Preferences for Technology-Mediated Behavioral Lifestyle Interventions With Different Levels of Coach and Peer Support Among Latino Men: Comparative Study Within One Arm of a Randomized Controlled Trial

Abstract

Background Although Latino men have the highest prevalence (45%) of obesity among all men in the United States, traditional weight loss interventions have not effectively engaged this hard-to-reach and diverse group. Offering choices among technology-mediated weight loss interventions may offer advantages. Objective The aim of this study is to examine Latino men’s preferences among 3 weight loss intervention options. We also examined whether attendance in group sessions (videoconference and in person) and weight loss differed according to intervention choice. Methods Latino men (n=200; mean age 47.3, SD 11.8 years) participated in a comparative effectiveness trial based on primary care and were randomized to receive the 1-year HOMBRE (Hombres con Opciones para Mejorar su Bienestar para Reducir Enfermedades Crónicas; English translation: Men With Options to Improve Their Well-being and Reduce Chronic Disease) intervention. HOMBRE is a weight loss intervention that offers 3 delivery options. During an orientation session, a trained bilingual coach helped men select 1 of the 3 intervention options that differed in coach, peer support, and available language. We used canonical discriminant analysis to assess multivariate associations of demographic, clinical, employment, cultural, and technology use and access factors with men’s intervention choices. We used generalized linear models to estimate weight loss at 6, 12, and 18 months for men in each intervention option. Results Among Latino men, 28% (56/200) chose videoconference groups, 31% (62/200) chose web-based videos, and 41% (82/200) chose in-person groups. The canonical discriminant analysis identified 1 orthogonal dimension that distinguished between men who chose an in-person group and men who chose web-based videos. Men who were older, spoke Spanish, and did not use a computer frequently had a higher probability of choosing in-person groups versus web-based videos. For men who selected a group delivery option, 86.9% (107/123) attended ≥25% of the sessions, 83.7% (103/123) attended ≥50% of the sessions, and 73.2% (90/123) attended ≥75% of the sessions, with no differences by type of group (videoconference or in person). Men who chose videoconference and in-person group sessions lost significantly more weight at 6 months (both P<.001) and 18 months (P=.02 and P=.04, respectively) than those who chose web-based videos. Men who chose in-person group sessions also lost significantly more weight at 12 months (P=.008) than those who chose web-based videos. Conclusions There were significant differences according to demographic, employment, cultural, and technology use factors between men who chose 1 of the 3 intervention options. Men who chose one of the group-based options (videoconference or in person) lost significantly more weight than those who chose web-based videos. Providing options that accommodate the diversity of Latino men’s preferences is important for increasing engagement in behavioral interventions. Trial Registration ClinicalTrials.gov NCT03092960; https://clinicaltrials.gov/ct2/show/NCT03092960

mHealth-Supported Gender- and Culturally Sensitive Weight Loss Intervention for Hispanic Men With Overweight and Obesity: Single-Arm Pilot Study

“…In the previously mentioned ANIMO study, where mHealth technology was not included, the mean weight loss in the GCSWLI at week 12 was −6.3 kg (95% CI −8.1 to −4.4 kg), and it was maintained at week 24 (−6.4 kg, 95% CI −8.6 to −4.3 kg) [ 21 ]. More recently, Rosas et al [ 14 ] conducted a study focusing on a choice-based technology-mediated lifestyle intervention for 200 Latino men. It compared 3 weight loss intervention options (videoconference, web-based videos, and in person) based on participants’ choices.…”

“…For example, attendance at individual counseling sessions for ANIMO was 77% and was 75% (144/192) for this mHealth study. Rosas et al [ 14 ] observed that the mean number of sessions attended out of 12 weeks was 10.9 (SD 2.6) for the videoconference sessions and 9.7 (SD 4.3) for in-person sessions. Continued efforts to examine which aspects of these studies, including delivery options and which intervention components (eg, mHealth) influence study effectiveness, are warranted.…”

“…In general, weight loss interventions in Hispanic adults have previously reported lower retention rates; however, they did not include mHealth components [ 40 ]. Rosas et al [ 14 ] observed a retention rate of 96.9%, suggesting that technology-mediated strategies may support retention efforts [ 14 ]. Our findings suggest moderate adherence to mHealth technology prescriptions, as the Fitbit Charge 2 wearable activity monitor was used 71.58% (962/1344) of the intervention days, and the Fitbit Aria Wi-Fi scale was used 30.51% (410/1344) of the intervention days.…”

“…A randomized clinical trial by Rosas et al [ 12 , 13 ] demonstrated the effective use of Fitbit devices among Hispanic participants with overweight or obesity, particularly when complemented by a culturally responsive lifestyle intervention. More recently, Rosas [ 14 ] found that Hispanic men who chose to attend web-based videoconference sessions lost significantly more weight when compared with a group who chose to watch prerecorded videos on the web. This finding suggests that providing options to accommodate the preferences of Hispanic men for intervention delivery methods can increase engagement in lifestyle interventions [ 14 ].…”

“…More recently, Rosas [ 14 ] found that Hispanic men who chose to attend web-based videoconference sessions lost significantly more weight when compared with a group who chose to watch prerecorded videos on the web. This finding suggests that providing options to accommodate the preferences of Hispanic men for intervention delivery methods can increase engagement in lifestyle interventions [ 14 ]. However, the use of mHealth technologies to support lifestyle behavior changes in weight loss interventions for Hispanic men remains largely untested.…”