Date of Award

8-2012

Level of Access

Campus-Only Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Food and Nutrition Sciences

Advisor

Adrienne A. White

Second Committee Member

Cristanna Cook

Third Committee Member

Richard A. Cook

Abstract

The PRECEDE-PROCEED health program planning model was applied to develop, implement, and evaluate a salient and sustainable weight management intervention. A steering committee, composed of researchers, stakeholders, and job training program young adults and staff, guided the research process. Multiple research methods were used for the initial four phases and resulted in social, epidemiological, behavioral, ecological, educational, and organizational diagnoses as outlined in PRECEDE to inform the intervention. PROCEED was implemented with disadvantaged young adults (n=165), 18-24 years, attending two job training programs. One site was used to recruit control participants and the other site to recruit treatment participants. A non-randomized, quasi-experimental test of the intervention was conducted using anthropometric measures and online survey instruments (i.e., eating and physical activity behavior and life satisfaction) at pre-(baseline), post-(10 weeks) and follow-up (22 weeks). During the 22-week intervention treatment participants met weekly over the first 10 weeks in classroom sessions to view 20 online educational modules about healthful eating, physical activity, and stress and time management. They received weekly nudges based on their Stage of Change to promote fruit and vegetable intake, physical activity and stress management and set goals for behavior change. Analyses included Student’s ttests, repeated measures of analysis of variance, linear regression modeling, and nonparametric tests. The treatment group was dichotomized for analysis based on intervention use. At baseline, males were overweight and females were obese, based on mean body mass index, and both reported high fruit and vegetable intake (>5 cups/day), physical activity (>30 minutes daily), and satisfaction with life (≥75% satisfied). Food self-regulation was higher for the high use treatment group versus the control group (multivariate-adjusted linear regression estimate of the difference in score 1.78, 95% CI: 0.23 to 3.33, p=0.025). There were trends of reduced emotional eating and improved food self-instruction benefits for high use treatment group compared to the control group. Further work is needed to enhance the effectiveness of healthy weight management programs for disadvantaged young adults. This project was supported by National Research Initiative Grant 2009-55215-05460 from the USDA National Institute for Food and Agriculture.

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