Development of a web-based intervention for weight gain prevention in mid-age women.
Edwards, Olivia Clare
Background: Given the high rates of obesity in mid-age women and poor long-term success rates of dieting strategies, there is increasing interest in novel approaches that address some of the key difficulties in long-term adherence to weight management behaviours. Among these are Intuitive Eating and Acceptance and Commitment Therapy (ACT) approaches; both of which have been associated with psychological benefits and lower BMI. As access to such treatments is limited for some high-risk groups, the Internet is a promising avenue for future delivery of interventions. Although studies have examined the independent effects of ACT and Intuitive Eating on weight management, none have investigated their combined effect on weight gain prevention through a web-based intervention. Methods: Development of initial draft concepts for website layout, features, and content for eleven intervention modules was undertaken based on existing health-related web-based interventions and published literature on ACT and Intuitive Eating. Draft materials were then tested in a series of thirteen general focus groups (n=26), and one Māori focus group (n=2) with 40-50 year old women with BMI >27kg/m2. Feedback from focus groups was used to inform amendments to website layout, features, and module content. Results: Focus group participants expressed that they particularly liked and perceived to be valuable the empowering thoughts and testimonials, the balance of text, audio and video content, the ability to monitor progress through a graphical representation of personal data, and options to customise reminders to individual preferences. Feedback indicated that modules 2, 5, 6 and 8 were the most accepted by participants. Whereas modules 1 and 3 were the most difficult to convey messages effectively, due to greater participant interest and higher expectations for these module topics. Specific module exercises stood out as particularly valuable to participants, including ‘Urge Surfing’, ‘Mindfully Eating a Raisin’, and ‘Leaves on a Stream’. Areas that were less well received which required revision included the health professional character in video lessons, the use of academic language, and the lack of social support. Participants expressed that they struggled to reduce their dieting mentality, and one module dedicated to achieve this may not be adequate. Māori participants also indicated the need to incorporate Te Whare Tapa Wha health concepts into the intervention, particularly in the intervention title – ‘Mind, Body, Food’. Conclusions: Since this project involved testing of the intervention in it’s first stages of development, further testing of materials in a web-based format is needed to better gauge perceived value. The non-dieting approach, with reduced focus on body weight, was perceived by women to be empowering. Most features associated with successful behaviour change via web-based interventions in previous published research were effectively incorporated into the intervention. More investigation is needed into low cost options for social support. Prior to the feasibility study, further focus group testing is needed of materials to evaluate acceptability and data saturation, especially among Māori women.
Advisor: Horwath, Caroline
Degree Name: Master of Dietetics
Degree Discipline: Human Nutrition
Publisher: University of Otago
Keywords: web-based; Internet; weight maintenance; mid-age; women; Acceptance and Commitment Therapy; Intuitive Eating
Research Type: Thesis