Racial Differences in Weight Loss Mediated by Engagement and Behavior Change.

Abstract

We set out to determine if a primarily Internet-delivered behavioral weight loss intervention produced differential weight loss in African American and non-Hispanic White women, and to identify possible mediators. Data for this analysis were from a randomized controlled trial, collected at baseline and 4-months. The intervention included monthly face-to-face group sessions and an Internet component that participants were recommended to use at least once weekly. We included overweight or obese African American and non-Hispanic White women (n=170), with at least weekly Internet access, who were able to attend group sessions. Monthly face-to-face group sessions were delivered in large or small groups. The Internet component included automated tailored feedback, self-monitoring tools, written lessons, video resources, problem solving, exercise action planning tools, and social support through message boards. Multiple linear regression was used to evaluate race group differences in weight change. Non-Hispanic White women lost more weight than African American women (-5.03% vs.-2.39%, P=.0002). Greater website log-ins and higher change in Eating Behavior Inventory score in non-Hispanic White women partially mediated the race-weight loss relationship. The weight loss disparity may be addressed through improved website engagement and adoption of weight control behaviors.