UVM Theses and Dissertations
Format:
Print
Author:
Micco, Nicole
Dept./Program:
Nutritional and Food Sciences
Year:
2005
Degree:
MS
Abstract:
Objectives: To determine whether a behavioral weight-loss program delivered over the Internet can stand alone as treatment, or whether the same online program supplemented with minimal (monthly) in-person treatment is more effective; to assess how different components of an Internet weight-loss prograni relate to outcomes. Design: A 6-month randomized clinical intervention with two conditions: Internet-only (I) and Internet + In-Person Support (I + IPS). Both conditions received a standard behavioral weight-loss program delivered via the Web, with lessons, weekly online group chats and therapist-reviewed self-monitoring diaries. Once a month, an in-person group meeting replaced the online chat for the (I+IPS) condition. Subjects: Eight-nine overweight or obese men (n=18) and women (BMI = 32.0 ⁺⁻ 3.8; age = 47.9 ⁺⁻ 10.1) enrolled; 70 participants completed 6-month measures.
Assessments: Body weight, dietary intake (FFQ), physical activity (Paffenbarger) at baseline and 6 months; additionally, at 6 months: social support measures, program adherence, Web site utilization Results: Based on the 70 subjects who completed 6-month measures. An independent samples t-test revealed no significant difference by condition in weight change over 6 months (-9.4 ⁺⁻ 8.8 kg vs -6.7 ⁺⁻ 4.6 kg; P =0.11, for I and I + IPS, respectively). There also were no differences, by condition, in the attendance rate at group meetings (75 ⁺⁻ 24% vs 71 ⁺⁻ 22%; p=0.52, for I and I +IPS), the average number of self-monitoring journals (of 26) submitted (20.3 ⁺⁻ 7.6 vs 20.3 ⁺⁻ 5.9; p=0.97, for land I+IPS) or the number of weeks for which calorie and exercise goals were met (Calorie: 14.7 ⁺⁻ 9.2 vs 12.0 ⁺⁻ 7.9 weeks; p=0.20, for I and I+IPS; Exercise: 17.3 ⁺⁻ 7.8 vs 15.6 ⁺⁻ 7.5 weeks; p=0.37). Subjects in the (I) group reported feeling more supported by peers than those in the (I+IPS}group, but the difference was not significant (p=0.07). Web site log-ins over 6 months did not differ significantly between conditions (205 ł 164 vs 190 ł 128 log-ins; p=0.69). Higher log-in frequencies correlated with greater weight loss (r=0.55; p<0.00l). Other Web features that were positively associated with weight loss were bulletin boards (r=0.31; p = 0.009), journal feedback pages (0.33; p=0.005), progress graphs (r=0.39; p =0.001) and motivational incentives pages (r=0.41; p=0.001).
Conclusions: Given a certain level of therapist and peer contact, weight-loss programs delivered entirely over the Internet may be as effective as online weight-management programs supplemented with minimal in-person treatment. Additionally, intensive Internet weight-loss programs appear to produce levels of weight loss typically seen in traditional face-to-face treatment. In this study, greater use of the Web site overall and the use of certain dynamic features (those that provide motivation and feedback) in particular were associated with greater weight losses.
Assessments: Body weight, dietary intake (FFQ), physical activity (Paffenbarger) at baseline and 6 months; additionally, at 6 months: social support measures, program adherence, Web site utilization Results: Based on the 70 subjects who completed 6-month measures. An independent samples t-test revealed no significant difference by condition in weight change over 6 months (-9.4 ⁺⁻ 8.8 kg vs -6.7 ⁺⁻ 4.6 kg; P =0.11, for I and I + IPS, respectively). There also were no differences, by condition, in the attendance rate at group meetings (75 ⁺⁻ 24% vs 71 ⁺⁻ 22%; p=0.52, for I and I +IPS), the average number of self-monitoring journals (of 26) submitted (20.3 ⁺⁻ 7.6 vs 20.3 ⁺⁻ 5.9; p=0.97, for land I+IPS) or the number of weeks for which calorie and exercise goals were met (Calorie: 14.7 ⁺⁻ 9.2 vs 12.0 ⁺⁻ 7.9 weeks; p=0.20, for I and I+IPS; Exercise: 17.3 ⁺⁻ 7.8 vs 15.6 ⁺⁻ 7.5 weeks; p=0.37). Subjects in the (I) group reported feeling more supported by peers than those in the (I+IPS}group, but the difference was not significant (p=0.07). Web site log-ins over 6 months did not differ significantly between conditions (205 ł 164 vs 190 ł 128 log-ins; p=0.69). Higher log-in frequencies correlated with greater weight loss (r=0.55; p<0.00l). Other Web features that were positively associated with weight loss were bulletin boards (r=0.31; p = 0.009), journal feedback pages (0.33; p=0.005), progress graphs (r=0.39; p =0.001) and motivational incentives pages (r=0.41; p=0.001).
Conclusions: Given a certain level of therapist and peer contact, weight-loss programs delivered entirely over the Internet may be as effective as online weight-management programs supplemented with minimal in-person treatment. Additionally, intensive Internet weight-loss programs appear to produce levels of weight loss typically seen in traditional face-to-face treatment. In this study, greater use of the Web site overall and the use of certain dynamic features (those that provide motivation and feedback) in particular were associated with greater weight losses.