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