Fit Freshmen: A mixed methods approach to developing weight control strategies for 1st year college students

College-age adults gain weight more rapidly than the general population, with a mean weight gain of ~1.8 to 4 kilograms during their first year at college. The purpose of this pilot RCT was to test the efficacy of a semester long internet weight-loss program based upon social cognitive theory for overweight college freshmen. Qualitative focus groups were used to provide feedback on content of the active intervention. Participants (n=27; mage=18.5±.6; mweight=90kg±18; 74% female) were randomly assigned to the active intervention (Fit Freshmen; FF) or a health information control group and completed baseline and 3 month follow-up measurements. When compared to controls FF participants experienced higher improvement in self-regulatory skills for portion control, fruit and vegetable consumption and physical activity (all p's<.05). Consumption of dietary fat and added sugar also decreased significantly for FF subjects when compared to controls (all p's<.05) while total energy intake differences were significant (p<.09). Trends in increased physical activity were present, but not significantly different between groups. Finally, FF lost significantly more weight than controls (mdifference=2.2kg; p<0.05) and more fat mass (mdifference=1kg; p<0.09). Themes for content improvement included providing a more detailed meal plan, reducing email contact, and increasing social activity opportunities. Program characteristics that were positively evaluated included the flexible exercise program, incentives for weight loss, and use of an onsite weigh station. This study provides promising outcomes for a scalable internet-based weight loss program for college freshmen and highlights features that could be improved to be more attractive to this population.