediates the relationship between PSMU and SP.Practical implicationsThis study shows that social media can alleviate seniors' loneliness, which could help relieve the pressures faced by health and social care systems. Social presence features are suggested to help older users interact with social health technologies in socially meaningful ways.Originality/valueThis study not only demonstrates that SP can play a crucial role in the relationship between both ASMU and PSMU and loneliness, but also unravels the links between SP and OSS, as well as USC.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Puranen ◽  
P Salokekkila ◽  
N Ahlblad-Makinen ◽  
A Haggman-Laitila

Abstract Background Healthy Life -groups are targeted to patients with symptoms of metabolic syndrome, problems with coping or overweight at public health centers in Helsinki. The aim of one-year Healthy Life -group is to give support for self-care and empowerment. The groups are generic, and each participant sets her own goal such as smoking cessation, alcohol or weight management. Methods To create opportunities for positive and empowering diet intervention for working aged population, we have started a pilot study with visual food diary (MealLogger). The nutritionist are coaching the three-month-intervention aiming at improving the diet quality. Participants share photos of their meals with each other and receive peer support. Results During years 2016 - 2018, 445 completed the one-year intervention in Healthy Life -groups. The mean decrease of weight loss was 4 kg (n = 222) and decrease of waist circumference 5 cm (n = 57). Conclusions Since the goal for most participants was weight loss, we decided to offer a modern intervention with MealLogger-application. During year 2019 we will complete six groups (about 100 participants) and we will measure participants food quality, weight, waist circumference, quality of life. The results we report in the autumn. Key messages To manage overweight epidemic, new prevention strategies are needed in the primary health care. Visual food diary enables positive and empowering approach to improve died quality and weight management.


2016 ◽  
Vol 23 (2) ◽  
pp. 263-272 ◽  
Author(s):  
Erik A Willis ◽  
Amanda N Szabo-Reed ◽  
Lauren T Ptomey ◽  
Felicia L Steger ◽  
Jeffery J Honas ◽  
...  

Introduction Currently, no systematic review/meta-analysis has examined studies that used online social networks (OSN) as a primary intervention platform. Therefore, the purpose of this review was to evaluate the effectiveness of weight management interventions delivered through OSN. Methods PubMed, EMBASE, PsycINFO, Web of Science, and Scopus were searched (January 1990–November 2015) for studies with data on the effect of OSNs on weight loss. Only primary source articles that utilized OSN as the main platform for delivery of weight management/healthy lifestyle interventions, were published in English language peer-reviewed journals, and reported outcome data on weight were eligible for inclusion in this systematic review. Five articles were included in this review. Results One-hundred percent of the studies ( n = 5) reported a reduction in baseline weight. Three of the five studies (60%) reported significant decreases in body weight when OSN was paired with health educator support. Only one study reported a clinical significant weight loss of ≥5%. Conclusion Using OSN for weight management is in its early stages of development and, while these few studies show promise, more research is needed to acquire information about optimizing these interventions to increase their efficacy.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033534 ◽  
Author(s):  
Tania Griffin ◽  
Yongzhong Sun ◽  
Manbinder Sidhu ◽  
Peymane Adab ◽  
Adrienne Burgess ◽  
...  

ObjectiveTo assess (1) the feasibility of delivering a culturally adapted weight management programme, Healthy Dads, Healthy Kids United Kingdom (HDHK-UK), for fathers with overweight or obesity and their primary school-aged children, and (2) the feasibility of conducting a definitive randomised controlled trial (RCT).DesignA two-arm, randomised feasibility trial with a mixed-methods process evaluation.SettingSocioeconomically disadvantaged, ethnically diverse localities in West Midlands, UK.ParticipantsFathers with overweight or obesity and their children aged 4–11 years.InterventionParticipants were randomised in a 1:2 ratio to control (family voucher for a leisure centre) or intervention comprising 9 weekly healthy lifestyle group sessions.OutcomesFeasibility of the intervention and RCT was assessed according to prespecified progression criteria: study recruitment, consent and follow-up, ability to deliver intervention, intervention fidelity, adherence and acceptability, weight loss, using questionnaires and measurements at baseline, 3 and 6 months, and through qualitative interviews.ResultsThe study recruited 43 men, 48% of the target sample size; the mean body mass index was 30.2 kg/m2 (SD 5.1); 61% were from a minority ethnic group; and 54% were from communities in the most disadvantaged quintile for socioeconomic deprivation. Recruitment was challenging. Retention at follow-up of 3 and 6 months was 63%. Identifying delivery sites and appropriately skilled and trained programme facilitators proved difficult. Four programmes were delivered in leisure centres and community venues. Of the 29 intervention participants, 20 (69%) attended the intervention at least once, of whom 75% attended ≥5 sessions. Sessions were delivered with high fidelity. Participants rated sessions as ‘good/very good’ and reported lifestyle behavioural change. Weight loss at 6 months in the intervention group (n=17) was 2.9 kg (95% CI −5.1 to −0.6).ConclusionsThe intervention was well received, but there were significant challenges in recruitment, programme delivery and follow-up. The HDHK-UK study was not considered feasible for progression to a full RCT based on prespecified stop–go criteria.Trial registration numberISRCTN16724454.


2018 ◽  
Vol 68 (674) ◽  
pp. e646-e653 ◽  
Author(s):  
Charlotte Albury ◽  
Elizabeth Stokoe ◽  
Sue Ziebland ◽  
Helena Webb ◽  
Paul Aveyard

BackgroundGuidelines encourage GPs to make brief opportunistic interventions to support weight loss. However, GPs fear that starting these discussions will lead to lengthy consultations. Recognising that patients are committed to take action could allow GPs to shorten brief interventions.AimTo examine which patient responses indicated commitment to action, and the time saved if these had been recognised and the consultation closed sooner.Design and settingA mixed-method cohort study of UK primary care patients participating in a trial of opportunistic weight management interventions.MethodConversation analysis was applied to 226 consultation audiorecordings to identify types of responses from patients that indicated that an offer of referral to weight management was well received. Odds ratios (OR) were calculated to examine associations between response types and likelihood of weight management programme attendance.ResultsAffirmative responses, for example ‘yes’, displayed no conversational evidence that the referral was well received and showed no association with attendance: ‘yes’ (OR 1.2, 95% confidence interval [CI] = 0.37 to 3.95, P = 0.97). However, ‘oh’-prefaced responses and marked positive responses, for example ‘lovely’, showed conversational evidence of enthusiasm and were associated with higher odds of commercial weight management service attendance. Recognising these could have saved doctors a mean of 31 seconds per consultation.ConclusionWhen doctors make brief opportunistic interventions that incorporate the offer of help, ‘oh’-prefaced or marked positive responses indicate enthusiastic acceptance of the offer and a higher likelihood of take-up. Recognising these responses and moving swiftly to facilitate patient action would shorten the brief intervention in many cases.


10.2196/24690 ◽  
2021 ◽  
Vol 23 (4) ◽  
pp. e24690
Author(s):  
Ran Xu ◽  
David Cavallo

Background Obesity is a known risk factor for cardiovascular disease risk factors, including hypertension and type II diabetes. Although numerous weight loss interventions have demonstrated efficacy, there is considerably less evidence about the theoretical mechanisms through which they work. Delivering lifestyle behavior change interventions via social media provides unique opportunities for understanding mechanisms of intervention effects. Server data collected directly from web-based platforms can provide detailed, real-time behavioral information over the course of intervention programs that can be used to understand how interventions work. Objective The objective of this study was to demonstrate how social network analysis can facilitate our understanding of the mechanisms underlying a social media–based weight loss intervention. Methods We performed secondary analysis by using data from a pilot study that delivered a dietary and physical activity intervention to a group of participants via Facebook. We mapped out participants’ interaction networks over the 12-week intervention period and linked participants’ network characteristics (eg, in-degree, out-degree, network constraint) to participants’ changes in theoretical mediators (ie, dietary knowledge, perceived social support, self-efficacy) and weight loss by using regression analysis. We also performed mediation analyses to explore how the effects of social network measures on weight loss could be mediated by the aforementioned theoretical mediators. Results In this analysis, 47 participants from 2 waves completed the study and were included. We found that increases in the number of posts, comments, and reactions significantly predicted weight loss (β=–.94, P=.04); receiving comments positively predicted changes in self-efficacy (β=7.81, P=.009), and the degree to which one’s network neighbors are tightly connected with each other weakly predicted changes in perceived social support (β=7.70, P=.08). In addition, change in self-efficacy mediated the relationship between receiving comments and weight loss (β=–.89, P=.02). Conclusions Our analyses using data from this pilot study linked participants’ network characteristics with changes in several important study outcomes of interest such as self-efficacy, social support, and weight. Our results point to the potential of using social network analysis to understand the social processes and mechanisms through which web-based behavioral interventions affect participants’ psychological and behavioral outcomes. Future studies are warranted to validate our results and to further explore the relationship between network dynamics and study outcomes in similar and larger trials.


2017 ◽  
Author(s):  
Elizabeth Prout Parks ◽  
Renee' H Moore ◽  
Ziyi Li ◽  
Chanelle T Bishop-Gilyard ◽  
Andrew R Garrett ◽  
...  

BACKGROUND Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. OBJECTIVE The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. METHODS In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or “posts” 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. RESULTS All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at the conclusion of the intervention (M=.589, P=.28). Increased social media comments correlated with weight change (r=–.633, P=.04). CONCLUSIONS This pilot trial demonstrated that the use of social media as an adjunct to medical weight management was feasible and acceptable to adolescents with severe obesity. Based upon these preliminary findings, social media may be an effective way to mitigate attrition from obesity treatment programs, and improve health outcomes in this high-risk population.


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