Adapting a Behavioral Weight Loss Intervention for Delivery via Facebook: A Pilot Series Among Low-Income Postpartum Women (Preprint)

Abstract

Background: Efforts to translate evidence-based weight loss interventions, such as the Diabetes Prevention Program (DPP), to low-income, postpartum women are limited by poor intervention attendance and high attrition rates. Strategies that improve engagement and retention in this population are needed to maximize the reach of evidence-based weight loss interventions. Purpose: To adapt a DPP-based weight loss intervention (Fresh Start) for Facebook delivery and to evaluate its feasibility among low-income postpartum women. Methods: This study comprised of three single group pilot studies where feasibility outcomes iteratively informed changes from one pilot to the next. We paralleled the in-person program to Facebook delivery by translating the protocol to a content library to be delivered in a Facebook feed with additional input from lifestyle coaches. Low-income postpartum women were recruited from Women, Infants, and Children (WIC) clinics in Worcester, MA. Participants were enrolled into a 16-week weight loss intervention delivered via Facebook. During the first eight weeks, Facebook intervention posts were delivered two times per day with additional posts from coaches. For the following 8 weeks, posts were delivered once per day without additional coaching. Outcome measures were collected at baseline and 16-week follow-up and included changes in weight as well as feasibility outcomes including retention, engagement (defined by likes, comments, and posts), and acceptability. Results: Pilot 1 (n = 27) had a retention rate of 89% and 62% engaged in the group during the 8-week coached phase. Mean weight loss was 2.6 pounds (SD = 8.64) and 75% reported being satisfied with the program. Pilot 2 (n = 24) had a retention rate of 83% and 55.2% engaged in the group during the 8-week coached phase. Mean weight loss was 2.5 pounds (SD = 9.23) and 80% were satisfied with the program. Pilot 3 (n = 16) had a retention rate of 88% and 67% engaged in the group during the 8-week coached phased. Mean weight loss was 7.0 pounds (SD = 11.6) and 64.3% were satisfied with the program. Conclusions: Findings demonstrated that a Facebook-delivered intervention was acceptable and could be feasibly delivered to the low-income, postpartum women. Future research is needed to evaluate the efficacy of a Facebook-delivered weight loss intervention.