Obesity is a significant public health concern, especially in the Deep South and in Mississippi where prevalence is among the worst in the nation paired, with other poor health outcomes and socioeconomic conditions. Lifestyle management programs that address modifiable risk factors, such as nutrition and physical activity, can be effective mitigation strategies to halt weight accumulation patterns and ameliorate metabolic risk factors for some populations. However, there is limited evidence regarding the implementation of effective practice models to address obesity risk in underserved and underrepresented populations, such as African Americans, and people in the stage of earlier adulthood. Furthermore, there is growing evidence supporting the impact of the COVID-19 pandemic on lifestyle management programs that should be considered in these populations. The purpose of this manuscript was to describe the development and telehealth implementation of a weight management program during the COVID-19 pandemic and provide a preliminary examination of recruitment strategies and baseline characteristics for enrolled participants. Passive recruitment (social media, web, email, and other media advertisements) resulted in 157 screening initiations, and 79 of those participants met the study inclusion criteria. Further, of the 79 eligible participants, 38 completed all study enrollment requirements and presented with metabolic abnormalities. The study findings add to the emerging body of evidence for how the pandemic may have impacted lifestyle management programs and is representative of an understudied and underrepresented population.
Citation: Jennifer L Lemacks, Laurie S Abbott, Cali Navarro, Stephanie McCoy, Tammy Greer, Sermin Aras, Michael B Madson, Jacqueline Reese-Smith, Chelsey Lawrick, June Gipson, Byron K Buck, Marcus Johnson. Passive recruitment reach of a lifestyle management program to address obesity in the deep south during the COVID-19 pandemic[J]. AIMS Public Health, 2023, 10(1): 116-128. doi: 10.3934/publichealth.2023010
Obesity is a significant public health concern, especially in the Deep South and in Mississippi where prevalence is among the worst in the nation paired, with other poor health outcomes and socioeconomic conditions. Lifestyle management programs that address modifiable risk factors, such as nutrition and physical activity, can be effective mitigation strategies to halt weight accumulation patterns and ameliorate metabolic risk factors for some populations. However, there is limited evidence regarding the implementation of effective practice models to address obesity risk in underserved and underrepresented populations, such as African Americans, and people in the stage of earlier adulthood. Furthermore, there is growing evidence supporting the impact of the COVID-19 pandemic on lifestyle management programs that should be considered in these populations. The purpose of this manuscript was to describe the development and telehealth implementation of a weight management program during the COVID-19 pandemic and provide a preliminary examination of recruitment strategies and baseline characteristics for enrolled participants. Passive recruitment (social media, web, email, and other media advertisements) resulted in 157 screening initiations, and 79 of those participants met the study inclusion criteria. Further, of the 79 eligible participants, 38 completed all study enrollment requirements and presented with metabolic abnormalities. The study findings add to the emerging body of evidence for how the pandemic may have impacted lifestyle management programs and is representative of an understudied and underrepresented population.
[1] | Hales CM, Carroll MD, Fryar CD, et al. (2020) Prevalence of obesity and severe obesity among adults: United States, 2017–2018. NCHS Data Brief 360: 1-8. |
[2] | US Preventive Services Task Force.Behavioral weight loss interventions to prevent obesity-related morbidity and mortality in adults: US Preventive Services Task Force recommendation statement. JAMA (2018) 320: 1163-1171. https://doi.org/10.1001/jama.2018.13022 |
[3] | Wadden TA, Tsai AG, Tronieri JS (2019) A Protocol to deliver intensive behavioral therapy (IBT) for obesity in primary care settings: the MODEL-IBT program. Obesity (Silver Spring) 27: 1562-1566. https://doi.org/10.1002/oby.22594 |
[4] | Wadden TA, Volger S, Sarwer DB, et al. (2011) A two-year randomized trial of obesity treatment in primary care practice. N Engl J Med 365: 1969-1979. https://doi.org/10.1056/NEJMoa1109220 |
[5] | Newton RL, Griffith DM, Kearney WB, et al. (2014) A systematic review of weight loss, physical activity and dietary intervention involving African American men. Obes Rev 15: 93-106. https://doi.org/10.1111/obr.12209 |
[6] | Royster MO, Richmond A, Eng E, et al. (2006) Hey brother, how's your health? A focus group analysis of the health and health-related concerns of African American men in a southern city in the US. Men and Masculinities 8: 389-404. https://doi.org/10.1177/1097184X04268798 |
[7] | Allen JD, Kennedy M, Wilson-Glover A, et al. (2007) African-American men's perceptions about prostate cancer: implications for designing educational interventions. Soc Sci Med 64: 2189-2200. https://doi.org/10.1016/j.socscimed.2007.01.007 |
[8] | Lee LT, Willing A, Agne AA, et al. (2016) Challenges to healthy eating practices: a qualitative study of Non-Hispanic black men living with diabetes. Diabetes Educ 42: 325-335. https://doi.org/10.1177/0145721716640904 |
[9] | Cheatham CT, Barksdale DJ, Rodgers SG (2008) Barriers to health care and health-seeking behaviors faced by black men. J Am Acad Nurse Pract 20: 555-562. https://doi.org/10.1111/j.1745-7599.2008.00359.x |
[10] | Ravenell JE, Johnson WE, Whitaker EE (2006) African-American men's perceptions of health: a focus group study. J Natl Med Assoc 98: 544-550. |
[11] | Lemacks JL, Abbott LS, Greer T, et al. (2021) The church bridge project focus group results: African American perspectives of weight management programs to improve nutrition and physical activity behaviors. BMC Nutr 7: 39. https://doi.org/10.1186/s40795-021-00442-2 |
[12] | Obesity Centers for Medicare and Medicaid Services.Intensive behavioral therapy for obesity (CAG-00423N) - Decision memo. USA Obesity Centers for Medicare and Medicaid Services (2011) . Available from: https://www.cms.gov/medicare-coverage-database/details/nca-decision-memo.aspx?&NcaName=Intensive%20Behavioral%20Therapy%20for%20Obesity&bc=ACAAAAAAIAAA&NCAId=253. |
[13] | Lemacks JL, James RE, Abbott L, et al. (2018) The church bridge project: an academic-community perspective of a church-based weight management pilot intervention among young adult African Americans. Prog Community Health Partnersh 12: 23-34. https://doi.org/10.1353/cpr.2018.0018 |
[14] | National Cancer Institute, Division of Cancer Control and Population Sciences.Dietary Screener Questionnaires (DSQ) in the NHANES 2009–10: DSQ. USA National Cancer Institute, Division of Cancer Control and Population Sciences . Available from: https://epi.grants.cancer.gov/nhanes/dietscreen/questionnaires.html |
[15] | Thompson FE, Midthune D, Kahle L, et al. (2017) Development and evaluation of the National Cancer Institute's Dietary Screener Questionnaire scoring algorithms. J Nutr 147: 1226-1233. https://doi.org/10.3945/jn.116.246058 |
[16] | Craig CL, Marshall AL, Sjöström M, et al. (2003) International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc 35: 1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB |
[17] | Kurtze N, Rangul V, Hustvedt BE (2008) Reliability and validity of the International physical activity questionnaire in the Nord-Trøndelag health study (Hunt) population of men. BMC Med Res Methodol 8: 63. https://doi.org/10.1186/1471-2288-8-63 |
[18] | Estabrooks P, You W, Hedrick V, et al. (2017) A pragmatic examination of active and passive recruitment methods to improve the reach of community lifestyle programs: The talking health trial. Int J Behav Nutr Phys Act 14: 7. https://doi.org/10.1186/s12966-017-0462-6 |
[19] | Lee RE, McGinnis KA, Sallis JF, et al. (1997) Active vs. passive methods of recruiting ethnic minority women to a health promotion program. Ann Behav Med 19: 378-384. https://doi.org/10.1007/BF02895157 |
[20] | Warren FC, Stych K, Thorogood M, et al. (2014) Evaluation of different recruitment and randomisation methods in a trial of general practitioner-led interventions to increase physical activity: a randomised controlled feasibility study with factorial design. Trials 15: 134. https://doi.org/10.1186/1745-6215-15-134 |
[21] | Pagoto SL, Schneider KL, Oleski JL, et al. (2012) Male inclusion in randomized trials of lifestyle weight loss interventions. Obesity 20: 1234-1239. https://doi.org/10.1038/oby.2011.140 |
[22] | Rosenbaum DL, Piers AD, Schumacher LM, et al. (2017) Racial and ethnic minority enrollment in randomized clinical trials of behavioral weight loss utilizing technology: A systematic review. Obes Rev 18: 808-817. https://doi.org/10.1111/obr.12545 |
[23] | Tsao CW, Aday AW, Almarzooq ZI, et al. (2022) Heart disease and stroke statistics-2022 update: A report from the American Heart Association. Circ 145: e153-e639. https://doi:10.1161/CIR.0000000000001052 |
[24] | U.S. Department of Agriculture, U.S. Department of Health and Human Services.Dietary Guidelines for Americans, 2020–2025. USA Department of Agriculture, Department of Health and Human Services . Available from: https://www.dietaryguidelines.gov/. |
[25] | Reichetzeder C (2021) Overweight and obesity in pregnancy: their impact on epigenetics. Eur J Clin Nutr 75: 1710-1722. https://doi.org/10.1038/s41430-021-00905-6 |
[26] | Caldwell AE, Thomas EA, Rynders C, et al. (2021) Improving lifestyle obesity treatment during the COVID-19 pandemic and beyond: New challenges for weight management. Obes Sci Pract 8: 32-44. https://doi.org/10.1002/osp4.540 |
[27] | Robinson E, Boyland E, Chisholm A, et al. (2021) Obesity, eating behavior and physical activity during COVID-19 lockdown: A study of UK adults. Appetite 156: 104853. https://doi.org/10.1016/j.appet.2020.104853 |
[28] | Nuss K, Coulter R, DeSilva B, et al. (2022) Evaluating the effectiveness of a family-based virtual childhood obesity management program delivered during the COVID-19 pandemic in Canada: prospective study. JMIR Pediatr Parent 5: e40431. https://doi.org/10.2196/40431 |
[29] | Corica D, Li Pomi A, Curatola S, et al. (2022) Impact of Covid-19 Pandemic on the Effectiveness of Outpatient Counseling in Childhood Obesity Management. Front Endocrinol (Lausanne) 13: 879440. https://doi.org/10.3389/fendo.2022.879440 |
[30] | Ross KM, Carpenter CA, Arroyo KM, et al. (2022) Impact of transition from face-to-face to telehealth on behavioral obesity treatment during the COVID-19 pandemic. Obesity (Silver Spring) 30: 858-863. https://doi.org/10.1002/oby.23383 |