Web-Based Weight Loss & Weight Maintenance Intervention for Older Rural Women, Also Known as Women Weigh-in for Wellness

University of Nebraska

Status: Completed

Conditions: Overweight and Obesity

Treatments: Behavioral: Experimental: WO & professional email counseling (WE); Behavioral: Experimental: Web-based only (WO) weight intervention; Behavioral: Experimental: WO plus peer-led discussion board (WD)

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT01307644

0237-10-FB

1R01NR010589-01A2 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This project will evaluate an Internet delivery strategy to address weight loss and maintenance among rural midlife and older women.

Full description

According to the National Institutes of Health, "obesity is one of the most daunting health challenges of the 21st century". Approximately 2/3 of all adults are overweight or obese. Efforts to abate the growing prevalence of obesity have not been successful. The Strategic Plan for NIH Obesity Research proposes preventing and treating obesity through lifestyle modification. The purpose of this study is to evaluate the effectiveness of a theory-based intervention framed within the Health Promotion Model (HPM) in facilitating weight loss and maintenance through promotion of healthy eating and physical activity among an underserved, vulnerable population of overweight or obese rural women aged 40-69. During these years, women experience increases in peri- and post-menopausal health risks that are magnified if they are overweight or obese. Weight loss will reduce risks and enhance functional status as they age. Maintenance of weight loss will be emphasized. The Internet offers a way to reach isolated rural women who have limited options for weight loss guidance. PUBLIC HEALTH RELEVANCE: Obesity is recognized as a major and growing public health problem. While many weight loss programs have been successful in the short term, they have not been successful in helping to maintain weight loss.

Enrollment: 301 patients

Sex: Female

Ages: 40 to 69 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• women aged 40-69
• overweight or Class I & II obese (BMI 28 to 39.9)or BMI 40 to 45 with physician clearance
• state a commitment to losing weight
• speak and read English
• able to communicate over the telephone
• able to use a computer with minimal assistance and complete electronic forms and surveys
• have access to and are able to access the Internet
• commitment to access the website as required by the research intervention including weekly self-reporting of calories and fat grams, weekly self-reporting of physical activity, pedometer steps, and body weight, and weekly (or more often) participation in other website components as determined by group to which randomized and phase of intervention
• have or are willing to obtain an email account
• have access to a DVD player
• able to walk without an assistive device
• answer 'no' to all questions on the Physical Activity Readiness Questionnaire (PAR-Q) or obtain clearance from their physician to become more active

Exclusion criteria

• diagnosed with Type 1 diabetes
• diagnosed with Type 2 diabetes and require insulin
• ≥ 10% weight loss in last six months
• enrolled in a weight loss management program
• enrolled in a formal program of cardiac rehabilitation or undergoing physical rehabilitation
• taking medications that affect weight loss or weight gain
• other physical or medical restrictions that would preclude following the minimum recommendations for moderate physical activity and healthy eating.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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301 participants in 3 patient groups

Web-based only (WO) weight intervention

Experimental group

Description:

A comprehensive lifestyle modification intervention for healthy eating and activity delivered by web only to facilitate Phase I weight loss (weekly messages baseline to 6 months), Phase 2 guided weight loss and weight maintenance (bi-weekly hot topics news, 6-18 months) and Phase 3 self-managed weight maintenance (6 monthly and 3 bi-monthly new content, 18-30 months).

Treatment:

Behavioral: Experimental: Web-based only (WO) weight intervention

WO & peer-led discussion board (WD)

Experimental group

Description:

Includes WO intervention, including all 3 Phases for weight loss and weight maintenance, supplemented with peer-lead discussion board. A peer leader will facilitate the asynchronous discussion group. The primary purpose of this group is to provide support, increase self-efficacy (role modeling by successful women and leader) and discuss progress toward goals.

Treatment:

Behavioral: Experimental: WO plus peer-led discussion board (WD)

Behavioral: Experimental: Web-based only (WO) weight intervention

WO & professional email counseling (WE)

Experimental group

Description:

Includes WO intervention, including all 3 Phases for weight loss and weight maintenance, supplemented with professional email-counseling by experienced counselor who will review women's web-logs of eating, activity, weight and goal-setting on web-site and send e-mail feedback.

Treatment:

Behavioral: Experimental: WO & professional email counseling (WE)

Behavioral: Experimental: Web-based only (WO) weight intervention