Features Predicting Weight Loss in Overweight or Obese Participants in a Web-Based Intervention: Randomized Trial Preventing weight gain in first year college students: an online intervention to prevent the "freshman fifteen". Why We Need More Than Just Randomized Controlled Trials to Establish the Effectiveness of Online Social Networks for Health Behavior Change Using social and mobile tools for weight loss in overweight and obese young adults (Project SMART): a 2 year, parallel-group, randomised, controlled trial. Click “Like” to Change Your Behavior: A Mixed Methods Study of College Students’ Exposure to and Engagement With Facebook Content Designed for Weight Loss Feasibility and preliminary efficacy of the ‘HEYMAN’ healthy lifestyle program for young men: a pilot randomised controlled trial Weight-Gain Reduction Among 2-Year College Students: The CHOICES RCT. Using Facebook and text messaging to deliver a weight loss program to college students. Effectiveness of a mHealth Lifestyle Program With Telephone Support (TXT2BFiT) to Prevent Unhealthy Weight Gain in Young Adults: Randomized Controlled Trial The Impact of an Online Social Network With Wireless Monitoring Devices on Physical Activity and Weight Loss The role of companionship, esteem, and informational support in explaining physical activity among young women in an online social network intervention A 2-year young adult obesity prevention trial in the US: Process evaluation results. A mobile health intervention for weight management among young adults: a pilot randomised controlled trial.
Background Obesity remains a serious issue in many countries . Web-based programs offer good potential for delivery of weight loss programs . Yet , many Internet-delivered weight loss studies include support from medical or nutritional experts , and relatively little is known about purely web-based weight loss programs . Objective To determine whether supportive features and personalization in a 12-week web-based lifestyle intervention with no in-person professional contact affect retention and weight loss . Methods We assessed the effect of different features of a web-based weight loss intervention using a 12-week repeated- measures r and omized parallel design . We developed 7 sites representing 3 functional groups . A national mass media promotion was used to attract overweight/obese Australian adults ( based on body mass index [ BMI ] calculated from self-reported heights and weights ) . Eligible respondents ( n = 8112 ) were r and omly allocated to one of 3 functional groups : information-based ( n = 183 ) , supportive ( n = 3994 ) , or personalized-supportive ( n = 3935 ) . Both supportive sites included tools , such as a weight tracker , meal planner , and social networking platform . The personalized-supportive site included a meal planner that offered recommendations that were personalized using an algorithm based on a user ’s preferences for certain foods . Dietary and activity information were constant across sites , based on an existing and tested 12-week weight loss program ( the Total Wellbeing Diet ) . Before and /or after the intervention , participants completed demographic ( including self-reported weight ) , behavioral , and evaluation question naires online . Usage of the website and features was objective ly recorded . All screening and data collection procedures were performed online with no face-to-face contact . Results Across all 3 groups , attrition was high at around 40 % in the first week and 20 % of the remaining participants each week . Retention was higher for the supportive sites compared to the information-based site only at week 12 ( P = .01 ) . The average number of days that each site was used varied significantly ( P = .02 ) and was higher for the supportive site at 5.96 ( SD 11.36 ) and personalized-supportive site at 5.50 ( SD 10.35 ) , relative to the information-based site at 3.43 ( SD 4.28 ) . In total , 435 participants provided a valid final weight at the 12-week follow-up . Intention-to-treat analyses ( using multiple imputations ) revealed that there were no statistically significant differences in weight loss between sites ( P = .42 ) . On average , participants lost 2.76 % ( SE 0.32 % ) of their initial body weight , with 23.7 % ( SE 3.7 % ) losing 5 % or more of their initial weight . Within supportive conditions , the level of use of the online weight tracker was predictive of weight loss ( model estimate = 0.34 , P < .001 ) . Age ( model estimate = 0.04 , P < .001 ) and initial BMI ( model estimate = -0.03 , P < .002 ) were associated with frequency of use of the weight tracker . Conclusions Relative to a static control , inclusion of social networking features and personalized meal planning recommendations in a web-based weight loss program did not demonstrate additive effects for user weight loss or retention . These features did , however , increase the average number of days that a user engaged with the system . For users of the supportive websites , greater use of the weight tracker tool was associated with greater weight loss The transition to college has been identified as a critical period for increases in overweight status . Overweight college students are at-risk of becoming obese adults , and , thus prevention efforts targeting college age individuals are key to reducing adult obesity rates . The current study evaluated an Internet intervention with first year college students ( N=170 ) r and omly assigned to one of four treatment conditions : 1 ) no treatment , 2 ) 6-week online intervention 3 ) 6-week weight and caloric feedback only ( via email ) , and 4 ) 6-week combined feedback and online intervention . The combined intervention group had lower BMI s at post-testing than the other three groups . This study demonstrated the effectiveness and feasibility of an online intervention to prevent weight gain among college students Despite their popularity and potential to promote health in large population s , the effectiveness of online social networks ( e.g. , Facebook ) to improve health behaviors has been somewhat disappointing . Most of the research examining the effectiveness of such interventions has used r and omized controlled trials ( RCTs ) . It is asserted that the modest outcomes may be due to characteristics specific to both online social networks and RCTs . The highly controlled nature of RCTs stifles the dynamic nature of online social networks . Alternative and ecologically valid research design s that evaluate online social networks in real-life conditions are needed to advance the science in this area BACKGROUND Few weight loss interventions are evaluated for longer than a year , and even fewer employ social and mobile technologies commonly used among young adults . We assessed the efficacy of a 2 year , theory-based , weight loss intervention that was remotely and adaptively delivered via integrated user experiences with Facebook , mobile apps , text messaging , emails , a website , and technology-mediated communication with a health coach ( the SMART intervention ) . METHODS In this parallel-group , r and omised , controlled trial , we enrolled overweight or obese college students ( aged 18 - 35 years ) from three universities in San Diego , CA , USA . Participants were r and omly assigned ( 1:1 ) to receive either the intervention ( SMART intervention group ) or general information about health and wellness ( control group ) . We used computer-based permuted-block r and omisation with block sizes of four , stratified by sex , ethnicity , and college . Participants , study staff , and investigators were masked until the intervention was assigned . The primary outcome was objective ly measured weight in kg at 24 months . Differences between groups were evaluated using linear mixed-effects regression within an intention-to-treat framework . Objective ly measured weight at 6 , 12 , and 18 months was included as a secondary outcome . The trial is registered with Clinical Trials.gov , number NCT01200459 . FINDINGS Between May 18 , 2011 , and May 17 , 2012 , 404 individuals were r and omly assigned to the intervention ( n=202 ) or control ( n=202 ) . Participants ' mean ( SD ) age was 22·7 ( 3·8 ) years . 284 ( 70 % ) participants were female and 125 ( 31 % ) were Hispanic .  Mean ( SD ) body-mass index at baseline was 29·0 ( 2·8 ) kg/m(2 ) . At 24 months , weight was assessed in 341 ( 84 % ) participants , but all 404 were included in analyses . Weight , adjusted for sex , ethnicity , and college , was not significantly different between the groups at 24 months ( -0·79 kg [ 95 % CI -2·02 to 0·43 ] , p=0·204 ) . However , weight was significantly less in the intervention group compared with the control group at 6 months ( -1·33 kg [ 95 % CI -2·36 to -0·30 ] , p=0·011 ) and 12 months ( -1·33 kg [ -2·30 to -0·35 ] , p=0·008 ) , but not 18 months ( -0·67 kg [ 95 % CI -1·69 to 0·35 ] , p=0·200 ) . One serious adverse event in the intervention group ( gallstones ) could be attributable to rapid and excessive weight loss . INTERPRETATION Social and mobile technologies did not facilitate sustained reductions in weight among young adults , although these approaches might facilitate limited short-term weight loss . FUNDING The National Heart , Lung , and Blood Institute of the National Institutes of Health ( U01 HL096715 ) Background Overweight or obesity is prevalent among college students and many gain weight during this time . Traditional face-to-face weight loss interventions have not worked well in this population . Facebook is an attractive tool for delivering weight loss interventions for college students because of its popularity , potential to deliver strategies found in successful weight loss interventions , and ability to support ongoing adaptation of intervention content . Objective The objective of this study was to describe participant exposure to a Facebook page design ed to deliver content to overweight/obese college students in a weight loss r and omized controlled trial ( N=404 ) and examine participant engagement with behavior change campaigns for weight loss delivered via Facebook . Methods The basis of the intervention campaign model were 5 self-regulatory techniques : intention formation , action planning , feedback , goal review , and self-monitoring . Participants were encouraged to engage their existing social network to meet their weight loss goals . A health coach moderated the page and modified content based on usage patterns and user feedback . Quantitative analyses were conducted at the Facebook post- and participant-level of analysis . Participant engagement was quantified by Facebook post type ( eg , status up date ) and interaction ( eg , like ) and stratified by weight loss campaign ( sequenced vs nonsequenced ) . A subset of participants were interviewed to evaluate the presence of passive online engagement or “ lurking . ” Results The health coach posted 1816 unique messages to the study ’s Facebook page over 21 months , averaging 3.45 posts per day ( SD 1.96 , range 1 - 13 ) . In all , 72.96 % ( 1325/1816 ) of the posts were interacted with at least once ( eg , liked ) . Of these , approximately 24.75 % ( 328/1325 ) had 1 - 2 interactions , 23.39 % ( 310/1325 ) had 3 - 5 interactions , 25.13 % ( 333/1325 ) had 6 - 8 interactions , and 41 posts had 20 or more interactions ( 3.09 % , 41/1325 ) . There was significant variability among quantifiable ( ie , visible ) engagement . Of 199 participants in the final intervention sample , 32 ( 16.1 % ) were highly active users and 62 ( 31.2 % ) never visibly engaged with the intervention on Facebook . Polls were the most popular type of post followed by photos , with 97.5 % ( 79/81 ) and 80.3 % ( 386/481 ) interacted with at least once . Participants visibly engaged less with posts over time ( partial r=–.33 ; P<.001 ) . Approximately 40 % of the participants interviewed ( 12/29 , 41 % ) reported passively engaging with the Facebook posts by reading but not visibly interacting with them . Conclusions Facebook can be used to remotely deliver weight loss intervention content to college students with the help of a health coach who can iteratively tailor content and interact with participants . However , visible engagement with the study ’s Facebook page was highly variable and declined over time . Whether the level of observed engagement is meaningful in terms of influencing changes in weight behaviors and outcomes will be evaluated at the completion of the overall study Background In young men , unhealthy lifestyle behaviours can be detrimental to their physical and /or mental health and set them on a negative health trajectory into adulthood . Despite this , there is a lack of evidence to guide development of effective health behaviour change interventions for young men . This study assessed the feasibility and preliminary efficacy of the ‘ HEYMAN ’ ( Harnessing Ehealth to enhance Young men ’s Mental health , Activity and Nutrition ) healthy lifestyle program for young men . Methods A pilot RCT with 50 young men aged 18–25 years r and omised to the HEYMAN intervention ( n = 26 ) or waitlist control ( n = 24 ) .  HEYMAN was a 3-month intervention , targeted for young men to improve eating habits , activity levels and well-being . Intervention development was informed by a participatory research model ( PRECEDE-PROCEED ) . Intervention components included eHealth support ( website , wearable device , Facebook support group ) , face-to-face sessions ( group and individual ) , a personalised food and nutrient report , home-based resistance training equipment and a portion control tool . Outcomes included : feasibility of research procedures ( recruitment , r and omisation , data collection and retention ) and of intervention components . Generalized linear mixed models estimated the treatment effect at 3-months for the primary outcomes : pedometer steps/day , diet quality , well-being and several secondary outcomes . Results A 7-week recruitment period was required to enrol 50 young men .  A retention rate of 94 % was achieved at 3-months post-intervention . Retained intervention participants ( n = 24 ) demonstrated reasonable usage levels for most program components and also reported reasonable levels of program component acceptability for attractiveness , comprehension , usability , support , satisfaction and ability to persuade , with scores ranging from 3.0 to 4.6 ( maximum 5 ) . No significant intervention effects were observed for the primary outcomes of steps/day ( 1012.7 , 95 % CI = −506.2 , 2531.6 , p = 0.191 , d = 0.36 ) , diet quality score ( 3.6 , 95 % CI = −0.4 , 7.6 , p = 0.081 , d = 0.48 ) or total well-being score ( 0.4 , 95 % CI = −1.6 , 2.5 , p = 0.683 , d = 0.11 ) . Significant intervention effects were found for daily vegetable servings , energy-dense , nutrient-poor foods , MVPA , weight , BMI , fat mass , waist circumference and cholesterol ( all p < 0.05 ) . Conclusions The HEYMAN program demonstrated feasibility in assisting young men to make some positive lifestyle changes . This provides support for the conduct of a larger , fully-powered RCT , but with minor amendments to research procedures and intervention components required . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN12616000350426 INTRODUCTION The young adult years have been recognized as an influential period for excess weight gain . Non-traditional students and those attending 2-year community colleges are at particularly high risk for a range of adverse weight-related outcomes . DESIGN Choosing Healthy Options in College Environments and Setting s was an RCT with students r and omly assigned into a control or intervention condition after baseline assessment . The study was design ed to evaluate if a 24-month weight-gain prevention intervention reduces the expected increase in BMI and overweight prevalence in young adults attending 2-year colleges . Two cohorts were recruited , corresponding to the fall and spring semesters . Data collection occurred at four time points for each cohort , with baseline occurring in fall 2011 for Cohort 1 and spring 2012 for Cohort 2 . The 24-month follow-up occurred in fall 2013 for Cohort 1 and spring 2014 for Cohort 2 . Data analysis occurred in 2015 - 2016 . SETTING / PARTICIPANTS This research was conducted with 441 students from three community colleges in Minnesota . INTERVENTION The 24-month intervention began with a 1-credit college course on healthy weight behaviors . A social networking and social support website was introduced as part of the course and participation encouraged for the duration of the trial . MAIN OUTCOME MEASURES Changes in BMI , weight , body fat percentage , waist circumference , and weight status were assessed . RESULTS Retention of the cohorts at 24 months was 83.4 % . There was not a statistically significant difference in BMI between conditions at the end of the trial . However , there was a statically significant difference in the prevalence of overweight/obesity between treatment conditions at 24 months . Also , participants r and omized to the intervention who were overweight or obese at baseline were more than three times as likely to transition to a healthy weight by the end of the trial as compared with control students . CONCLUSIONS The intervention was not successful in achieving BMI differences between treatment groups . However , an 8 % reduction in the prevalence of overweight and obesity over time may have population -level significance . TRIAL REGISTRATION This study is registered at www . clinical trials.gov NCT01134783 OBJECTIVE Between 31 and 35 % of the college-aged population is overweight or obese , yet few weight loss trials for this population have been conducted . This study examined the feasibility , acceptability , and initial efficacy of a technology-based 8-week weight loss intervention among college students . DESIGN AND METHODS Students ( N = 52 ) were r and omly assigned to one of the three arms : Facebook ( n = 17 ) ; Facebook Plus text messaging and personalized feedback ( n = 18 ) ; Waiting List control ( n = 17 ) , with assessment s at 4 weeks and 8 weeks ( post-treatment ) . Participants were 20.47 ± 2.19 years old , 86.45 ± 17.11 kg , with a body mass index of 31.36 ± 5.3 kg/m(2 ) . Participants were primarily female ( 86.5 % ) , and the sample was racially diverse ( 57.7 % Caucasian , 30.8 % African American , 5.8 % Hispanic , and 5.7 % other races ) . RESULTS The primary outcome was weight loss after 8 weeks ( post-treatment ) ; 96.0 % of the participants completed this assessment . At 8 weeks , the Facebook Plus group had significantly greater weight loss ( -2.4 ± 2.5 kg ) than the Facebook ( -0.63 ± 2.4 kg ) and Waiting List ( -0.24 ± 2.6 kg ) ( both Ps < 0.05 ) . Weight change at 8 weeks was not significantly different between the Facebook and Waiting List groups . CONCLUSIONS Results show preliminary efficacy and acceptability of the two active intervention arms ( 97.0 % found the program helpful , 81.3 % found the videos/h and outs helpful , and 100 % would recommend the program to others ) . Results indicate the potential for an innovative weight loss intervention that uses technology platforms ( Facebook and text messaging ) that are frequently used and already integrated into the cultural life of college students Background Weight gained in young adulthood often persists throughout later life with associated chronic disease risk . Despite this , current population prevention strategies are not specifically design ed for young adults . Objective We design ed and assessed the efficacy of an mHealth prevention program , TXT2BFiT , in preventing excess weight gain and improving dietary and physical activity behaviors in young adults at increased risk of obesity and unhealthy lifestyle choices . Methods A two-arm , parallel-group r and omized controlled trial was conducted . Subjects and analyzing research ers were blinded . A total of 250 18- to 35-year-olds with a high risk of weight gain , a body mass index ( BMI ) of 23.0 to 24.9 kg/m2 with at least 2 kg of weight gain in the previous 12 months , or a BMI of 25.0 to 31.9 kg/m2 were r and omized to the intervention or control group . In the 12-week intervention period , the intervention group received 8 text messages weekly based on the transtheoretical model of behavior change , 1 email weekly , 5 personalized coaching calls , a diet booklet , and access to re sources and mobile phone apps on a website . Control group participants received only 4 text messages and printed dietary and physical activity guidelines . Measured body weight and height were collected at baseline and at 12 weeks . Outcomes were assessed via online surveys at baseline and at 12 weeks , including self-reported weight and dietary and physical activity measures . Results A total of 214 participants —110 intervention and 104 control — completed the 12-week intervention period . A total of 10 participants out of 250 (4.0%)—10 intervention and 0 control — dropped out , and 26 participants (10.4%)—5 intervention and 21 control — did not complete postintervention online surveys . Adherence to coaching calls and delivery of text messages was over 90 % . At 12 weeks , the intervention group were 2.2 kg ( 95 % CI 0.8 - 3.6 ) lighter than controls ( P=.005 ) . Intervention participants consumed more vegetables ( P=.009 ) , fewer sugary soft drinks ( P=.002 ) , and fewer energy-dense takeout meals ( P=.001 ) compared to controls . They also increased their total physical activity by 252.5 MET-minutes ( 95 % CI 1.2 - 503.8 , P=.05 ) and total physical activity by 1.3 days ( 95 % CI 0.5 - 2.2 , P=.003 ) compared to controls . Conclusions The TXT2BFiT low-intensity intervention was successful in preventing weight gain with modest weight loss and improvement in lifestyle behaviors  among overweight young adults . The short-term success of the 12-week intervention period shows potential . Maintenance of the behavior change will be monitored at 9 months . Trial Registration Trial Registration : The Australian New Zeal and Clinical Trials Registry ACTRN12612000924853 ; https://www.anzctr.org.au/Trial/ Registration /Trial Review .aspx?ACTRN=12612000924853 ( Archived by WebCite at http://www.webcitation.org/6Z6w9LlS9 ) Background : Online social networks ( OSNs ) are a new , promising approach for catalyzing health-related behavior change . To date , the empirical evidence on their impact has been limited . Purpose : Using a r and omized trial , we assessed the impact of a health-oriented OSN with accelerometer and scales on participant ’s physical activity , weight , and clinical indicators . Methods : A sample of 349 PeaceHealth Oregon employees and family members were r and omized to the iWell OSN or a control group  and followed for 6 months in 2010 - 2011 . The iWell OSN enabled participants to connect with “ friends , ” make public postings , view contacts ’ postings , set goals , download the number of their steps from an accelerometer and their weight from a scale , view trends in physical activity and weight , and compete against others in physical activity . Both control and intervention participants received traditional education material on diet and physical activity . Laboratory data on weight and clinical indicators ( triglycerides , high-density lipoprotein , or low-density lipoprotein ) , and self-reported data on physical activity , were collected at baseline , 3 months , and 6 months . Results : At 6 months , the intervention group increased leisure walking minutes by 164 % compared with 47 % in the control group . The intervention group also lost more weight than the controls ( 5.2 pounds compared with 1.5 pounds ) . There were no observed significant differences in vigorous exercise or clinical indicators between the 2 groups . Among intervention participants , greater OSN use , as measured by number of private messages sent , was associated with a greater increase in leisure walking and greater weight reduction over the study period . Conclusions : The study provides evidence that interventions using OSNs can successfully promote increases in physical activity and weight loss The primary objective of the current study was to examine the relationship between  social support  and  physical activity  within the theory of planned behavior ( TPB ) theoretical framework . This study used data from the Internet Support for Healthy Associations Promoting Exercise r and omized controlled trial . A total of 134 female undergraduate students participated in the study , which included baseline and post measures of perceived social support for physical activity ( esteem , informational , and companionship ) , TPB variables related to physical activity ( perceived behavioral control , intention , and attitude ) , and physical activity behavior .  Path analysis revealed a significant indirect relationship between change in companionship support and physical activity mediated by change in intention ( .13 , p < .01 ) and a significant direct relationship between change in esteem support and change in physical activity ( .26 , p = .03 ) . The model explained 27 % of the variance in physical activity and 59 % of the variance in intention . Overall , change in social support exerted a small to medium amount of influence on change in physical activity in this modified TPB model when controlling for traditional model constructs . Encouraging companionship and esteem support should be considered as a strategy for increasing physical activity in this population Our objective was to conduct a process evaluation of the CHOICES ( Choosing Healthy Options in College Environments and Setting s ) study , a large , r and omized , controlled trial design ed to prevent unhealthy weight gain in young adults ( aged 18 - 35 ) attending 2-year community colleges in the USA . The 24-month intervention consisted of participation in an academic course and a social networking and support website . Among intervention participants , completion rates for most course activities were > 80 % , reflecting a high level of dose received . Course retention and participant satisfaction were also high . Engagement results , however , were mixed with less than half of participants in the online and hybrid sections of the course reporting that they interacted with course material s ≥3 h/week , but 50 - 75 % reporting that they completed required lessons ' all/very thoroughly ' . Engagement in the website activities was also mixed with more than half of intervention participants logging onto the website during the first month , but then declining to 25 - 40 % during the following 23 months of the intervention . Intervention engagement is a challenge of online interventions and a challenge of working with the young adult age group in general . Additional research is needed to explore strategies to support engagement among this population , particularly for relatively long intervention duration BACKGROUND Today 's generation of young adults are gaining weight faster than their parents ; however , there remains insufficient evidence to inform interventions to prevent this weight gain .  Mobile phones are a popular means of communication that may provide a convenient , inexpensive means to deliver health intervention programmes . This pilot study aim ed to measure the effect of a 12-week mobile health ( mHealth ) intervention on body weight , body mass index and specific lifestyle behaviours addressed by the programme . METHODS University students and staff aged 18 - 35 years ( n = 51 ) were r and omised ( ratio 1 : 1 , intervention : control ) . Both groups received a printed diet booklet with instructions prepared by a dietitian . The intervention group also received Short Message Service ( SMS ) text messages ( four per week ) , e-mails ( four per week ) , and had access to smartphone applications and Internet forums . RESULTS Pre- to post-intervention , participants in the intervention group decreased their body weight [ mean ( SD ) ] [ -1.6 ( 2.6 ) kg ] , increased their light intensity activity [ 34 ( 35 ) min day(-1 ) ] and reported an increased vegetable ( 1.0 median serving day(-1 ) ) and decreased sugar-sweetened beverage intake [ -355 ( 836 ) mL week(-1 ) ] . Despite this , post-intervention changes in outcomes were not significantly different from controls . CONCLUSIONS The piloted mHealth programme provided some short-term positive changes in weight , nutrition and physical activity using a low cost , convenient delivery method for this population . However , changes were no different from those observed among controls . This might partly be explained by intervention participants ' low engagement with the programme , which is likely to require further modification to provide more regular , personalised , monitored support
Background Social media has been widely adopted by young adults , consequently health research ers are looking for ways to leverage this engagement with social media for the delivery of interventions and health promotion campaigns .
Weight gain and sub-optimal dietary choices are common in young adults , and social media may be a potential tool to facilitate and support healthier choices .