Experiences of African American Breast Cancer Survivors Using Digital Scales and Activity Trackers in a Weight Gain Prevention Intervention: Qualitative Study.

BACKGROUND: The use of digital tools to promote daily self-weighing and daily activity tracking may be a promising strategy for weight control among African American breast cancer survivors (AABCS). There have been no studies exploring the acceptability and feasibility of using digital tools for weight control or qualitative studies characterizing perceptions of daily self-weighing and daily activity tracking among AABCS. OBJECTIVE: This study aimed to explore the subjective experiences of daily self-weighing and daily activity tracking using digital tools, including wireless scales and activity trackers, in a sample of AABCS participating in two technology-based weight gain prevention interventions over 6 months. METHODS: Semistructured interviews (N=21) were conducted in person or over the phone, were audio recorded, and then transcribed verbatim. Each transcript was read to identify key themes and develop a codebook. Each transcript was coded using Atlas.ti software, and code outputs were used to identify overarching themes and patterns in the data. RESULTS: On average, participants were 52.6 (SD 8.3) years of age, with obesity at baseline (BMI 33.1 kg/m2, SD 5.9), and weighed on 123.4 (SD 48.0) days out of the 168 days (73.5%) in the study period. Women tended to attribute their weight gain to cancer treatment and framed program benefits in terms of improved quality of life and perceptions of prolonging their survival following treatment. Using the smart scale for daily self-weighing was viewed as the tool by which participants could control their weight and improve their health and well-being posttreatment. The activity tracker increased awareness of physical activity and motivated participants to be more active. CONCLUSIONS: Participants reported positive experiences and benefits from daily self-weighing and daily activity tracking. Findings suggest that daily self-weighing and daily activity tracking using digital tools are well-received, acceptable, and feasible intervention strategies for AABCS in the context of posttreatment weight management.

Engagement and Weight Loss in a Web and Mobile Program for Low-Income Postpartum Women: Fit Moms/Mamás Activas.

Internet-based weight loss programs can be effective in promoting weight loss and are less-intensive than traditional face-to-face approaches, which may provide more flexibility for postpartum, low-income women to engage in such programs. Few studies have examined patterns of engagement in internet-based programs for this population. This article used data from the internet-based Fit Moms/Mamás Activas intervention, a 12-month cluster randomized controlled trial that was effective in promoting postpartum weight loss among low-income, predominantly Hispanic women. The overall objectives of this study were to (1) characterize patterns of engagement with the Fit Moms/Mamás Activas website among intervention participants and (2) explore associations between engagement and 12-month weight loss outcomes among study completers (87.4%). A number of engagement variables were calculated for each participant, including website logins; time spent on the website; number of posts to the "Discussion Forum;" number of days tracking weight, diet, and physical activity; number of page visits to various website components; and number of in-person visits attended. The average number of logins was 70.74 (approximately once weekly), and average total time spent on the website was 185.35 minutes (approximately 3 hours) over 1 year. Self-monitoring ("Web Diary") and social support ("Discussion Forum") were the most frequently visited components of the website, and more frequent engagement with these components, as well as greater attendance at in-person group sessions, predicted greater percent weight loss at 12 months. Interventions highlighting these features may be particularly effective for weight loss in this population.

Exploring the Potential for Technology-Based Nutrition Education Among WIC Recipients in Remote Alaska Native Communities.

OBJECTIVE: Estimate media technology use in Alaska Native communities to inform the feasibility of technology-based nutrition education. METHODS: A self-administered questionnaire was mailed to a random selection of about 50% of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) authorized representatives in remote Alaska Native communities (n = 975). Media technology use, interest in media technology-based nutrition education, and potential barriers were assessed. Chi-square tests were used to investigate associations among technology use, age, and education. RESULTS: Technology use was common among respondents (n = 368); use was significantly more common among younger age groups and participants with a higher level of education. Smartphone (78.8%) and Facebook (95.8%) use was comparable to national averages, but having a computer at home (38.4%) was much less likely. Less than 50% of participants have Internet access at home. CONCLUSIONS AND IMPLICATIONS: Findings shed light on new opportunities for WIC and other programs to deliver nutrition education to Alaska Native people in remote communities.

Recruitment Strategies and Lessons Learned from the Children's Healthy Living Program Prevalence Survey.

The US Affiliated Pacific region's childhood obesity prevalence has reached epidemic proportions. To guide program and policy development, a multi-site study was initiated, in collaboration with partners from across the region, to gather comprehensive information on the regional childhood obesity prevalence. The environmental and cultural diversity of the region presented challenges to recruiting for and implementing a shared community-based, public health research program. This paper presents the strategies used to recruit families with young children (n = 5775 for children 2 - 8 years old) for obesity-related measurement across eleven jurisdictions in the US Affiliated Pacific Region. Data were generated by site teams that provided summaries of their recruitment strategies and lessons learned. Conducting this large multi-site prevalence study required considerable coordination, time and flexibility. In every location, local staff knowledgeable of the community was hired to lead recruitment, and participant compensation reflected jurisdictional appropriateness (e.g., gift cards, vouchers, or cash). Although recruitment approaches were site-specific, they were predominantly school-based or a combination of school- and community-based. Lessons learned included the importance of organization buy-in; communication, and advance planning; local travel and site peculiarities; and flexibility. Future monitoring of childhood obesity prevalence in the region should consider ways to integrate measurement activities into existing organizational infrastructures for sustainability and cost-effectiveness, while meeting programmatic (e.g. study) goals.