Feasibility and preliminary efficacy of the ‘HEYMAN’ healthy lifestyle program for young men: a pilot randomised controlled trial

Abstract

BackgroundIn young men, unhealthy lifestyle behaviours can be detrimental to their physical and/or mental health and set them on a negative health trajectory into adulthood. Despite this, there is a lack of evidence to guide development of effective health behaviour change interventions for young men. This study assessed the feasibility and preliminary efficacy of the ‘HEYMAN’ (Harnessing Ehealth to enhance Young men’s Mental health, Activity and Nutrition) healthy lifestyle program for young men.MethodsA pilot RCT with 50 young men aged 18–25 years randomised to the HEYMAN intervention (n = 26) or waitlist control (n = 24). HEYMAN was a 3-month intervention, targeted for young men to improve eating habits, activity levels and well-being. Intervention development was informed by a participatory research model (PRECEDE-PROCEED). Intervention components included eHealth support (website, wearable device, Facebook support group), face-to-face sessions (group and individual), a personalised food and nutrient report, home-based resistance training equipment and a portion control tool. Outcomes included: feasibility of research procedures (recruitment, randomisation, data collection and retention) and of intervention components. Generalized linear mixed models estimated the treatment effect at 3-months for the primary outcomes: pedometer steps/day, diet quality, well-being and several secondary outcomes.ResultsA 7-week recruitment period was required to enrol 50 young men. A retention rate of 94% was achieved at 3-months post-intervention. Retained intervention participants (n = 24) demonstrated reasonable usage levels for most program components and also reported reasonable levels of program component acceptability for attractiveness, comprehension, usability, support, satisfaction and ability to persuade, with scores ranging from 3.0 to 4.6 (maximum 5). No significant intervention effects were observed for the primary outcomes of steps/day (1012.7, 95% CI = −506.2, 2531.6, p = 0.191, d = 0.36), diet quality score (3.6, 95% CI = −0.4, 7.6, p = 0.081, d = 0.48) or total well-being score (0.4, 95% CI = −1.6, 2.5, p = 0.683, d = 0.11). Significant intervention effects were found for daily vegetable servings, energy-dense, nutrient-poor foods, MVPA, weight, BMI, fat mass, waist circumference and cholesterol (all p < 0.05).ConclusionsThe HEYMAN program demonstrated feasibility in assisting young men to make some positive lifestyle changes. This provides support for the conduct of a larger, fully-powered RCT, but with minor amendments to research procedures and intervention components required.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12616000350426.Electronic supplementary materialThe online version of this article (doi:10.1186/s12937-017-0227-8) contains supplementary material, which is available to authorized users.

Effectiveness of lifestyle interventions for preventing harmful weight gain among young adults from lower socioeconomic status and ethnically diverse backgrounds: a systematic review

“…Five out of the six studies (including a large study; n = 5903) found ethnicity did not significantly moderate the intervention effect on weight . This suggests a trend towards no effect.…”

“…As three studies did not report the mean change in body weight and two were not lifestyle programme based , they were excluded from the review. This left 30 studies, from 33 papers , included in the review. The PRISMA flow diagram for the review process of study selection is shown in Fig .…”

“…All five subgroup analyses revealed that there were no evidence of intervention effects being moderated by ethnicity . Two of these studies included a subgroup analysis to determine if SES had any significant effect on effectiveness of intervention , which revealed SES did not have any effect. One study also included a subgroup analysis to determine if income moderated intervention effect, income was shown to have a significant effect at post‐intervention (3 months) but not at follow‐up (9 months) .…”

“… and Ashton et al . were able to prevent weight gain, and analyses showed the interventions to be equally effective for all socioeconomic subgroups. On the other hand, Allman‐Farinelli et al .…”

“…This improvement should be acknowledged, with a previous systematic review calling for increased representativeness of participants to enhance the external validity . However, of the 30 studies included in the review, only six interventions included subgroup analyses to determine if ethnicity moderated change in weight and only two included subgroup analyses to determine if SES moderated change in weight . It is pertinent to acknowledge that some studies may not include subgroup analyses because the sample power calculations did not all account for such comparisons.…”