RESUMEN
OBJECTIVE: Early weight loss is a strong predictor of longer-term and clinically meaningful weight loss but has not been studied in the context of mobile health ('mHealth') interventions. METHODS: GoalTracker was a randomized trial among adults (21-65 years) with overweight or obesity comparing three 12-week standalone mHealth interventions for weight loss. All arms received a free commercial mobile app (MyFitnessPal) for daily self-monitoring of diet and/or weight and a goal to lose 5% of weight by 3 months. Collapsing across arms, this analysis examined participants with a 1-month weight (n = 84), categorizing them as either early responders (≥2% weight loss at 1 month) or early non-responders (<2% weight loss at 1 month). RESULTS: Early responders - 36% of participants - had greater per cent weight change at 3 months (-5.93% [95% confidence interval: -6.82%, -5.03%]) than early non-responders (-1.45% [-2.15%, -0.75%]), which was sustained at 6 months (-5.91% [-7.33%, -4.48%] vs. -1.28% [-2.37%, -0.19%]; ps < 0.0001). Over half (57%) of early responders achieved ≥5% weight loss at 3 months vs. 11% of early non-responders. At 4 weeks, self-monitoring frequency (weight/diet) was significantly greater among early responders, which continued across 12 weeks. CONCLUSION: Responding early to an mHealth treatment is associated with higher engagement and greater likelihood of achieving clinically meaningful weight loss.
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BACKGROUND: African-Americans have higher rates of obesity-associated chronic diseases. Serum 25-hydroxyvitamin D (25(OH)D) shows an inverse association with obesity status. We investigated whether vitamin D supplementation changes body mass index (BMI). SUBJECTS: In total, 328 overweight African-Americans were enrolled over three consecutive winter periods (2007-2010) into a randomized, double-blind, placebo-controlled trial to receive cholecalciferol supplementation (0, 1000 international units (IU), 2000 IU or 4000 IU per day) for 3 months. Plasma concentrations of 25(OH)D and anthropometric measurements were done at baseline, 3 and 6 months. RESULTS: At 3 months, vitamin D supplementation in three dose groups (1000 IU, 2000 IU or 4000 IU per day) did not cause any significant changes in BMI as compared with placebo group 3-month change in BMI per 1000 IU per day estimate (SE): 0.01 (0.039); P=0.78. CONCLUSIONS: In overweight African-Americans, short-term high-dose vitamin D supplementation did not alter BMI.
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When compared with men of other racial or ethnic groups, African American men are more likely to experience adverse health conditions. The systematic review objectives were to (i) determine the current evidence base concerning African American men's response to lifestyle behavioural interventions designed to promote weight loss, increase physical activity, and/or improve healthy eating and (ii) determine the next steps for research in these areas. The PubMed, Web of Science, Psych Info and Cochrane databases were searched to identify papers published before January 1, 2013 that reported change in weight, physical activity and/or dietary patterns in African American men aged 18 and older, as a result of behavioural change strategies. The titles and abstracts of 1,403 papers were screened; after removing duplicates, 141 papers were read to determine their eligibility. Seventeen publications from 14 studies reported outcomes for African American men. Eight large multi-centre trials and six community-based studies were identified. African American men were an exclusive sample in only four studies. Five studies showed statistically significant improvements. Although the available evidence appears to show that these interventions produce positive results, the relative and the long-term effectiveness of weight loss, dietary and/or physical activity interventions for this population are unknown.
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Terapia Conductista , Negro o Afroamericano , Dieta Reductora , Ejercicio Físico , Obesidad/prevención & control , Pérdida de Peso , Negro o Afroamericano/estadística & datos numéricos , Terapia Conductista/métodos , Dieta Reductora/psicología , Ejercicio Físico/psicología , Conductas Relacionadas con la Salud , Humanos , Masculino , Actividad Motora , Obesidad/psicología , Estados Unidos/epidemiologíaRESUMEN
Electronic health (eHealth) interventions have demonstrated efficacy for weight management. However, little is known about their efficacy among racial/ethnic minority populations, in whom there is a disproportionate prevalence of obesity. This systematic review evaluated the efficacy of eHealth weight management interventions among overweight and obese racial/ethnic minority adults. We required that trial samples be comprised of at least 50% racial/ethnic minorities or report outcomes by race/ethnicity. We searched five electronic databases for trials conducted through June 2012. Six papers met our eligibility criteria. These studies provide suggestive evidence that eHealth interventions can produce low magnitude, short-term weight loss among racial/ethnic minorities. Trials were methodologically sound, with high retention and participant engagement. There was no evidence detailing the efficacy of mobile health approaches, although this area is promising given high utilization rates of mobile devices among racial/ethnic minorities. More evidence, particularly from longer-term trials, is necessary to demonstrate that eHealth intervention approaches can produce clinically meaningful (≥ 5% of initial body weight) weight loss among racial/ethnic minority populations.
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Promoción de la Salud , Disparidades en Atención de Salud/estadística & datos numéricos , Grupos Minoritarios , Obesidad/prevención & control , Telemedicina , Pérdida de Peso , Adulto , Medicina Basada en la Evidencia , Humanos , Aceptación de la Atención de Salud/estadística & datos numéricos , Evaluación de Programas y Proyectos de Salud , Garantía de la Calidad de Atención de Salud , Factores Socioeconómicos , Estados Unidos/epidemiologíaRESUMEN
STUDY OBJECTIVE: To examine history of alcohol abuse/dependence disorder in relation to unfair treatment, racial/ethnic discrimination, and ethnic identification among Asian Americans. DESIGN: Weighted multivariate analyses of cross-sectional national survey data predicting lifetime history of alcohol abuse/dependence disorders. SETTING: USA, Asian Americans. PARTICIPANTS: 2007 Asian American adults recruited to the National Latino and Asian American Study (NLAAS; 2002-2003). RESULTS: Controlling for sociodemographic characteristics, Asian Americans who reported experiencing unfair treatment had higher odds of history of alcohol abuse/dependence disorder (OR 5.26, 95% CI 1.90 to 14.56). Participants who reported high levels of ethnic identification had lower odds of history of alcohol abuse/dependence disorders (OR 0.46, 95% CI 0.23 to 0.90). Ethnic identification moderated the influence of racial/ethnic discrimination (p = 0.097). Among participants with low levels of ethnic identification, racial/ethnic discrimination was associated with greater odds of having a history of alcohol disorder compared with those with high levels of ethnic identification. CONCLUSIONS: Social hazards such as unfair treatment and racial/ethnic discrimination should be considered in the development of programmes addressing alcohol disorders among Asian Americans. Interventions that promote ethnic identification in this population may be particularly relevant in mitigating the negative influence of racial/ethnic discrimination on alcohol disorders.
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Trastornos Relacionados con Alcohol/etnología , Asiático/etnología , Prejuicio , Relaciones Raciales/psicología , Adulto , Trastornos Relacionados con Alcohol/psicología , Asiático/psicología , Estudios Transversales , Cultura , Femenino , Humanos , Masculino , Estados Unidos/epidemiologíaRESUMEN
The relation between gender-role percepts and academic goal-setting was explored. An inventory examining the aspects of masculinity that would facilitate or inhibit academic goal-setting was developed based on a literature review of how masculinity relates to academic behaviors. A diverse sample of students (120 male, 147 female, 14 not indicating sex) was measured on three aspects of sex and academic goal-setting behavior. Factor analysis confirmed the content validity of masculine factors having facilitative (Mastery Competitiveness) and inhibitory (Antisocial Competitiveness) academic properties. Regression analyses indicated that sex-role orientations (Competitiveness and Hypermasculinity) significantly predicted academic goal-setting behaviors (R2 = .136). Finally, men scored higher than women on the subscales measuring Hypermasculinity and Antisocial or Competitiveness, while there were no sex differences on the Mastery Competitiveness subscale. The implications of these findings and suggestions for research are discussed.