Twitter-Delivered Behavioral Weight-Loss Interventions: A Pilot Series

Abstract

BackgroundLifestyle interventions are efficacious at reducing risk for diabetes and cardiovascular disease but have not had a significant public health impact given high cost and patient and provider burden.ObjectiveOnline social networks may reduce the burden of lifestyle interventions to the extent that they displace in-person visits and may enhance opportunities for social support for weight loss.MethodsWe conducted an iterative series of pilot studies to evaluate the feasibility and acceptability of using online social networks to deliver a lifestyle intervention.ResultsIn Study 1 (n=10), obese participants with depression received lifestyle counseling via 12 weekly group visits and a private group formed using the online social network, Twitter. Mean weight loss was 2.3 pounds (SD 7.7; range -19.2 to 8.2) or 1.2% (SD 3.6) of baseline weight. A total of 67% (6/9) of participants completing exit interviews found the support of the Twitter group at least somewhat useful. In Study 2 (n=11), participants were not depressed and were required to be regular users of social media. Participants lost, on average, 5.6 pounds (SD 6.3; range -15 to 0) or 3.0% (SD 3.4) of baseline weight, and 100% (9/9) completing exit interviews found the support of the Twitter group at least somewhat useful. To explore the feasibility of eliminating in-person visits, in Study 3 (n=12), we delivered a 12-week lifestyle intervention almost entirely via Twitter by limiting the number of group visits to one, while using the same inclusion criteria as that used in Study 2. Participants lost, on average, 5.4 pounds (SD 6.4; range -14.2 to 3.9) or 3.0% (SD 3.1) of baseline weight, and 90% (9/10) completing exit interviews found the support of the Twitter group at least somewhat useful. Findings revealed that a private Twitter weight-loss group was both feasible and acceptable for many patients, particularly among regular users of social media.ConclusionsFuture research should evaluate the efficacy and cost-effectiveness of online social network-delivered lifestyle interventions relative to traditional modalities.

Interest in a Twitter-delivered weight loss program among women of childbearing age

“…Two recent systematic reviews indicated that online social networks have been primarily used as an adjunct to in-person or web-based weight loss interventions, rather than as the primary treatment modality [18,19]. We recently conducted a series of pilot studies that demonstrated that delivering a weight loss intervention via a private Twitter group is feasible and acceptable [34]. Our results suggest that women of childbearing age are interested in a weight loss program delivered entirely via Twitter.…”

“…Future studies could include asking women to evaluate how engaging they would find specific posts or articles, and also examining which types of posts netted the most engagement. In our previous study of a Twitter-delivered weight loss intervention, participants reported that one of the biggest barriers to engaging was not being sure what to post [34], suggesting that providing participants with guidance on what to post may be one avenue for enhancing engagement. Research is needed to understand how to increase engagement in behavioral interventions delivered via online social networks, including how to encourage visible interactions from participants who prefer to lurk (i.e., read content without visibly engaging) [42].…”

The Feasibility of Incentivizing Participation in an Online Social Network Weight Loss Program

“…[3] In fact, large patient communities have organically developed online which may provide a critical mass for health promotion interventions. [4,5] For example, online social networks are increasingly being researched as a modality for delivering behavioral weight loss interventions. [6] Some studies have used online social networks as an adjunct to clinic-based weight loss programs, either by conducting scheduled group chats online [7,8] or by providing a message board/forum for participants to submit questions and chat.…”

“…[9,10] Other studies have used online social networks as the main delivery modality for weight loss interventions. [5,11,12] Two systematic reviews of 12 and 20 studies, respectively, revealed that such interventions have shown modest outcomes. [6,13] Only one study isolated the impact of the online social network, showing that an online exercise intervention that included an online social network outperformed the same intervention without the online social network.…”

Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women (Preprint)

“…A third approach has been to incentivize participants based on the number of posts they contributed to the Facebook group [51]. Finally, some recent studies have investigated the type of intervention content that stimulates the highest level of engagement [27,[52][53][54][55]. One study found that polls, posts asking participants to suggest a tip for others, and weight-related posts were the most engaging among participants in a 4-month weight loss study [52].…”