UNREALISTIC DREAM WEIGHT GOALS AND STUDY COMPLETION IN P.R.I.S.E.®: a LIFESTYLE MODIFICATION INTERVENTION FOR EMPLOYED AFRICAN AMERICAN WOMEN 公开

Zhang, Siyu (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/rr171x37r?locale=zh
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Abstract

UNREALISTIC DREAM WEIGHT GOALS AND STUDY COMPLETION IN P.R.I.S.E.®: a LIFESTYLE MODIFICATION INTERVENTION FOR EMPLOYED AFRICAN AMERICAN WOMEN
By Siyu Zhang

Purpose: Obesity (body mass index (BMI) ≥ 30) and being overweight (BMI 25 - 29.9) are predictors for many diseases such as diabetes, hypertension and cardiovascular disease. African American females have high rates of obesity and being overweight. The aim of P.R.I.S.E®, a worksite fitness program was to increase physical activity and promote weight loss among employed African American women. Unrealistic dream weight goals (UDWG) may impede the success of weight loss and attribute to study drop-out. The purpose of this study was to investigate the relationship between UDWG and study completion.

Method: UDWG is defined as when one's personal weight loss goal exceeds the medically advised goal by 50%. In this intervention study, 208 employed African American women were included. Participants were classified as completers if enrolled for over 168 days. Data from P.R.I.S.E.® including age, BMI, past weight loss experience, and weight efficacy lifestyle (WEL) were potential predictors of completion. Multiple logistic regression models were developed to evaluate the association between predictors and outcome. Collinearity, interaction and confounding were assessed for all variables.

Results: The majority of participants were obese (59.6%) and almost half were over 40 years old (45.7%). Data revealed a high drop-out rate for participants with 61.5% of the women (80 women) completing the intervention program. Odds of completion were low among participants who were young and had UDWG. Age, BMI, past weight loss experience, and WEL were confounders of the association between UDWG and completion. Having less success in previous weight loss attempts was predictive of higher drop-out rates than those who were successful losing weight in the past. Participants who were currently trying to lose weight were more likely to complete the program.

Conclusion: High drop-out rates among those enrolled in fitness and weight loss intervention programs are critical concerns. Through examining characteristics of completers and non-completers, more effective health lifestyle programs can be developed. Based on study results, having an UDWG reduces the likelihood of completion. Including information on how to have an appropriate perspective towards one's weight loss and how to establish a reasonable weight loss goal is important for program completion.

Table of Contents

TABLE OF CONTENTS
CHAPTER 1:...1
BACKGROUND/LITERATURE REVIEW...1

Overweight and obesity...1
Overweight statistics in African American Women...1
Benefits of physical activity and relationship with obesity...2
Over expected weight loss for physical activity...5
Self efficacy...6
Weight loss experience...7
Exercises barriers / benefits...8

CHAPTER II:...9

INTRODUCTION...9

P.R.I.S.E.®: Preps, Reps, Increased Steps and Encouragement...9
Hypotheses...10

METHODS...10

Study Sites and Target Population...10
Data Collection and Management...11
Measurement and Instruments...12
Overweight and obesity...12
Study Completion...12
Dream Weight Goals...13
Weight Loss History...14
Analysis...15

RESULTS...15
DISCUSSION...19
REFERENCES...21
TABLES...25

Table 1. Demographic Characteristics of P.R.I.S.E Completers & Non-Completers...25
Table 2. Characteristics of P.R.I.S.E Participants with Realistic/Unrealistic Dream Weight...26
Table 3. Relationship of Potential Factors Affecting Completion & Unrealistic Dream Weight Goal...27
Table 4. Crude Odds Ratio for Drop-Out by Main Exposures & Potential Confounders...28
Table 5. Dream Weight Goal & Completion Association, Controlling for Confounding...29
Table 6. Coefficients & Statistics for Final Logistic Model of Participant Dropout...30

FIGURES...31

Figure 1. DAG...31

CHAPTER 3:...32
APPENDICES:...36

APPENDIX A. Medically Advised Weight Loss Goal & Unrealistic Weight Loss Goal...36
APPENDIX B. Completion Rates of Several Worksite Fitness Intervention Studies...37
APPENDIX C: Information Available Online RE: Setting Realistic Weight Loss Goals...38

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