Participation In Weight Management Program Research Articles

Examining the effect of parent participation in an adult weight management program on changes in children's weight.

Children of parents participating in weight management programs (WMPs) are more likely to adopt their parents' weight control practices. Little is known about the weight outcomes of children who have a parent participating in a WMP. This study aimed to assess this relationship. Children 2-17 years of age with a parent who participated in a WMP were included in the study. Multilevel linear mixed-effects regression models were used, stratified by child weight status at the time of parental WMP participation (healthy weight, overweight/obesity) to determine change in children's BMIz from before to after parents WMP participation, including covariates of parent BMI and parental feeding practices. Parents (N=77) were mostly white (76%) and female (84%). Children (N=114) had a mean age of 10.5 ± 4.6; 47% had overweight or obesity. Children with overweight or obesity prior to their parent's WMP had a decrease in BMIz (-0.68) after the WMP while children with a healthy weight had no significant change. Children with overweight or obesity had a decrease in BMIz from before to after parent's participation in a WMP. Further research is needed to understand changes in family eating practices that occur during and after parent WMP participation.

National Veterans Health Administration MOVE! Weight Management Program Participation During the COVID-19 Pandemic.

IntroductionIn response to COVID-19, the Veterans Health Administration (VHA) converted appropriate outpatient visits to virtual care, including MOVE! Weight Management Program for Veterans (MOVE!) visits. Before the pandemic, most veterans participated in MOVE! in person, with several telehealth modalities available. We sought to describe national trends in MOVE! participation during the pandemic (March 2020–January 2021) overall and by modality and to compare participation to prepandemic levels.MethodsWe conducted a national retrospective cohort study of veterans who participated in MOVE! from January 2018 through January 2021. We examined MOVE! participation across VHA aggregated at the national level by month, including the number of visits, participants, and new participants in person and via telehealth, including telephone, clinic-to-clinic synchronous video, anywhere-to-anywhere (eg, provider home to patient home) synchronous video, and remote education and monitoring. We also determined the percentage of all MOVE! visits attributable to each modality and the monthly percentage change in participation during the pandemic compared with monthly averages in prior years.ResultsBefore March 2020, 20% to 30% of MOVE! was delivered via telehealth, which increased to 90% by April 2020. Early in the pandemic, telephone-delivered MOVE! was the most common modality, but anywhere-to-anywhere synchronous video participation increased over time. Compared with the same months in prior years, total monthly MOVE! participation remained 20% to 40% lower at the end of 2020 and into January 2021.ConclusionThe VHA MOVE! program rapidly shifted to telehealth delivery of weight management services in response to the pandemic. However, a gap remained in the number of veterans receiving these services compared with prior years, suggesting potential unmet needs for weight management.

90. Appointment Attendance, Weight at 6-Months, and Surgery Completion Among Adolescent Bariatric Surgery Candidates

To ensure better postoperative outcomes, adolescents seeking bariatric surgery are advised monthly by an interdisciplinary team to establish healthier habits for weight management. Because behavioral changes are adapted slowly, sporadic and limited participation in weight management programs is unlikely to produce long-term health benefits and may impact whether adolescents proceed with surgery. The aim of this study was to examine demographic and basic treatment adherence as predictors of pre-surgery weight change and transition to surgery.

Family members' experiences with adult participation in weight management programs: Triadic perspectives from patients, partners and children.

Spouses are known to influence the outcomes of an individual's attempt at weight loss, but little is known about the broader influence of, and on, the family. The objectives were to explore: (a) the effects of an adult weight management program on the family and (b) family factors that help or hinder patient weight loss. A qualitative design was employed to explore triadic family members' experiences of patient participation in a weight management program. Semi-structured interviews were conducted with patients, partners and children (ages 7-18). Questions included support for patient participation and weight loss, dietary choices, meal preparation, physical activity routines, the home-food environment, communication about health and family dynamics. Thematic analysis was used, where codes and categories of codes were then grouped together to create themes and subthemes. Nineteen triadic interviews were conducted (57 total). Seven themes emerged, including four related to Outcomes (objective 1): (a) shift in family dynamics, (b) family behaviour change, (c) child observations of family change, (d) indirect benefit to partner; and three related to Process (objective 2): (e) level of accountability, (f) patient perception of support and (g) support is essential and flexible. Future research and clinical applications from these themes should seek to determine the positive behaviour change that was evident in the families that were interviewed, where the culmination of family interactions, expectations and concurrent partner weight loss indicates the potential longevity of weight management programs beyond patients' own participation.

Recruiting young women to weight management programs: Barriers and enablers.

Recruiting young women to weight management research programs is difficult. The purpose of this study was to gain insights into the barriers and motivators that influence participation and to explore effective methods of recruitment from the perspective of young women with obesity living in both urban and regional areas. Semi-structured interviews were used to elicit information from focus groups. The interviews were transcribed, coded and analysed qualitatively. Eight focus groups, which included a total of 27 women, were conducted. Participants had a mean age of 29.1 (±5.1) years and a mean body mass index of 35.8 (±2.9) kg/m2 . The barriers to participation were multifaceted and largely similar across urban and regional participants. Fear of judgement and uncertainty about the process were major psychosocial barriers. A lack of tailoring of program content was an important program-related barrier. Physical barriers such as time commitment, cost and access were discussed extensively, particularly in urban groups. The provision of incentives and the use of positive language that focusses on the benefits of the intervention were viewed positively. Physical and virtual methods of recruitment were identified as potentially effective provided they were presented in media that this group is likely to use and can access in a private location. The results of this study provide a greater understanding of the challenges faced by young women in relation to participation in weight management programs and some of the potential methods that could be utilised to facilitate participation.

Access to primary care child weight management programs: Urban parent barriers and facilitators to participation.

The prevalence and comorbidities of childhood obesity among low-income urban children are a significant health issue in the United States. Programs designed to assist families are underutilized. The aim of this study is to describe barriers and facilitators relevant to intervention program participation from the perspective of parents who have children who are overweight or obese. Systematic thematic analysis of focus groups and semi-structured interviews with parents from multiple urban pediatrics and family medicine practices were used to gather data. A framework analysis approach was used and a codebook of themes was developed. Transcripts were coded independently by the research team and consensus among researchers was reached. Forty-eight parents participated in the study. Perceived barriers to participation included (1) varied referral process (lack of follow-up or varying referral experience), (2) costs (time and program fee), (3) logistics (location and program schedule), and (4) child motivation. Perceived facilitators to participation included (1) systematic referral process (in-office referral and timely follow-up), (2) program content and organization, and (3) no cost. Multiple barriers and facilitators affect weight management program participation among families, which should be specifically targeted in future obesity interventions in order to effectively reach urban, minority parents and children.

ForgIng New paths in DIabetes PrevenTion (FINDIT): Study Protocol for a Randomized Controlled Trial

BackgroundPrediabetes is an asymptomatic condition in which patients’ blood glucose levels are higher than normal but do not meet diagnostic criteria for type 2 diabetes mellitus (T2DM). A key window of opportunity to increase engagement of patients with prediabetes in strategies to prevent T2DM is when they are screened for T2DM and found to have prediabetes, yet the effects of this screening and brief counseling are unknown.MethodsIn this parallel-design randomized controlled trial we will recruit 315 non-diabetic patients from the Ann Arbor VA Medical Center (AAVA) who have one or major risk factors for T2DM and an upcoming primary care appointment at the AAVA, but have not had a hemoglobin A1c (HbA1c) test to screen for T2DM in the previous 12 months. After informed consent, participants will complete a baseline survey and be randomly assigned to, at the time of their next primary care appointment, one of two arms: (1) to have a hemoglobin A1c (HbA1c) test to screen for T2DM and receive brief, standardized counseling about these results or (2) to review a brochure about clinical preventive services. Participants will complete surveys 2 weeks, 3 months, and 12 months after their primary care appointment, and a weight measurement 12 months after their primary care appointment. The primary outcome is weight change after 12 months. The secondary outcomes are changes in perception of risk for T2DM; knowledge of T2DM prevention; self-efficacy and motivation to prevent T2DM; use of pharmacotherapy for T2DM prevention; physical activity; participation in weight management programs; and mental health. Quantitative analyses will compare outcomes among participants in the HbA1c test arm found to have prediabetes with participants in the brochure arm. Among participants in the HbA1c test arm found to have prediabetes we will conduct semi-structured interviews about their understanding of and reactions to receiving a prediabetes diagnosis.DiscussionThis trial will generate foundational data on the effects of a prediabetes diagnosis and brief counseling on patients’ preventive behaviors and mediators of these behaviors that will enable the development of novel strategies to improve patient engagement in T2DM prevention.Trial registrationClinicalTrials.gov, NCT02747108. Registered on 18 April 2016.

Weight and Veterans' Environments Study (WAVES) I and II: Rationale, Methods, and Cohort Characteristics.

To present the rationale, methods, and cohort characteristics for 2 complementary "big data" studies of residential environment contributions to body weight, metabolic risk, and weight management program participation and effectiveness. Retrospective cohort. Continental United States. A total of 3 261 115 veterans who received Department of Veterans Affairs (VA) health care in 2009 to 2014, including 169 910 weight management program participants and a propensity score-derived comparison group. The VA MOVE! weight management program, an evidence-based lifestyle intervention. Body mass index, metabolic risk measures, and MOVE! participation; residential environmental attributes (eg, food outlet availability and walkability); and MOVE! program characteristics. Descriptive statistics presented on cohort characteristics and environments where they live. Forty-four percent of men and 42.8% of women were obese, whereas 4.9% of men and 9.9% of women engaged in MOVE!. About half of the cohort had at least 1 supermarket within 1 mile of their home, whereas they averaged close to 4 convenience stores (3.6 for men, 3.9 for women) and 8 fast-food restaurants (7.9 for men, 8.2 for women). Forty-one percent of men and 38.6% of women did not have a park, and 35.5% of men and 31.3% of women did not have a commercial fitness facility within 1 mile. Drawing on a large nationwide cohort residing in diverse environments, these studies are poised to significantly inform policy and weight management program design.

Parent and Health Care Provider Perceptions for Development of a Web-Based Weight Management Program for Survivors of Pediatric Acute Lymphoblastic Leukemia: A Mixed Methods Study

BackgroundSurvivors of pediatric acute lymphoblastic leukemia (ALL) may experience unhealthy weight gain during treatment, which has been associated with higher risk for chronic health issues.ObjectiveThe purpose of this study was to obtain feedback on weight management in pediatric ALL survivors and on the content and implementation of a Web-based weight management program.MethodsStudy participants included 54 parent survey respondents and 19 pediatric oncology professionals in 4 focus groups. Survey questions included report of child weight status and interest in participating in weight management programming at various time points. Pediatric oncology professionals were asked about the preferred topics and timing, as well as their role. Focus group data were analyzed by a multidisciplinary research team for common themes.ResultsThe mean age of survivors was 6.5 years. By parent report, 19% of children were overweight and 25% were obese. Preferred timing for weight management program participation was within 3 months of starting maintenance chemotherapy (23/53, 43%) or within 12 months after completion of all cancer treatments (18/53, 34%). Pediatric oncology professionals likewise considered the maintenance phase appropriate. They considered parenting to be an important topic to include and indicated that their most appropriate roles would be promotion and support.ConclusionsParents and pediatric oncology professionals are interested in and supportive of early weight management in pediatric ALL survivors. Future research needs to identify strategies to integrate this into pediatric cancer care and to evaluate the feasibility and efficacy of these strategies.

National evaluation of obesity screening and treatment among veterans with and without mental health disorders

ObjectiveThe objective was to determine whether obesity screening and weight management program participation and outcomes are equitable for individuals with serious mental illness (SMI) and depressive disorder (DD) compared to those without SMI/DD in Veterans Health Administration (VHA), the largest integrated US health system, which requires obesity screening and offers weight management to all in need. MethodsWe used chart-reviewed, clinical and administrative VHA data from fiscal years 2010–2012 to estimate obesity screening and participation in the VHA’s weight management program (MOVE!) across groups. Six- and 12-month weight changes in MOVE! participants were estimated using linear mixed models adjusted for confounders. ResultsCompared to individuals without SMI/DD, individuals with SMI or DD were less frequently screened for obesity (94%–94.7% vs. 95.7%) but had greater participation in MOVE! (10.1%–10.4% vs. 7.4%). MOVE! participants with SMI or DD lost approximately 1 lb less at 6 months. At 12 months, average weight loss for individuals with SMI or neither SMI/DD was comparable (−3.5 and −3.3 lb, respectively), but individuals with DD lost less weight (mean=−2.7 lb). ConclusionsDisparities in obesity screening and treatment outcomes across mental health diagnosis groups were modest. However, participation in MOVE! was low for every group, which limits population impact.

The effect of a weight management program on postural balance in obese children

The present study aimed to investigate whether obese children improve their balance and postural performance following a 6-month-weight management program. Twenty-nine obese children aged 6-14 years were examined posturographically before and after participation in weight management program. The interactive balance system evaluated the stability index, Fourier spectral analysis, weight distribution index, and falling index. The performance was evaluated for eight positions requiring closure of eyes, standing on pillows, as well as head turns. Anthropometric measurements (e.g., weight, height, BMI, and BMI percentiles) were also determined before and after the intervention. We found significant increase in height and significant decreased in BMI percentile following the intervention program (p<.05). Pre-intervention BMI percentile was found to be correlated with stability index in most of the positions measured (e.g., normal open position=.464; p=.011). Following the intervention program, an interaction was found between BMI percentile differences (pre- versus post-interventional) and balance (stability index and F2-F4 frequencies of most standing positions). Furthermore, a correlation was found between general stability and the falling index (.446; p=.015). Regression analysis showed that only initial weight distribution index and post-intervention BMI entered the equation as predictors of post-intervention weight distribution index. Weight management program for childhood obesity improved stability, reduced potential vestibular stress/disturbances, and decreased falling probability of the participants. Further longitudinal studies are needed to verify the relationship between physical activity, weight loss, and reduction of subsequent injuries in obese children.

The Effects of Weight Management Programs on Self-Esteem in Pediatric Overweight Populations

Review published findings on self-esteem and pediatric overweight, and changes in self-esteem subsequent to weight management programs. We used PsycInfo and MedLine searches to identify peer-reviewed journal articles examining self-esteem changes following participation in weight management programs. Data regarding the relationship between self-esteem and obesity is mixed. Factors that place overweight children "at-risk" for low self-esteem include early adolescence, female gender, identification with majority cultural standards of body shape, exposure to teasing and peer victimization, a history of greater parental control over feeding, and internal attributions about weight status. Data from intervention studies suggest positive effects on self-esteem across settings. Components related to self-esteem improvements include weight change, parent involvement, and group intervention format. Well-designed, longitudinal studies using multidimensional measures of self-esteem, and following CONSORT guidelines are needed to confirm and expand these findings. Emphasis should be placed on examining mediators and moderators of self-esteem change.

SELF-ESTEEM CHANGES IN CHILDREN ENROLLED IN WEIGHT MANAGEMENT PROGRAMS

The purpose of this study was to examine self-esteem changes in school aged children enrolled in weight management programs. The study group was comprised of 54 obese children ages 10-15 enrolled in a weight management program. The control group was comprised of 60 obese children who had never been enrolled in a weight management program. Each child was measured for body mass index (BMI) and weight. All the children filled out the Pier-Harris Children's Self-Concept Scale at the beginning of the study and 12 weeks later following the study group's completion of the weight management program. The groups were similar in average age, weight, BMI, and self-concept score at the beginning of the study. At the end of the 12 weeks, there was no significant change in the average weight or BMI in either the study or control group. There was a significant decrease in the self-concept score in the study group but not in the control group. The greatest score changes came from the physical appearance subscale. Participation in weight management programs may put children at risk for lower self-esteem (self-concept) while producing limited weight loss results.