ObjectiveTo examine social network member characteristics associated with weight loss.MethodsCross-sectional examination of egocentric network data from 245 Black and Hispanic adults with BMI ≥ 25 kg/m2 enrolled in a small change weight loss study. The relationship between weight loss at 12 months and characteristics of helpful and harmful network members (relationship, contact frequency, living proximity and body size) were examined.ResultsThere were 2,571 network members identified. Mean weight loss was -4.8 (±11.3) lbs. among participants with network help and no harm with eating goals vs. +3.4 (±7.8) lbs. among participants with network harm alone. In a multivariable regression model, greater weight loss was associated with help from a child with eating goals (p=.0002) and coworker help with physical activity (p=.01). Weight gain was associated with having network members with obesity living in the home (p=.048) and increased network size (p=.002).ConclusionsThere was greater weight loss among participants with support from children and coworkers. Weight gain was associated with harmful network behaviors and having network members with obesity in the home. Incorporating child and co-worker support, and evaluating network harm and the body size of network members should be considered in future weight loss interventions.

Implementation was shaped by clinic setting and adaptive strategies. Future WIC interventions may benefit from formal consideration of intervention fit with local clinic setting and allowable adaptations.

The initiative seems to be effective at increasing exclusive BF, particularly among non-Hispanic black and Hispanic women in the New York State WIC program.

Small eating behavior changes are proposed as more feasible to achieve and maintain than larger changes used in traditional behavioral weight loss studies. However, it is unclear whether overweight Black and Hispanic adults in a low-income urban setting experience small changes as feasible and what might influence feasibility. Participants' experiences in a 12-week pilot weight loss intervention were explored qualitatively to determine the feasibility of making small eating behavior changes in this population. After the intervention (69% retention), semi-structured interviews with 46 men and women (mean age 51, 50% Non-Hispanic Black, 43% Hispanic) revealed that making small eating changes was a process shaped by participants' intrapersonal and interpersonal eating environments. Participants responded to intrapersonal and interpersonal eating environmental challenges by adapting small change strategies, navigating eating environments, and negotiating household eating practices. Findings highlight how even small eating behavior changes called for adaptation, navigation, and negotiation of complex eating environments in daily life. These findings were used to improve the trial that followed and underline the importance of feasibility studies to inform community trials. Findings also add to understanding of contextual challenges and the skills needed to implement small changes in a low income, ethnic minority population.

Small eating behavior changes (SEBCs) are proposed as more feasible to make & sustain than larger changes typical of traditional behavioral weight loss interventions. This qualitative analysis focuses on how the social environment impacts the experience of SEBC in a 12 week pilot weight loss intervention. Interviews with 46 men & women (mean age 51, mean initial BMI 34kg/m2, 56% Black, 41% Hispanic) investigated challenges, facilitators, & the role of social interactions in making one participant‐selected SEBC. Verbatim transcripts were analyzed using the constant comparative method. Emergent themes included work & family demands, food roles & responsibilities, home food environment, & network responses to intervention involvement acting as both barriers & facilitators. Participants also discussed strategies used to negotiate SEBCs in the social environment & navigate challenges, including selective disclosure of intervention involvement, integrating SEBCs into social settings, & asserting food control. Gender differences were reported: men were less likely to report family influence & more likely to report strategies to navigate their social environment. Small EBC interventions should (1) consider the impact of the social environment & (2) help participants develop strategies to identify & navigate social barriers to EBC.Grant Funding Source: NHLBI, USDA Ecology of Obesity Training Grant