Community based peer supported weight loss intervention on women with overweight and obesity

Year 2024, , 173 - 185, 16.08.2024

Berna Bilgin Şahin , Erhan Eser

https://doi.org/10.20518/tjph.1411189

Abstract

Objective: The purpose of this study was to assess the success of the new peer-led weight loss community intervention model in women aged 18-64.

Methods: Women leaders in the community (n = 11) were identified to supervise and monitor their target group of women during the intervention which included a balanced diet and regular physical activity program. Initially, all women aged 18–64 in the district (n = 655) were screened and 396 were found to have a BMI > 25.0. Of these, 137 volunteered to participate in the program. 86.9% of the women completed the 3rd month, and 78.1% completed the 6th month of the intervention. Univariate (Paired t-test and Wilcoxon signed rank test for dependent groups; Student’s t test, Mann–Whitney U test, Kruskal–Wallis, Chi-square, and Fisher’s exact test for independent groups) and Multiple Linear Regression analyses were conducted in the study. Type 1 error limit was accepted as 0.05 in the analyses.

Results: Significant improvements were observed in the body weight of the participants in the 3rd (-1.1±2.5 kg) month of the intervention (p<0.05). At 3rd and 6th months of the intervention, 10.9% and 13.1% of women lost at least 5% of their weight, while 8.4% and 11.2% of women jumped to a better BMI category, respectively.

Conclusion: The exercise program implemented (regardless of covariate variables) was effective on the weight loss. Community-based peer-led obesity interventions are challenging but promising.

Keywords

Obesity, Prevention And Control, Women’s Health, Residence Characterictics

Ethical Statement

This study is approved by Manisa Celal Bayar University, Faculty of Medicine, Clinical Researches Ethical Committee (Date: 21/06/2017, Decision no. 25160. The authors declare no conflicts of interest.

Supporting Institution

Supported by Manisa Celal Bayar University Research Projects Coordination Office

Project Number

It was granted by the Manisa Celal Bayar University Research Projects Coordination Office through Project Grant Number 2018-013.

Thanks

We acknowledge their very valuable support of family health center staff, Dr.Ersan Erhan Demir and Midwife Zeliha Demir, dietitian Didem Karakaş, trainer Şule Özgüneş and pharmacist Kıymet Sayitoğlu Özbek.

References

• Türkiye Endokrinoloji ve Metabolizma Derneği. Obezite Tanı ve Tedavi Kılavuzu. Ankara; 2019. Available at: https://file.temd.org.tr/Uploads/publications/guides/documents/20190506163904-2019tbl_kilavuz5ccdcb9e5d.pdf?a=1. Accessed August 9,2024
• WHO. World health statistics 2023: monitoring health for the SDGs, sustainable development goals [online]. Available at: https://www.who.int/publications/i/item/9789240074323. Accessed August 9,2024
• WHO. Global Health Observatory (GHO) data-Turkey [online]. 2016. Available at: https://www.who.int/nmh/countries/tur_en.pdf?ua=1. Accessed August 9,2024
• Timmis A, Townsend N, Gale C et al. European Society of Cardiology: Cardiovascular Disease Statistics 2017. Eur Heart J. 2018;39(7):508-79.
• Bray GA. Use and Abuse of Appetite-Suppressant Drugs in the Treatment of Obesity. Ann Intern Med. 1993;119(7_Part_2):707-13.
• Lea D, Bradbery J. Oxford Adavnced Learner’s Dictionaries. 10th ed. Oxford University Press.
• Yaslı G , Horasan G , Batı H . Gençlerde sigaradan korunma konusunda akran eğitimi programının etkinliği. Turk J of Public Health. 2012; 10(2): 59-67.(in Turkish).
• Bulduk, S, Erdogan S. The effects of peer education on reduction of the HIV/sexually transmitted infection risk behaviors among Turkish university students. JANAC 2012;23(3): 233-243.
• Hageman PA, Pullen CH, Hertzog M, Pozehl B, Eisenhauer C, Boeckner LS. Web-Based Interventions Alone or Supple-mented with Peer-Led Support or Professional Email Counseling for Weight Loss and Weight Maintenance in Women from Rural Communities: Results of a Clinical Trial. J Obes. 2017;(1):1602627
• Cherrington AL, Willig AL, Agne AA, Fowler MC, Dutton GR, Scarinci IC. Development of a theory-based, peer support in-tervention to promote weight loss among Latina immigrants. BMC Obesity. 2015;2(7):1-9.
• Barnes RD, White MA, Martino S, Grilo CM. A randomized controlled trial comparing scalable weight loss treatments in primary care. Obesity. 2014;22(12):2508-16.
• Barr-Anderson DJ, Laska MN, Veblen-Mortenson S, Farbakhsh K, Dudovitz B, Story M. A School-Based, Peer Leadership Physical Activity Intervention for 6th Graders: Feasibility and Results of a Pilot Study. JPAH 2012;9(4):492-9.
• Colvin JW. Peer tutoring and social dynamics in higher education. Mentoring & tutoring. 2007;15(2):165–181.
• Santee J, Garavalia L. Peer tutoring programs in health professions schools. Am J Pharm Educ. 2006;70(3):Article 70.
• Hohmann, AA, Shear MK. Community-based intervention research: Coping with the “noise” of real life in study design. Am J Psychiat 2002; 159(2), 201-207
• David BA, Vincent CB, Harold EY. The Measurement of Attitudes Toward and Beliefs About Obese Persons. Int j Eat Disor-der 1991; 10(5), 599-607.
• Dedeli O, Bursalioglu SA, Deveci A. Validity and reliability of the Turkish version of the attitudes toward obese persons scale and the beliefs about obese persons scale. Clinical Nursing Studies. 2014;2(4):105-17.
• Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ) – Short and Long Forms. 2005. Available at: file:///C:/Users/HP/Downloads/ActivityQuestionnaireIPAQShortandLongForms.pdf. Accessed August 9,2024
• Öztürk M. A research on reliability and validity of international physical activity questionnaire and determination of physi-cal activity level in university students. Master’s Thesis. Ankara: T.C. Hacettepe Üniversitesi; 2005.
• Aydemir Ö. T Guvenir, L Kuey, S Kultur. Validity and Reliability of Turkish Version of Hospital Anxiety and Depression Scale. Turk Psikiyatri Derg. 1997;4(8).
• Sahin, BB, Eser E. Effectiveness of a Peer Support Intervention Program on Obesity Control Among Women in a Rural Ar-ea of Turkey. 2021 (DOI: https://doi.org/10.21203/rs.3.rs-970741/v1)
• Sevim Yilmaz T, Ergör G. “Effect of behavioral approach on weight loss in overweight and obese women at the primary care” EJPH 25.suppl_3 (2015): ckv175-251.
• Takada A, Nakamura R, Furukawa M, Takahashi Y, Nishimura S, Kosugi S. The Relatıonshıp Between Weıght Loss And Tıme And Rısk Preference Parameters: A Randomızed Controlled Trıal. J Biosoc Sci,. 2011;43(04):481-503.
• Bennett GG, Warner ET, Glasgow RE et al. Obesity Treatment for Socioeconomically Disadvantaged Patients in Primary Care Practice. Arch Intern Med. 2012;172(7):565-74.
• Greaves CJ, Middlebrooke A, O’Loughlin L et al. Motivational interviewing for modifying diabetes risk: a randomised con-trolled trial. Br J Gen Pract 2008;58(553):535-40.
• Appel LJ, Clark JM, Yeh HC et al. Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice. N Engl J Med. 2011;365(21):1959-68.
• Karataş ME, Günay T. The Effect of Behavioral Treatment on Nutritional Behaviors of Obese Women. Bes Diy Derg [Inter-net]. 2013; 41(3):194-201. Available at: https://beslenmevediyetdergisi.org/index.php/bdd/article/view/228. Accessed August 9,2024
• Bayburtluoğlu C, Öztürk S, Yılmaz M, Cerit Ç. Obezite Kaderimiz Değil (Kırklareli Pınarhisar Örneği). 2. International 20. National Public Health Congress Proceedings Book.; 2018. s. 972-3. Available at: https://www.halksagligiokulu.org/Kitap/DownloadEBook/e16c1443-8948-4b54-be93-c64133191bfa. Accessed August 9,2024
• Kozica SL, Harrison CL, Teede HJ, Ng S, Moran LJ, Lombard CB. Engaging rural women in healthy lifestyle programs: in-sights from a randomized controlled trial. Trials 2015;16(1):413.
• Austin JL, Smith JE, Gianini L, Campos-Melady M. Attitudinal familism predicts weight management adherence in Mexi-can–American women. J Behav Med 2013;36:259-69.
• Kong A, Beresford SAA, Imayama I et al. Adoption of diet-related self-monitoring behaviors varies by race/ethnicity, edu-cation, and baseline binge eating score among overweight-to-obese postmenopausal women in a 12-month dietary weight loss intervention. Nutr Res. 2012;32(4):260-5.
• Elfhag K, Rössner S. Initial weight loss is the best predictor for success in obesity treatment and sociodemographic liabili-ties increase risk for drop-out. PEC 2010; (79):361-6.
• Burgess E, Hassmén P, Pumpa KL. Determinants of adherence to lifestyle intervention in adults with obesity: a systematic review. Clinical Obesity 2017; 7:123-35.
• Perry B, Ciciurkaite G, Brady CF, Garcia J. Partner Influence in Diet and Exercise Behaviors: Testing Behavior Modeling, Social Control, and Normative Body Size. PLoS One 2016; 11(12), e0169193.
• Ajzen, I. The theory of planned behavior. Organizational behavior and human decision processes 1991; 50(2), 179-211.
• Gillison F, Stathi A, Reddy P. et al. Processes of behavior change and weight loss in a theory-based weight loss intervention program: a test of the process model for lifestyle behavior change. Int J Behav Nutr Phys Act 2015; 12,2.
• Varkevisser RDM, Van Stralen MM, Kroeze W, Ket JCF, Steenhuis IHM. Determinants of weight loss maintenance: a sys-tematic review. Obes Rev. 2019; 20(2):171-211.
• Chung LM, Fong SS. Predicting actual weight loss: A review of the determinants according to the theory of planned behav-iour. Health Psychol Open 2015; 15;2(1)
• Cheng OY, Yam CLY, Cheung NS, Lee PLP, Ngai MC, Lin CY. Extended Theory of Planned Behavior on Eating and Physical Activity. Am J Health Behav. 2019; 1;43(3):569-581.
• Dombrowski SU, Knittle K, Avenell A, Araújo-Soares V, Sniehotta FF. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ 2014; 348:g2646.