Developing the Choosing Health digital weight loss and maintenance intervention using an Intervention Mapping approach (Preprint)

2021 ◽  
Author(s):  
Iga Palacz-Poborczyk ◽  
Paulina Idziak ◽  
Anna Januszewicz ◽  
Aleksandra Luszczynska ◽  
Eleanor Quested ◽  
...  

BACKGROUND Digital health promotion programs tailored to the individual are a potential cost-effective and scalable solution to enable self-management and provide support to people with excess body weight. However, solutions that are personalised, theory- and evidence- based and widely accessible are still limited. OBJECTIVE This study aimed to develop a digital behaviour change program, Choosing Health, that could identify modifiable predictors of weight loss and maintenance for each individual and utilise these to provide tailored support. METHODS We applied an Intervention Mapping protocol to design the program. This systematic approach to develop theory- and evidence-based health promotion programs consisted of 6 steps: development of (1) a logic model of the problem, (2) model of change, (3) intervention design and (4) production, (5) the implementation plan, and (6) evaluation plan. The decisions made during the Intervention Mapping process were guided by theory, existing evidence, and our own research (including four focus groups, N=40, expert consultations, N=12 and interviews, N=11). The stakeholders included researchers, public representatives (including individuals with overweight and obesity), and experts from the variety of relevant backgrounds (including nutrition, physical activity, and healthcare sector). RESULTS Following a structured process, we developed a tailored intervention that has potential to reduce excess body weight and support behaviour changes in people with overweight and obesity. The Choosing Health intervention consists of tailored personalised text messages and email support that correspond with theoretical domains potentially predictive of weight outcomes for each participant. Intervention content includes behaviour change techniques to support motivation maintenance, self-regulation, habit formation, environmental restructuring, social support and addressing physical and psychological resources. CONCLUSIONS Use of an Intervention Mapping protocol enabled the systematic development of the Choosing Health intervention and guided the implementation and evaluation of the program. Through the involvement of different stakeholders, including representatives of general public, we were able to map out program facilitators and barriers while increasing ecological validity of the program, to ensure that we build an intervention that is useful, user friendly, and informative. We also summarised lessons learnt for the Choosing Health intervention development and for other health promotion programs. CLINICALTRIAL This is an Intervention Mapping study which is currently evaluated through a Randomised Controlled Trial. This trial was registered with www.clinicaltrials.gov; registration number NCT04291482. INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2020-040183

2019 ◽  
Vol 6 (1) ◽  
pp. 51-57 ◽  
Author(s):  
O. A. Gerasimchik ◽  
Ya. V. Girsh

Background. The steady growth of obesity in the children’s age group determines the need for integrated modern approaches to diagnosis and therapy.Objective. To determine the body composition of adolescents with different body mass for the quantitative analysis of the internal environment of the organism using the method bioimpendancemetria.Design and methods. To determine the composition of the body, 121 adolescents aged 10–17 years were examined, the average age was 13.9 years (± 2.1). Evaluation of anthropometric data and determination of BMI at the 1st stage of the study allowed to identify 3 groups of patients: group 1 — adolescents with normal body weight, 40 people (33 %), group 2 — overweight, 48 people (40 %) and group 3 — obese, 33 adolescents (27 %). At stage 2nd, the analysis of the body structure using computer impedance, which allows to determine the composition of the body in a percentage.Results. When assessing the structure of the body, in group with normal body weight, the content of adipose tissue corresponds to the normal value. In adolescents overweight and obesity in 100 % of cases there was an increased content of fat mass. In the group of adolescents with normal body weight, the percentage deviation of AKM is 16–17 %, in the group with excess body weight 12–40 %. Insufficient as well as excessive percentage of AKM causes hunger. The higher AKM in full adolescents, the more difficult the process of weight loss. During the evaluation of the main metabolism it was found that in the group of obese patients the indicators exceeded those in the groups with normal and overweight.Conclusion. The use of bioimpedance analysis allows to create an optimal set of sequential effects aimed at correcting the fat mass, water composition and muscle mass of the patient, which determines a more directed and effective weight loss and the possibility of dynamic control.


2015 ◽  
Vol 29 (2) ◽  
pp. 94-112 ◽  
Author(s):  
Misoon Song ◽  
Suyoung Choi ◽  
Se-an Kim ◽  
Kyoungsan Seo ◽  
Soo Jin Lee

Development of behavior theory–based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome–focused health education programs.


2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Win Hlaing Than ◽  
Jack K C Ng ◽  
Gordon C K Chan ◽  
Winston Fung ◽  
Cheuk Chun Szeto

Abstract Background and Aims The prevalence of obesity has increased over the past decade in patients with End Stage Kidney Disease (ESKD). Obesity at the initiation of peritoneal dialysis (PD) was reported to adversely affect clinical outcomes. However, there are few studies on the prognostic relevance of weight gain after PD. Method We reviewed the change in body weight of 954 consecutive PD patients from the initiation of dialysis to 2 years after they remained on PD. Clinical outcomes including patient survival, technique survival, and peritonitis rate in the subsequent two years were reviewed. Results The mean age was 60.3 ± 12.2 years; 535 patients (56.1%) were men and 504 (52.8%) had diabetes. After the first 2 years on PD, the average change in body weight was 1.2± 5.1 kg; their body weight was 63.0 ± 13.3 kg; body mass index (BMI) 24.4 ± 4.4 kg/m2. The patient survival rates in the subsequent two years were 64.9%, 75.0%, and 78.9% (log rank test, p = 0.008) for patients with weight loss ≥3 kg during the first 2 years of PD weight change between -3 and +3 kg, and weight gain ≥3 kg, respectively. The corresponding technique survival rates in the subsequent two years were 93.1%, 90.1%, 91.3%, respectively (p = 0.110), and the peritonitis rates were 0.7±1.5, 0.6±1.7, and 0.6±1.1 episodes per patient-year, respectively (p = 0.3). When the actual BMI after the first 2 years of PD was categorized into underweight, normal weight, marginal overweight, overweight, and obesity groups, the patient survival rates in the subsequent two years were 77.3%, 75.2%, 73.3%, 74.3%, and 75.9%, respectively (p= 0.005), and technique survival 98.0%, 91.9%, 88.0%, 92.8%, and 81.0%, respectively (p= 0.001). After adjusting for confounding clinical factors by multivariate Cox regression models, weight gain ≥ 3kg during the first 2 years of PD was an independent protective factor for technique failure (adjusted hazard ratio [AHR] 0.049; 95% confidence interval [CI] 0.004-0.554, p = 0.015), but was an adverse predictor of patient survival (AHR 2.338, 95%CI 1.149-4.757, p = 0.019). In contrast, weight loss ≥ 3kg during the first 2 years of PD did not predict subsequent patient or technique survival. Conclusion Weight gain during the first 2 years of PD confers a significant risk of subsequent mortality but appears to be associated with a lower risk of technique failure. The mechanism of this discordant risk prediction deserves further study.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e020802 ◽  
Author(s):  
Bishwajit Ghose ◽  
Sanni Yaya

ObjectivesTo investigate the (1) time trends in body mass index (BMI) and (2) relationship between media use and body weight status among adult women in Nigeria. We hypothesise that higher frequency of media use is associated with higher likelihood of being overweight and obesity among adult women.Study designCross-sectional.SettingUrban and rural settings in Nigeria.ParticipantsAdult non-pregnant women aged between 15 and 49 years.MethodsData were derived from Nigeria Demographic and Health Surveys conducted in 2003, 2008 and 2013. The outcome variable was excess body weight (overweight and obesity), and main explanatory variables were frequency of reading newspaper, listening to radio and television (TV) viewing. Datasets were merged to perform pooled analysis, and were analysed using bivariate and multivariable regression techniques.ResultsOf the 69 401 participants, 16.2% had a BMI of 25.0–29.9 kg/m2(95% CI 15.8 to 16.6) and 6.6% had >30 kg/m2(95% CI 6.3 to 6.9). Between 2003 and 2013, the prevalence of overweight women increased by 4.1%, and that of obesity by 2.2%. Overall, radio was the most popular media followed by TV and newspaper. Respectively, 15.6% and 11.7% of the women reported using radio and TV almost every day and 30.6% and 25.1% at least once a week. In multivariable analysis, watching TV almost every day and at least once a week were associated with, respectively, 1.6 and 1.2 times higher odds of being overweight, and 2.7 and 1.5 times higher odds of being obese compared with those who never used radio. Similarly, significant associations were observed for newspaper and radio use as well.ConclusionThe prevalence of overweight and obesity is noticeably high among Nigerian women and has been increasing steadily over the past decade. A statistically significant association exists between BMI and the use of newspaper, radio and TV. Further studies are required to develop a better understanding of the mechanisms that underlie this relationship.


2020 ◽  
Vol 4 (1-3) ◽  
pp. 45
Author(s):  
Dania Mirza Ramadhanty ◽  
Bernie Endyarni Medise

Objective. Overweight is one of the health problems that often occur in children and adolescents throughout the world, both in developed and developing countries. Study results in USA showed yearly increase of overweight prevalence in children aged 2–19 years old. In addition, based on the results by the National Health and Nutrition Examination Survey 2009–2010 in United States, the highest percentage of overweight and obesity by age group was found at 12–19 years old (33.6%). Basic Health Research/Riskesdas’s data in 2013 showed the prevalence of overweight in adolescents aged 16–18 years old in Indonesia reached the highest value of 11.5%. Moreover, most teenagers see their body images as a match between self’s and others’ ideal perception. Teenagers with positive body image tend to be more confident and also easier to get along with other people, especially their peers. In this study, researcher aimed to investigate the relationship between teenagers who have excess body weight with body image, whether it had positive or negative impact.Methods: This was a cross-sectional study. Data collection was done from December 2017 to January 2018. Data collected were anthropometric measurements (weight and height) and the King College London Body Image Questionnaire's filled by participants. From 400 subjects who filled the questionnaires, a total of 350 participants matched the inclusion criteria and were analyzed. Chi square test was done as data analysis.Results: Chi-square analysis for excess body weight status in relation to body image scores showed no relationship (p=1,000).Conclusions: There was no significant relationship between excessive body weight and body image. 


2016 ◽  
Vol 12 (3) ◽  
pp. 244-251 ◽  
Author(s):  
Deirdre K. Tobias ◽  
JoAnn E. Manson

The obesity paradox for survival among individuals with type 2 diabetes has been observed in some but not all studies. Conflicting evidence for the role of overweight and obesity in all-cause mortality may largely be a result of differences in study populations, epidemiological methods, and statistical analysis. For example, analyses among populations with long-term prevalent diabetes and the accrual of other chronic health conditions are more likely to observe that the sickest participants have lower body weights, and therefore, relative to normal weight, overweight and even obesity appear advantageous. Other mortality risk factors, such as smoking, also confound the relationship between body weight and survival, but this behavior varies widely in intensity and duration, making it difficult to assess and effectively adjust for in statistical models. Disentangling the potential sources of bias is imperative in understanding the relevance of excess body weight to mortality in diabetes. In this review, we summarize methodological considerations underlying the observed obesity paradox. Based on the available evidence, we conclude that the obesity paradox is likely an artifact of biases, and once these are accounted for, it is evident that compared with normal body weight, excess body weight is associated with a greater mortality risk.


2012 ◽  
Vol 26 (6) ◽  
pp. 1744-1750 ◽  
Author(s):  
Emilio Ortega ◽  
Rosa Morínigo ◽  
Lilliam Flores ◽  
Violeta Moize ◽  
Martin Rios ◽  
...  

2018 ◽  
Vol 64 (1) ◽  
pp. 99-107 ◽  
Author(s):  
John M Jakicic ◽  
Renee J Rogers ◽  
Kelliann K Davis ◽  
Katherine A Collins

Abstract BACKGROUND Overweight and obesity are significant public health concerns that are linked to numerous negative health consequences. Physical activity is an important lifestyle behavior that contributes to body weight regulation. CONTENT Physical activity is inversely associated with weight gain and the incidence of obesity. Physical activity also contributes to additional weight loss when coupled with dietary modification, and it can result in modest weight loss when not coupled with dietary modification. Moreover, physical activity is associated with improved long-term weight loss and prevention of weight gain following initial weight loss. Current evidence supports that physical activity should be moderate to vigorous in intensity to influence body weight regulation. There is also a growing body of evidence that physical activity can be accumulated throughout the day in shorter periods of time rather than being performed during a structured and longer period, and that physical activity performed in this manner can be important for body weight regulation. SUMMARY The literature supports the inclusion of physical activity as an important lifestyle behavior for regulating body weight. There are multiple intervention approaches that may be effective for enhancing physical activity engagement within the context of weight control.


Sign in / Sign up

Export Citation Format

Share Document