Two‐Year Internet‐Based Randomized Controlled Trial for Weight Loss in African‐American Girls

Abstract

. Two-year Internet-based randomized controlled trial for weight loss in African-American girls. Obesity. 2006;14:1231-1243. Objective: A randomized controlled trial tested the efficacy of an internet-based lifestyle behavior modification program for African-American girls over a 2-year period of intervention. Research Methods and Procedures: Fifty-seven overweight (mean BMI percentile, 98.3) African-American girls (mean age, 13.2 years) were randomly assigned to an interactive behavioral internet program or an internet health education program, the control condition. Overweight parents were also participants in the study. Forty adolescentparent dyads (70%) completed the 2-year trial. Outcome data including BMI, body weight, body composition, and weight loss behaviors were collected at baseline and at 6-month intervals. A computer server tracked use of the web sites. Results: An intention-to-treat statistical approach was used, with the last observation carried forward. In comparison with the control condition, adolescents in the behavioral program lost more mean body fat (BF) (Ϫ1.12 Ϯ 0.47% vs. 0.43 Ϯ 0.47% BF, p Ͻ 0.05), and parents in the behavioral program lost significantly more mean body weight (Ϫ2.43 Ϯ 0.66 vs. Ϫ0.35 Ϯ 0.64 kg, p Ͻ 0.05) during the first 6 months. This weight loss was regained over the next 18 months. After 2 years, differences in fat for adolescents (Ϫ0.08 Ϯ 0.71% vs. 0.84 Ϯ 0.72% BF) and weight for parents (Ϫ1.1 Ϯ 0.91 vs. Ϫ0.60 Ϯ 0.89 kg) did not differ between the behavioral and control programs. Discussion: An internet-based weight management program for African-American adolescent girls and their parents resulted in weight loss during the first 6 months but did not yield long-term loss due to reduced use of the web site over time.

Approaches to the Prevention and Management of Childhood Obesity: The Role of Social Networks and the Use of Social Media and Related Electronic Technologies

“…Baranowski et al, 60 however, did not show any significant difference in girls randomized to a monthly Internet intervention and those receiving no Internet intervention; however, both groups also attended a special 4-week summer day camp, and there was a significant difference in the baseline mean BMI between the Internet intervention group (21.1±4.4 kg/m 2 ) and the control group (26.3±7.9 kg/m 2 ). White et al 61 and Williamson et al 58,59 studied the same cohort, demonstrating that active family-based behavioral Internet interventions resulted in more loss of body weight and lower dietary fat intake than passive primary health education. The Internet-based interactive program included e-mail counseling on self-monitoring, problem solving, goal setting, and relapse prevention.…”

“…Six of these studies suffered from small sample size (n=35-80), [56][57][58][59][60] and 3 studies were from the same cohort of patients. 58,59,61 Doyle et al 57 and Celio et al 56 demonstrated a reduction in BMI z scores in those receiving an interactive Internet-delivered cognitive behavioral program compared with those receiving usual care with basic information provided on nutrition and physical activity.…”

Evidence Update on the Treatment of Overweight and Obesity in Children and Adolescents

“…The use of technology (e.g., Internet, telephone) may be another appropriate avenue to enable broader dissemination of treatments, and research has begun to examine this option. In one study of Internet-delivered treatment, overweight African American female adolescents in the online behavioral treatment lost more weight than a control group; however, this was not maintained at 2-year follow-up, possibly because program usage decreased over this time (Williamson et al, 2006). An additional study found decreases in BMI over time (Taylor et al, 2012), whereas another study found an Internet-based program efficacious only among children who used the programs frequently (Delamater et al, 2013), suggesting that maintaining program usage is critical for establishing this treatment approach.…”

Web-Based Family Intervention for Overweight Children: A Pilot Study

“…This is a critical need because previous research indicates overweight children decrease their use of a web program over time. 55 Other health-oriented web programs for youth have successfully included a social networking component or ''chat room'' as part of the intervention, which may help with engagement over time. 61 Once engagement is established, it is essential to maintain program interest through frequently updating materials and creating fun interactive game-like activities.…”

“…53 Another study showed decreased dietary fat intake and reduced body fat after 6 months of treatment, with increased use of the web site associated with better outcomes 54 ; however, weight loss was not maintained at 2 years, with decreased web use occurring over time. 55 Additional studies have found web-based programs to result in increases in physical activity and improved dietary intake in children as young as 8 years of age. [56][57][58][59] There are many web sites with information related to child obesity, some with interactive games to increase children's nutritional and physical activity knowledge and skills.…”