Progress 02/15/05 to 02/14/10
Outputs
OUTPUTS: Behavior Change for Obesity Prevention in Young Adults (WebHealth) employs an internet-delivered educational program designed to prevent unwanted weight gain among young adults on college campuses. The program includes 10 lessons on nutrition, body size acceptance, internal regulation of food intake, enhancing food variety, eating enjoyment, and long-term energy balance regulation. The program was developed using the Instructional Design Model (IDM) (Dick, Carey & Carey, 2005) and lessons were evaluated using the Instructional, Materials Motivation Survey (IMMS) (Keller 1987). A total of 34 on-line focus groups in college students (n=242) were conducted. Focus group data was used to develop the on-line program following the IDM. The intervention was pilot tested in Spring 2007 with 172 students. A total of 133 (77.3%) completed all 10 lessons and the post assessment. Based on the pilot evaluation, lessons were shortened and made more interactive and training in anthropometric assessment was standardized. The full study started Fall 2007 with the enrollment of 1689 participants who completed both on-line assessment and physical assessment. Subjects were randomized into treatment or no-treatment control. At post assessment, after the 10-week program (or control condition), 1365 (80.8%) completed both on-line assessment and in-person physical assessment. Most treatment subjects completed all 10 lessons (84%). At 15-month follow-up, 1126 (66.7%) completed both on-line assessment and in-person physical assessment. Approximately 38% of treatment subjects completed a process evaluation post-intervention. Although they evaluated the program as satisfying and relevant, participants indicated they wanted less text, more fun and a greater focus, "Just tell me what I need to know." PARTICIPANTS: A total of 12 faculty from 8 participating institutions (University of Rhode Island, University of Maine, Syracuse University, Pennsylvania State University, Michigan State University, South Dakota State University, Tuskegee University, University of Wisconsin-Madison) worked on this project. In addition, 3 post-doctoral fellows, 3 doctoral students and 21 masters level students worked on the project. The project provided opportunities for undergraduate student training in most institutions as well as senior and master's level research projects leading to 11 master's theses. Five graduate students received awards from professional organizations for presentations at professional meetings. The investigators appreciate the contribution of S. Schoff who replaced K. Kritsch on this project. TARGET AUDIENCES: The target audience for this intervention is college students. However, Pennsylvania State University has received funding to adapt some of the lessons for low-income, non-college student populations of young adults and South Dakota State University has received funding to modify the interventions for diverse groups of young adults. PROJECT MODIFICATIONS: The only significant modification was a no-cost extension for one year to allow for data analysis and publications.
Impacts
This project advanced the discipline of nutrition education by utilizing on-line focus groups, integrating assessment of biopsychophysiological parameters such as anthropometrics, sleep behavior and eating competence with educational outcomes, and added to the understanding of college student health related behaviors. The intervention had no effect on 15-month follow-up BMI (both groups increased from BMI=23.4+-3.5 to BMI=23.8+-3.8) or cardio-respiratory fitness (treatment decreased estimated VO2max from 42.7+-6.0 baseline to 42.0+-5.7 follow-up and control decreased estimated VO2max from 42.8+-6.0 baseline to 41.8+-5.9 follow-up). However, fruit and vegetable intake measured by the NCI Screener increased by 1/2 cup more in the treatment than control group (p<.001) and activity measured by the IPAQ Short Form decreased by 239 MET min/week less in the treatment than the control group (p<.05). The program is being packaged and, after additional testing, should be available for dissemination on college campuses. The following two additional studies were funded based on this project: Impact Assessment of About Eating, an online curriculum on eating competence for low-income Pennsylvanians 2009-2010 (Lohse, PI) FNS, USDA $98,886 and Development of a Randomized Trial Guided by the Process of PRECEDE-PROCEED for Prevention of Excessive Weight Gain in Communities of Young Adults 2009-2012 (Kattelmann, PI) NRI, USDA $ 1,499,491.
Publications
- Greaney ML, Lees FD, White AA, Dayton SF, Riebe D, Blissmer B, Shoff S, Walsh J, Greene GW.(2009) College Students' Barriers and Enablers for Healthful Weight Management: A Qualitative Study. J Nutr Educ Behav 41(4):281-286.
- Schembre, S, Greene, G, Melanson, K.(2009) Development and Validation of a Weight-Related Eating Questionnaire. Eating Behaviors 10:119-124.
- Shoff S, Nuss E, Horacek T, Boyle C, Lohse B, Patterson J, Krall J, White A, Mathews D, Schembre S, Greene G.(2009) Sleep quality is associated with eating behavior in 18-24 year old college students. J Nutr Educ Behav 41:S8 (Abstract).
- Mathews D, White A, Shoff S.(2009) Effect of Sleep Quality on Quality of Life and Anthropometrics in 18-24 Year Old University of Maine College Students. J Nutr Educ Behav 41:S34 (Abstract).
- Herrick, M., Kattelmann, K., Wey, H., White, A.,Hoerr, S., Horacek, T., Lohse, B., Patterson, J., Phillips, B., Schoff, S., Boyle, C., Greene, G.(2009) Association between participant baseline characteristics and time spent on WebHealth lessons. J Nutr Educ Behav 41:S33-34 (Abstract).
- Lohse B, Krall JS, Patterson J, Loken E, Horacek T.(2009) Challenges evaluating an online intervention to enhance eating competence of low-income women. J Amer Diet Assoc 109 (9 Suppl3):A-89 (Abstract).
- Lohse B, Stotts JL, Patterson J, Horacek T, Do M, White A, Greene G.(2009) Development of a web-based module about eating competence for low-income audiences. FASEB J 23:550.7; (Abstract).
- Kattelmann, K, Greene, GW, Hoerr, S, Horacek, T, Welsh, S, White, A.(2009) A Non-Diet Curriculum for Obesity Prevention in Young Adults: Design and Outcomes. Symposium presented at Society for Nutrition Education Annual Meeting, New Orleans, LA July 12-14, 2009.
- Blissmer, BJ, Beebe, S, Riebe,D, Greene, GW.(2009) An accurate and feasible field test for estimating health promotion effects on fitness: Predicting cardiorespiratory fitness in men using a simple three minute assessment. Paper presented at the 137th American Public Health Association Annual Meeting, Philadelphia, PA, November 7-11, 2009.
- Mathews, D. White A.(2009) Are Sleep Quality and Duration related to Young Adult College Students Body Mass Index and Quality of Life Indicators Maine Nutrition Council Quarterly Meeting. Orono, ME. January 6, 2009.
- Lohse, B.(2009) Eating Competence as a Biobehavioral Phenomenon. Nutrition, Genes, and Physical Activity: Understanding Obesity from Conception and Beyond. University Park, PA; August 12, 2009.
- Nuss E.(2008) Associations between sleep quality, body size and eating behavior in college students. Undergraduate Research Symposium University of Wisconsin April 16, 2008.
- Murashima M, Hoerr SL, Hughes SO.(2008) Maternal parenting behaviors in childhood relate to weight status in young adulthood. The International Congress of Behavioral Medicine. Tokyo, Japan, August 2008.
- Lohse, B.(2008) Eating Competence: Eating As a Reasonable Adventure. The Lillian Fountain Smith Conference for Nutrition Educators. Fort Collins, CO; June 12, 2008.
- Lohse B, Patterson J, Stotts JL, Do M, Greene GW, White AA.(2008) Eating competence change in web-based non-dieting curriculum appears gender-specific. FASEB J 22:684.3 (Abstract).
- Greene, GW, Andrade, AM, Melanson, K, Hoerr, S, Kattelmann, K.(2008) Eating Rate And Body Mass Index In College Students. J Amer Diet Assoc 108 (9 Suppl 3):A-26 (Abstract).
- Stotts J, Lohse B, Patterson J, Horacek T, White A, Greene G.(2007) Eating competence in college students nominates a non-dieting approach to weight management. FASEB J 21: 527.6(Abstract).
- Lee SY, Greaney ML, Lees FD, Norsworthy B, Hoerr SL, Dayton SF, Roy JL, White AA, Greene GW.(2007) Factors affecting college students' regulation on food and non-alcoholic beverage consumption. FASEB J 21:671 (Abstract).
- Lohse B, Stotts JL, Bagdonis J.(2007) Income sub stratification within a low income sample denotes dropout and completion patterns in nutrition education intervention for young adults. FASEB J 20(5):A1312 (Abstract).
- Kresge, DL, Greene, GW, Huard, C, Balestracci, K, Wei, W, Melanson, KJ.(2006) Relationships between biomarkers of satiety, appetite, and body size in young adults. FASEB J 20: 527.6 (Abstract).
- Carpenter C, Greene G, Balestracci K, Blissmer B, Reibe D, Kresge D, Melanson K.(2005) Evaluating Non-Diet and Healthy Eating Interventions in College Students. Obes Res 13 Suppl: A200 (Abstract).
- Kresge D, Greene G, Carpenter C, Balestracci K, Wei W, Melanson K.(2005) Relationships between ratings of hunger and satiety and biomarkers of satiety may be influence by BMI. Obes Res 13 Suppl: A47 (Abstract).
- Melanson K, Carpenter C, Balestracci K, Kresge D, Wei W, Greene G.(2005) Relationships among dietary behaviors, appetite and subjects characteristics in young adults. Obes Res 13 Suppl: A68 (Abstract).
- Lohse. B.(2008) Back Translating Eating Competence into Education for Adults. The Penn State Nutrition Conference. State College, PA; May 16, 2008.
- Murashima M Hoerr SL, Hughes SO, Ridenour M, Kattelmann K.(2008) Maternal feeding behaviors in childhood relate to weight status in young adulthood. The International Congress of Dietetics. Yokohama, Japan. September 2008.
- Boyle C. Horacek T, Brann L. Raj S.(2008) Process Evaluation of Project WebHealth: An Online Non-diet Nutrition and Fitness Course for College Students. New York State Dietetic Association Meeting Albany, NY May 4-5, 2008.
- Drake SC, Zanley E, Murashima M, Lee SY, Hoerr SL.(2008) Is non-diet on-line intervention for weight management in college students effective Michigan Dietetic Association Annual Conference, Sterling Heights, MI. April 2008.
- Lohse, B.(2007) Modifying A Non-Dieting Online Curriculum for Weight Management for Low Income Pennsylvanians. Outreach Health Thematic Initiative Forum, Obesity and Its Complications: Innovative Approaches to Prevention and Treatment. College of Health and Human Development, The Pennsylvania State University, University Park, PA. September 24, 2007.
- Roy J, White AA.(2007) UMaine College Males Identify Factors Influencing Healthy Weight Maintenance. Maine Nutrition Council Quarterly Meeting. Orono, ME. January 10, 2007.
- Greaney, M, Lees, F, Lee, SY, Norsworthy, BN, Dayton, SA, Hoerr, S, Roy, J, White, A, Greene, G.(2006) A qualitative analysis of enablers and barriers to physical activity among college students. Poster presented at the American Public Health Association 134th Annual Meeting. Boston, MA, November 4-8, 2006.
- Greene G, Hoerr S, Horacek T, Kattelmann K, Lohse B, Patterson J, Phillips B, White A. (2006) College males and females participate in online study to identify similarities and differences in their food and physical activity behavior. International Society for Behavioral Nutrition and Physical Activity. Annual Conference Proceedings. Boston, MA.
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Progress 02/15/05 to 02/14/06
Outputs
During year 1 the 8 participating institutions developed an organizational structure with subcommittees focusing on curriculum development, instrument selection, web intervention development, and qualitative assessment of the target population's interests and concerns about weight. A system of monthly conference calls was developed and investigators met face-to-face two times. Two preliminary studies were completed in Spring 2005 and 16 focus groups conducted in Fall 2006. Overall, intervention development is proceeding as planned, however we will be requesting a no-cost extension due to start-up delays at many institutions and to better fit into the academic calendar. The revised timeline is as follows: Year 01 (February 15, 2005 - January 14, 2006) preliminary studies, curriculum development and qualitative assessments of young adults (16 focus groups); Year 02 (February 15, 2006 - February 14, 2007) qualitative testing of intervention themes (32 focus groups),
completion of curriculum development, finalization of intervention including assessment protocol, and initiation of pilot study Spring 2007 (n=200); Year 03 (February 15, 2007 - February 14,2008) revision of intervention based on pilot and completion of intervention in Fall 2007 (n=2,000) including baseline and post-intervention assessments; Year 04 (February 15, 2008 - February 14, 2009) completion of follow-up (Fall 2008); Year 05 (no-cost extension) (February 15, 2009 - February 14, 2010) completion of analyses (Spring 2009) and manuscript preparation (Fall 2009). Specific accomplishments in Spring 2005 included completion of a preliminary non-diet intervention at the University of Rhode Island and completion of a test of on-line focus groups at the University of Maine. Three posters were presented at the North American Association for the Study of Obesity. The preliminary study at the University of Rhode Island randomized 71 students stratified by gender (17 males, 54 females)
from an introductory nutrition class to a non-diet or fruit and vegetable intervention. Both interventions were effective in helping students maintain weight (there was no significant change in body weight over the 10 week study period) but participants in both groups improved eating behaviors. Results of the preliminary study and qualitative assessment of program completers were used in curriculum development. The preliminary study at the University of Maine assessed response to on-line compared to in person focus groups in young adult males. Results confirmed previous research that on-line focus groups were appropriate for this age group. Based on this study, we will utilize the on-line methodology in focus groups in the Fall 2005 and Spring 2006. Specific accomplishments in Fall 2005 included completion of 16 focus groups (8 for males and 8 for females)including 150 participants. In addition, the on-line assessment system that will be utilized in the study was tested. Although
results are currently being analyzed using NVivo software, themes emerged that will be used in curriculum development.
Impacts
The proposed project has the potential for reducing the rate of weight gain in young adults. This could help slow the development of obesity in America.
Publications
- Carpenter C, Greene G, Balestracci K, Blissmer B, Reibe D, Kresge D, Melanson K. Evaluating Non-Diet and Healthy Eating Interventions in College Students. Obes Res 2005; 13 Suppl: A200.
- Kresge D, Greene G, Carpenter C, Balestracci K, Wei W, Melanson K. Relationships between ratings of hunger and satiety and biomarkers of satiety may be influence by BMI. Obes Res 2005; 13 Suppl: A47.
- Melanson K, Carpenter C, Balestracci K, Kresge D, Wei W, Greene G. Relationships among dietary behaviors, appetite and subjects characteristics in young adults. Obes Res 2005; 13 Suppl: A68.
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