eat smart, move more, weigh less
TRANSCRIPT
Eat Smart, Move More, Weigh Less:A Community-Based Weight Management Program for Adults Sheree Vodicka, MA RD LDN, Kathyrn Kolasa PhD RD LDN, Carolyn Dunn PhD, Cathy Thomas, MAEd, Lori Schneider, MA CHES PAPHS, & Christine Smith, MS NC Division of Public Health, Raleigh, NC; East Carolina University, Brody School of Medicine, Greenville, NC; NC State University, NC Cooperative Extension, Raleigh, NC; Wayne County Cooperative Extension Service, Goldsboro, NC
Curriculum Development• Amultidisciplinarydevelopmentteamreviewedthescientificliteratureandidentifiedstrategiesproventobeeffectiveforweightlossandweightmanagement.Theteamdevelopedlessonplansbasedonthesestrategies
• Thecurriculumwasreviewedbylocal,stateandnationalexperts and revised
• Thecurriculum:
—IsbasedontheTheoryofPlannedBehavior
— Incorporates planning, tracking andlivingmindfully
— Is based on the evidence of whatworksforweightloss
Results2
•Overallweightlossforthecohortaveraged7pounds(p<.0001),representinga3.6%decreaseinbodyweight
—mean192#pre;185#post
•85.7%ofparticipantsimprovedBMI —mean32.4pre;31.1post;n=647
•77.4%reducedwaistcircumference —mean40.2”pre;38.6”post;n=681
•58.5%loweredbothsystolicanddiastolicbloodpressure —meansystolic128pre;124post;meandiastolic79pre;
77post;n=289
•Mostreportedimprovingdietaryhabits —86.7%reporteatingfewercalories;88.1%reducedportions
•Fewerparticipantsreportedincreasingphysicalactivitybeyond 30minutesperday
—40.3%reportedbeingactivemorethan30minutesperday, while49.5%reportedaddingstrengthtraining
•91.7%ofparticipantsweremoremindfulofwhatandhowmuch they eat
Dissemination• Infall2007,thedevelopmentteamconductedtrainingfor200Family&ConsumerScienceAgentsfromCooperativeExtensionandhealthdepartmentHealthPromotionCoordinators(healtheducators)representing85ofNC’s100counties.
• Trainingcomponents: —Curriculumcontent,includingthetheoryofplannedbehavior —Theevidenceforwhatworksforweightloss —Basicsinmedicalandsurgicalobesitymanagement,aswellasan
overviewofpopularsupplements —Strategiesforsuccessfullymarketingandoperatingweight
managementprograms
• InJanuary2008,classeslaunchedin38counties.
• Classeswereheldprimarilyinworksites,withsomeheldinschools,churchesandothercommunitysettings.
• Averagecosttoparticipantswas$20,rangingfrom$5to$75.
Evaluation Methods• Eachparticipantcompletedanthropometricmeasuresatthefirstclassincluding:
—Blood pressure —Waistcircumference —Height,weight(BMIcalculated)
• Eachparticipantcompletedasurveyduringthelastclasstoreportbehaviorchangeandprovidefeedbackonthecurriculum.
• Eachparticipantcompletedpost-curriculumanthropometricmeasurements.
• Eachinstructorcompletedasurveytoprovidefeedbackonthecurriculum.
IntroductIonObesityisnowwidelyrecognizedasoneofthemostpressingpublichealthchallengesintheUnitedStates.Eat Smart, Move More NC isastatewidemovementthatpromotesincreasedopportunitiesforhealthyeatingandphysicalactivitywhereverpeoplelive,learn,earn,playandpray.The Eat Smart, Move More, Weigh Less curriculumsupportsthismovementwithgroupeducationandsocialsupport.
THEoRy of PLANNED BEHAVioR—MADE SiMPLE
BEHAVioR
AdaptedfromIcekAjzen’sTheoryofPlannedBehaviori believe that if i do this behavior
it will promote weight loss.
i am supported by others to do this behavior.
i believe that it is within my control to do this behavior.
iNTENTioN
Plan Track+ Live Mindfully
Healthy Weight
Lessons and Key Messages
The Magazine
The Personal Journal
Lesson core concept
introduction WeightLossReadiness;Plan,Track&LiveMindfully
Make your Commitment Setting realistic goals
Re-Think your Drink Theroleofcaloriecontainingbeveragesinweightlossandstrategiesformanagingbeveragecalorieintake
Eat fewer Calories Useoflowercaloriefoodpreparationtechniques
Move More Theroleofregularphysicalactivityinweightmanagement
Check the facts Label reading
Enjoy More Vegetables Vegetablesasastrategyforlimitingcalorieintake
Right-Size your Portions Theroleofportionsizesinweightmanagementandstrategies for portion control
Plan, Shop, fix and Eat Theroleofhomecookedmealsinmanagingweightandstrategiesforpreparingandeatingmoremealsfromhome
Eat Less fast food Theroleoffastfoodinunhealthyweightsandstrategiesformanagingfastfoodintake
Move Strong Therolethatstrengthtrainingplaysinweightmanagement
Enjoy More fruit Therolefruitplaysincontrollingcalorieintake
Start Smart Therolebreakfastplaysinmanagingweight
Move forward Theroleofprogressivelymoreexerciseinweightlossandweightmaintenance
Keep your Commitment Settingrealisticgoalstomaintainweightlossandplanningfor special occasions
Eat out Less Therolethatmealsawayfromhomeplayinunhealthyweightandstrategiesforeatingathomemoreoften
Tame the Tube Therolethattelevision—andotherscreens—playinweightmanagementandstrategiesforcontrollingscreentime
Pack Smart Lunches Howtoplanandpackhealthy,low-calorielunches
Enjoy More Whole Grains Therolethatwholegrainsplayinweightmanagementandstrategiesforeatingmore
Participant Demographics1
•821participantsfrom38NCcounties
•Averageage:51years
•86.1%female;9%male
•22.5%AfricanAmerican; 1.2%Hispanic/Latino; 66.3%White; 10%Other
concLusIons•Thecurriculumappearstobesuccessfulinaidingmodestweightloss.•Participantsweremoresuccessfulatchangingdietarybehaviorsandbecomingmindfulofeatingbehaviors;theywerelesssuccessfulwithachievingmoreaggressiveexerciserecommendations.•Initialfeedbackwasverypositivefrombothparticipantsandinstructors.•Thecontentcanbecoveredin15classes,ratherthan19,bycollapsingsometopics.•Thisdeliverymodelappearstomeetaneedinthecommunityforlow-costweightmanagementofferedinnon-healthcaresettings.
1Missingdatainsomecasesiftotalnotequalto100 2TheresultsarepreliminaryasofMay2009.
Behavior % yes % Already % No Doing This
Activemorethan 30minutesperday 40.3 14.2 45.3
Includestrengthtraining 49.5 11.4 39.0
Eatfewercalories 86.7 6.6 6.6
Eatsmallerportions 88.1 6.8 5.1
AmmoremindfulofwhatIeat 91.7 7.1 1.1