A Tailored intervention program for overweight and obese veterans: who benefits and when

Abstract

This descriptive, exploratory study examined longitudinal clinical data for variables associated with weight reduction among veterans enrolled in a weight reduction intervention, the MOVE! Program. Variables of interest included background characteristics and exposure to components of the intervention. Background, intervention, and outcome variables were organized around the Interaction Model of. Client Health Behavior. In addition to the outcomes related to weight, hemoglobin A1C, blood pressure, and serum lipid levels were examined. Thirteen percent of participants (N = 53 of 404) achieved a 5°/o weight reduction. Overall, .the sample was primarily non-Hispanic (96% ), urban (83o/o ), Black (58.4%)), married (58.4o/o) and male (-80%). The mean age was 56 years. Common comorbidities associated with obesity were evident including diabetes (30.2o/o), hypertension (60.9%), and hyperlipidemia (54.0o/o). The average body mass index was -35. All available data were collected from program entry to a designated stop date; therefore, participants had unequal and irregular data points. Participants were observed repeatedly over time with 51 °/o having 10 or more observations. A little more than half of the participants were group attendees (-56o/o) rather than self-managed. The majority of the intervention exposures were group rather than· individual or telephone visits with providers. Achieving a 5°/o weight reduction was significantly associated with age in years (OR 1.04), group attendance beyond the day of orientation (OR 6.61 ), · attendance at the holiday eating class (OR 3.67), exposure over time (measured ·in weeks, OR 1.02), and the interaction between time and group (OR .97). Weight reduction in pounds was significantly associated with age, baseline body mass index, total number of group classes attend.ed, and telephone contact with the registered nurse. Using repeated measures of weight, the trajectory of weight was significantly associated with gender, baseline body mass index, and exposure to the intervention over time. Examination of additional outcomes revealed that components of the intervention were associated with beneficial changes in hemoglobin A1C, blood pressure, and serum lipid levels. Further research is needed to more fully describe successful weight reducers and the identify best practices to convert unsuccessful weight reducers to successful ones.