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Weight Wiser Group holding certificates
Weight Wiser program leaders

Weight management programs that focus on behavior change can be effective in leading to weight loss, but most are done in controlled settings. As a result, it is often difficult to know whether the intervention can be sustained outside of the test environment. Now researchers at the University of North Carolina at Chapel Hill have successfully implemented a previously proven weight-loss program in the “real-world” through select North Carolina health departments and have published their findings online February 14 in the journal Obesity.

Carmen Samuel-Hodge, PhD, research assistant professor of nutrition at Gillings School of Global Public Health and research fellow at the Center for Health Promotion and Disease Prevention at The University of North Carolina at Chapel Hill, and her colleagues trained staff members at six randomly selected health departments to implement a proven weight loss program among low-income, middle-age women in their communities. After 16 weeks, the 126 program participants showed an average of 4 percent loss of their initial body weight, which is comparable to other successful weight loss programs. Their findings demonstrate that training local staff members in an evidence-based program can lead to successful and clinically meaningful weight loss.

The present study was an extension of the Weight Wise Program developed by Samuel-Hodge and her team, which showed significant weight loss in participants who were part of a program tested in a North Carolina community health center setting and led by the research team. The implementation study reported in Obesity tested whether the same program could be as effective when the research team trained health department employees to implement the program.

“We’ve missed the mark if our research does not promote health in those with the greatest need in our state,” Samuel-Hodge said.  “This research is an important translation of what works in settings where it needs to work.”

The Weight Wise II study drew recruits from low-income, mid-life women, a group at particularly high risk for obesity-related chronic diseases. The average age of participants was 51 years. Fifty-three percent were African-American, and 20 percent reported a household income of less than $10,000 per year, although more than half reported being employed.  The study also monitored the cost of implementing the program, as health departments and other organizations serving the target population often do not have resources to implement effective programs. The final cost of the program was $327 per participant, but the program was offered without cost through the research study.

“Weight loss programs that work can be costly – $200 to $1,400 per person – and this program of 16 sessions certainly falls closer to the lower end of this range,” Samuel-Hodge said.

Health department staff members received 26 hours of basic nutrition and physical activity training, as well as information about behavior change strategies, motivational interviewing, intervention implementation and data collection. The research team also provided small incentives during the program and materials for participant recruitment, but each health department group decided how best to recruit participants into the study and use the incentive funds.

“This real-world demonstration of effectiveness should encourage future translational studies in more diverse settings and populations,” Samuel-Hodge said.

The UNC Center for Health Promotion and Disease Prevention is a Centers for Disease Control and Prevention-funded Prevention Research Center.

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