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Relationships Between Barriers, Motives, Retention and Effectiveness in a Commercial Weight Loss Program.
Shah Bhagat, Mita
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Data from seven work sites that had purchased a commercial weight loss program for their employees was used to determine (a) the most prevalently identified barriers and motives for weight loss, (b) the relationship between barrier identification and subsequent attrition at 3 and 6 months post program initiation, (c) the relationship between motive identification and subsequent attrition at 3 and 6 months, (d) the relationship between barrier identification on weight loss at 3 and 6 months, (e) the relationship between motive identification on weight loss at 3 and 6 months, (f) the effectiveness of the program at the end of three and six months of participation (g) the reach of the program into the eligible employee population, and (h) the proportion of the targeted employee population that ultimately benefited from the program and the degree to which they benefited (i.e., effectiveness that accounts for reach and retention). The most frequently selected barriers were being stressed, having too many opportunities to eat unhealthy foods, and a lack of time to exercise. The most frequently selected motives were to look better, a sense of it being the â right timeâ , and to improve health. Chi square test revealed that those participants who selected a given barrier or motive were more likely to be retained than those who did not select a given barrier at the beginning of the program. When we controlled for age and gender, we found that women who selected motives at the beginning of the program were more likely to be retained on this program than men. Age of the participants did not influence their retention on the program. Logistic regression analysis when controlling for gender & age indicated that women and older adults were somewhat more likely to be retained on the program at both 3 and 6 months of participation. Multivariate regression analysis indicated that there was no significant association between selection of total motivators and barriers and weight loss at 3 & 6 months of participation. Intention to treat analyses using baseline value carried forward for participants lost to attrition revealed that participants lost a significant (p<.01), yet modest, 2.1 lbs of weight at 3 and 2.5 lbs of weight at 6 months of participation. Follow-up analyses were conducted to determine the overall proportion of the workforce that benefited (i.e., lost weight) at 6 months. Of the 1607 participants who were retained at 6 months 1088 were successful in losing weight and lost, on average 9.4 pounds (95% CI: 8.8 to 9.9 pounds), a clinically significant 4.4% of initial body weight. Thus, 10.1% of the total employee population benefited from the weight loss program and lost a clinically relevant amount of weight. The findings of this study indicate that information on motives and barriers most frequently identified by the participants can be used to customize weight loss programs in order to enhance retention of its participants. Also presenting reach by effectiveness data to the employers could help them in making more sophisticated decisions while choosing a commercial weight loss program for their employees.
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