LaRose J G, Guthrie K M, Lanoye A, Tate D F, Robichaud E, Caccavale L J, Wing R R
Virginia Commonwealth University School of Medicine Richmond VA USA; Weight Control and Diabetes Research Center The Miriam Hospital Providence RI USA; Alpert Medical School of Brown University Providence RI USA.
Alpert Medical School of Brown University Providence RI USA; Centers for Behavioral and Preventive Medicine The Miriam Hospital Providence RI USA.
Obes Sci Pract. 2016 Dec;2(4):341-354. doi: 10.1002/osp4.71. Epub 2016 Oct 6.
Emerging adults ages 18-25 are at high risk for obesity, but are markedly underrepresented in behavioural weight loss (BWL) programs and experience lower engagement and retention relative to older adults.
To utilize a mixed methods approach to inform future efforts to effectively recruit and engage this high-risk population in BWL programs.
We used a convergent parallel design in which quantitative and qualitative data were given equal priority. Study 1 ( = 137, age = 21.8 + 2.2, BMI = 30.1 + 4.7) was a quantitative survey, conducted online to reduce known barriers and minimize bias. Study 2 ( = 7 groups, age = 22.3 + 2.2, BMI = 31.5 + 4.6) was a qualitative study, consisting of in person focus groups to gain greater depth and identify contextual factors unable to be captured in Study 1.
Weight loss was of interest, but weight itself was not a central motivation; an emphasis on overall lifestyle, self-improvement and fitness emerged as driving factors. Key barriers were time, motivation and money. Recruitment processes should be primarily online with messages tailored specifically to motivations and preferences of this age group. Preferences for a program were reduced intensity and brief, hybrid format with some in-person contact, individual level coaching, experiential learning and peer support. Key methods of promoting engagement and retention were autonomy and choice, money and creating an optimal default.
An individually tailored lifestyle intervention that addresses a spectrum of health behaviours, promotes autonomy and emphasizes activity and fitness may facilitate recruitment and engagement in this population better than traditional BWL protocols.
18 - 25岁的新兴成年人肥胖风险很高，但在行为减肥（BWL）项目中的代表性明显不足，与老年人相比，他们的参与度和留存率较低。
采用混合方法，为未来有效招募这一高风险人群并使其参与BWL项目的努力提供信息。
我们采用了收敛平行设计，其中定量和定性数据具有同等优先级。研究1（n = 137，年龄 = 21.8 ± 2.2，BMI = 30.1 ± 4.7）是一项定量调查，通过在线方式进行，以减少已知障碍并尽量减少偏差。研究2（n = 7组，年龄 = 22.3 ± 2.2，BMI = 31.5 ± 4.6）是一项定性研究，由面对面的焦点小组组成，以获得更深入的信息并识别研究1中无法捕捉到的背景因素。
减肥是人们感兴趣的，但体重本身并不是核心动机；对整体生活方式、自我提升和健身的强调成为驱动因素。关键障碍是时间、动力和金钱。招募过程应主要通过在线进行，信息要专门针对该年龄组的动机和偏好进行定制。对项目的偏好是强度较低、简短的混合形式，有一些面对面接触、个人层面的指导、体验式学习和同伴支持。促进参与和留存的关键方法是自主性和选择、金钱以及创建最佳默认设置。
一种针对一系列健康行为进行个性化定制、促进自主性并强调活动和健身的生活方式干预措施，可能比传统的BWL方案更有助于招募和吸引这一人群。
