Efficacy of an internet-based behavioral weight loss program for overweight adolescent African-American girls

  • D. A. Williamson
  • P. Davis Martin
  • M. A. White
  • R. Newton
  • H. Walden
  • E. York-Crowe
  • A. Alfonso
  • S. Gordon
  • D. Ryan
Original Research Paper

Abstract

Objective: This randomized controlled trial tested the efficacy of an internetbased lifestyle behavior modification program for weight management in African-American girls. Design: African-American girls were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. The behavioral intervention included internet counseling and was highly interactive. The control intervention was a passive (non-interactive) educational program. Parents were also participants in the study. Participants in both treatment groups met in face-to-face sessions on four occasions over the first 12 weeks of a 6-month intervention. Subjects: The study enrolled 57 African-American adolescent girls (ages 11 to 15 years) who were overweight or obese and had at least one biological parent who was obese [body mass index (BMI) >30 kg/m2]. Of the 57 participants, 50 (88%) completed the 6-month trial. Measurements: Outcome data, including BMI, body weight, body composition, dietary intake, and weight loss behaviors were collected at baseline and 6-months later. A computer server tracked utilization of the websites. Participation in the program was measured by number of “hits” on the website. Results: Compared to the control condition, adolescents in the behavioral treatment lost more body fat (group difference =1.6% body fat) and parents lost significantly more body weight (group difference =2.1 kg). Utilization of the behavioral website by adolescents and parents was associated with positive outcome. Dietary fat intake was lowered for adolescents and parents in the behavioral treatment group. Conclusion: An internet-based behavioral intervention was superior to internet-based health education and yielded decreased body fat for adolescent girls and decreased body weight for parents.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Flegal K.M., Carroll M.D., Kuczmarski R.J., Johnson C.L.: Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int. J. Obes. Relat. Metab. Disord., 22, 39–47, 1998.PubMedCrossRefGoogle Scholar
  2. 2.
    National Heart Lung and Blood Institute: NHLBI report of the Task Force on Behavioral Research in cardiovascular disease. Available at: http://www.nhlbi.nih.gov/ resources/docs/taskforc.htm. Accessed 2001.Google Scholar
  3. 3.
    World Health Organization Consultation of Obesity. Obesity: preventing and managing the global epidemiology: Geneva 1998.Google Scholar
  4. 4.
    Wolf A.M., Colditz G.A.: Current estimates of the economic cost of obesity in the United States. Obes. Res., 6, 97–106, 1998.PubMedCrossRefGoogle Scholar
  5. 5.
    Serdula M.K., Ivery D., Coates R.J., Freedman D.S., Williamson D.F., Byers T.: Do obese children become obese adults? A review of the literature. Prev. Med., 22, 167–177, 1993.PubMedCrossRefGoogle Scholar
  6. 6.
    Himes J.H., Dietz W.H.: Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. Am. J. Clin. Nutr., 59, 307–316, 1994.PubMedGoogle Scholar
  7. 7.
    Kumanyika S.K.: Minisymposium on obesity: overview and some strategic considerations. Annu. Rev. Public Health, 22, 293–308, 2001.PubMedCrossRefGoogle Scholar
  8. 8.
    Kumanyika S.K., Obarzanek E., Stevens V.J., Hebert P.R., Whelton P.K., Kumanyaka S.K.: Weight-loss experience of black and white participants in NHLBIsponsored clinical trials. Am. J. Clin. Nutr., 53 (6 Suppl.), 1631S–1638S, 1991.PubMedGoogle Scholar
  9. 9.
    Malarcher A.M., Casper M.L., Matson Koffman D.M., Brownstein J.N., Croft J., Mensah G.A.: Women and cardiovascular disease: addressing disparities through prevention research and a national comprehensive state-based program. J. Womens Health Gend. Based Med., 10, 717–724, 2001.PubMedCrossRefGoogle Scholar
  10. 10.
    Harsha D.W., Bray G.A.: Body composition and childhood obesity. Endocrinol. Metab. Clin. North Am., 25, 871–885, 1996.CrossRefGoogle Scholar
  11. 11.
    Yanovski J.A., Yanovski S.Z.: Treatment of pediatric and adolescent obesity. JAMA, 289, 1851–1853, 2003.PubMedCrossRefGoogle Scholar
  12. 12.
    Wadden T.A., Stunkard A.J., Rich L., Rubin C.J., Sweidel G., McKinney S.: Obesity in black adolescent girls: a controlled clinical trial of treatment by diet, behavior modification, and parental support. Pediatrics, 85, 345–352, 1990.PubMedGoogle Scholar
  13. 13.
    Zabinski M.F., Celio A.A., Jacobs M.J., Manwaring J., Wilfley D.E.: Internet-based prevention of eating disorders. Eur. Eat. Disord. Rev., 11, 183–197, 2003.CrossRefGoogle Scholar
  14. 14.
    14. Suler J.: The psychology of cyberspace. Available at: http://www.rider.edu/users/suler/psycyber/psycyber.html. Accessed 2001.Google Scholar
  15. 15.
    Harvey-Berino J., Pintauro S., Buzzell P., Di Giulio M., Casey Gold B., Moldovan C., Ramirez E.: Does using the Internet facilitate the maintenance of weight loss? Int. J. Obes. Relat. Metab. Disord., 26, 1254–1260, 2002.PubMedCrossRefGoogle Scholar
  16. 16.
    Harvey-Berino J., Pintauro S., Buzzell P., Gold E.C.: Effect of internet support on the long-term maintenance of weight loss. Obes. Res., 12, 320–329, 2004.PubMedCrossRefGoogle Scholar
  17. 17.
    Tate D.F., Jackvony E.H., Wing RR.: Effects of Internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial. JAMA, 289, 1833–1836, 2003.PubMedCrossRefGoogle Scholar
  18. 18.
    Tate D.F., Wing R.R., Winett R.A.: Using Internet technology to deliver a behavioral weight loss program. JAMA, 285, 1172–1177, 2001.PubMedCrossRefGoogle Scholar
  19. 19.
    Baranowski T., Baranowski J.C., Cullen K.W., Thompson D.I., Nicklas T., Zakeri I.E., Rochon J.: The Fun, Food, and Fitness Project (FFFP): the Baylor GEMS pilot study. Ethn. Dis., 13 (1 Suppl. 1), S30–S39, 2003.PubMedGoogle Scholar
  20. 20.
    Wing R.R.: Behavioral weight control. In: Wadden T.A., Stunkard A.J., (Eds.), Handbook of Obesity Treatment. New York, Guilford, 2002, pp. 301–316.Google Scholar
  21. 21.
    National Center for Health Statistics. Prevelance of overweight and obesity among adults: United States. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/obese/obse99.htm. Accessed 2001.Google Scholar
  22. 22.
    Epstein L.H., Wing R.R., Koeske R., Andrasik F., Ossip D.J.: Child and parent weight loss in family-based behavior modification programs. J. Consult. Clin. Psychol., 49, 674–685, 1981.PubMedCrossRefGoogle Scholar
  23. 23.
    Epstein L.H., Valoski A., Wing R.R., McCurley J.: Tenyear outcomes of behavioral family-based treatment for childhood obesity. Health Psychol., 13, 373–383, 1994.PubMedCrossRefGoogle Scholar
  24. 24.
    Kutlesic V., Williamson D.A., Gleaves D.H., Barbin J.M., Murphy-Eberenz K.P.: The Interview for the Diagnosis of Eating Disorders-IV: Application to DSMIV Diagnostic Criteria. Psychol. Assess., 10, 41–48, 1998.CrossRefGoogle Scholar
  25. 25.
    Johnson R.K., Driscoll P., Goran M.I.: Comparison of multiple-pass 24-hour recall estimates of energy intake with total energy expenditure determined by the doubly labeled water method in young children. J. Am. Diet. Assoc., 96, 1140–1144, 1996.PubMedCrossRefGoogle Scholar
  26. 26.
    Block G., Woods M., Potosky A., Clifford C.: Validation of a self-administered diet history questionnaire using multiple diet records. J. Clin. Epidemiol., 1327–1335, 1990.Google Scholar
  27. 27.
    Smith C.F., Williamson D.A., Womble L.G., Johnson J., Burke L.E.: Psychometric development of a multidimensional measure of weight-related attitudes and behaviors. Eat. Weight Disord., 5, 73–86, 2000.PubMedCrossRefGoogle Scholar
  28. 28.
    Parcel G.S., Edmundson E., Perry C.L., Feldman H.A., O’Hara-Tompkins N., Nader P.R., Johson C.C., Stone E.J.: Measurement of self-efficacy for diet-related behaviors among elementary school children. J. Sch. Health, 65, 23–27, 1995.PubMedCrossRefGoogle Scholar
  29. 29.
    Parcel G.S., Simons-Morton B., O’Hara N.M., Baranowski T., Wilson B.: School promotion of healthful diet and physical activity: impact on learning outcomes and self-reported behavior. Health Educ. Q., 16, 181–199, 1989.PubMedCrossRefGoogle Scholar
  30. 30.
    Maloney M.J., McGuire J.B., Daniels S.R.: Reliability testing of a children’s version of the Eating Attitude Test. J. Am. Acad. Child Adolesc. Psychiatry, 27, 541–543, 1988.PubMedCrossRefGoogle Scholar
  31. 31.
    Diener E., Emmons R.A., Larsen R.J., Griffin S.: The satisfaction with life scale. J. Person. Assess., 49, 71–75, 1985.CrossRefGoogle Scholar
  32. 32.
    Kovacs M.: The Children’s Depression Inventory (CDI). Toronto, Ontario, Canada, Multi-Health Systems, Inc., 1992.Google Scholar
  33. 33.
    Rosenberg M.: Self-Esteem Measure. Princeton, Princeton University Press, 1965.Google Scholar
  34. 34.
    Schumm W.R., McCollum E.E., Bugaighis M.A., Jurich A.P., Bollman S.R.: Characteristics of the Kansas Family Life Satisfaction Scale in a Regional Sample. Psychological Reports, 58, 975–980, 1986.CrossRefGoogle Scholar
  35. 35.
    Derogatis L.R.: SCL-90: administration scoring procedures manual-I for the (revised) version. Baltimore, MD, Johns Hopkins University School of Medicine, Clinical Psychometrics Research Unit, 1977.Google Scholar
  36. 36.
    Saelens B.E., Sallis J.F., Wilfley D.E., Patrick K., Cella J.A., Buchta R.: Behavioral weight control for overweight adolescents initiated in primary care. Obes. Res., 10, 22–32, 2002.PubMedCrossRefGoogle Scholar
  37. 37.
    Berkowitz R.I., Wadden T.A., Tershakovec A.M., Cronquist J.L.: Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. JAMA, 289, 1805–1812, 2003.PubMedCrossRefGoogle Scholar
  38. 38.
    Goldfield G.S., Raynor H.A., Epstein L.H.: In: Wadden T.A., Stunkard A.J. (Eds.), Handbook of Obesity Treatment. New York, Guilford, 532–554, 2002.Google Scholar
  39. 39.
    Beaton G.H., Burema J., Ritenbaugh C.: Errors in the interpretation of dietary assessments. Am. J. Clin. Nutr., 65 (4 Suppl.), 1100S–1107S, 1997.PubMedGoogle Scholar
  40. 40.
    Kretsch M.J., Fong A.K., Green M.W.: Behavioral and body size correlates of energy intake underreporting by obese and normal-weight women. J. Am. Diet. Assoc., 99, 300–306, quiz 307–308, 1999PubMedCrossRefGoogle Scholar

Copyright information

© Editrice Kurtis 2005

Authors and Affiliations

  • D. A. Williamson
    • 1
  • P. Davis Martin
    • 1
  • M. A. White
    • 1
  • R. Newton
    • 1
  • H. Walden
    • 1
  • E. York-Crowe
    • 1
  • A. Alfonso
    • 1
  • S. Gordon
    • 1
  • D. Ryan
    • 1
  1. 1.Pennington Biomedical Research CenterBaton RougeUSA

Personalised recommendations