What Are the Weight Loss Outcomes among African American Women in Online Behavioral Weight Control Programs?



Delia Smith West* Jean Harvey*
Rebecca Krukowski*
Delia Smith West*, University of South Carolina, Columbia, United States
Jean Harvey*, University of Vermont, Burlington, United States
Rebecca Krukowski*, University of Tennessee Health Sciences Center, Memphis, United States


Track: Research
Presentation Topic: Health disparities
Presentation Type: Poster presentation
Submission Type: Single Presentation

Last modified: 2014-06-04
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Abstract


Background: Online weight control programs have a growing evidence base and offer advantages in terms of extended reach and lower barriers to engaging in behavioral treatment. African American women have significantly higher rates of overweight and obesity than seen among Caucasian American women and therefore might uniquely benefit from online programs. There are indications in-person behavioral treatment programs may produce smaller weight losses among African American women than seen among their Caucasian sisters. We are aware of no examinations of responses of African American women to multi-component web-based behavioral weight loss treatment programs. Objective: To examine the weight loss outcomes of African American women engaged in an online weight control program. Methods: Data from two randomized controlled studies that implemented the same culturally adapted online behavioral weight control program are combined and examined. A total of 140 obese (mean BMI=38.1) African American women were randomized to an online group behavioral weight control program, which consisted of synchronous chat sessions, and access to online self-monitoring and social support tools as part of these 2 RCTs. Forty three obese (mean BMI=36.2) African American women were randomized to receive the same behavioral program delivered in-person, allowing a comparison of outcomes between online and in-person delivery of weight control to this high risk group. Furthermore, 109 obese (mean BMI=35.8) Caucasian women were randomized to the online weight control arm, allowing a comparison of outcomes between race groups enrolled in online programs. Weight was measured at baseline, 6- and 18-months and percent weight lost from baseline was calculated as the primary outcome. Results: African American women lost 3.4% (+/-5.1) at 6 months and 1.8% (+/-6.3) at 18 months in the online behavioral weight control program. This compares with 6.3% (+/-5.8) at 6-months and 4.8% (+/-8.8) at 18-months among African American women receiving the same program in person. Thus, African American women lost more weight with the in-person program than with online delivery at 6 months (p= 0.004) and 18 months (p= 0.49). Caucasian women who also received the weight control program online lost significantly more weight at 6-months (5.8% +/-5.3) than did African American women (p=0.0005), but weight losses of Caucasians at 18-months
(3.6% +/-8.1) did not differ from African American women. Conclusions: Although African American women average significantly greater weight loss with in-person delivery of a behavioral weight control program than with online delivery of the same program, weight loss with this online program was commensurate with other reports of in-person intervention with African American women. Further, long-term weight loss outcomes among African American women in the online program were comparable with those seen among Caucasian women, albeit modest weight loss. Online delivery has the potential for broad reach and reducing barriers to access. Therefore, methods to enhance weight loss outcomes with online delivery for African American women have the potential for substantive public health impact in a population group which experiences high levels of obesity and significant associated morbidity.




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